ATI RN
Pathophysiology Final Exam
1. A nurse is teaching a young adult patient about oral contraceptives, which the patient will soon begin taking. The patient's primary concern is the effectiveness of the medication in preventing pregnancy. The nurse should teach the patient that oral contraceptives, when taken consistently, are how effective in preventing pregnancy?
- A. Between 96% and 98%
- B. Approximately 98.5%
- C. Highly effective, but partially dependent on genetic factors
- D. Nearly 100%
Correct answer: D
Rationale: When taken correctly, estrogen–progestin contraceptive preparations are nearly 100% effective in preventing pregnancy. Choices A, B, and C are incorrect. Choice A suggests a range below the actual effectiveness, choice B provides a specific percentage that is not accurate, and choice C introduces the concept of genetic factors which is not relevant to the effectiveness of oral contraceptives.
2. A 5-year-old male was diagnosed with normocytic-normochromic anemia. Which of the following anemias does the nurse suspect the patient has?
- A. Sideroblastic anemia
- B. Hemolytic anemia
- C. Pernicious anemia
- D. Iron deficiency anemia
Correct answer: B
Rationale: The correct answer is B, Hemolytic anemia. Normocytic-normochromic anemia is a type of anemia characterized by normal-sized and normal-colored red blood cells. Hemolytic anemia is a condition where red blood cells are destroyed prematurely, leading to normocytic-normochromic anemia. Sideroblastic anemia (Choice A) is characterized by ringed sideroblasts in the bone marrow. Pernicious anemia (Choice C) is due to vitamin B12 deficiency. Iron deficiency anemia (Choice D) is characterized by microcytic-hypochromic red blood cells.
3. What is the treatment for patients with hemophilia A?
- A. Chemotherapy
- B. Factor VIII replacement
- C. Heparin administration
- D. Bone marrow transplant
Correct answer: B
Rationale: The correct treatment for patients with hemophilia A is Factor VIII replacement. Hemophilia A is a genetic disorder where there is a deficiency in clotting factor VIII. Therefore, replacing this factor is crucial in managing and preventing bleeding episodes. Choice A, chemotherapy, is not the correct treatment for hemophilia A. Choice C, heparin administration, is not recommended as it can further increase the risk of bleeding in patients with hemophilia. Choice D, bone marrow transplant, is not a standard treatment for hemophilia A.
4. Mrs. Mendoza is a 75-year-old client who has dementia of the Alzheimer’s type and confabulates. The nurse understands that this client:
- A. Denies confusion by being jovial.
- B. Pretends to be someone else.
- C. Rationalizes various behaviors.
- D. Fills in memory gaps with fantasy.
Correct answer: D
Rationale: Confabulation, a common symptom in dementia, involves filling in memory gaps with fabricated stories rather than intentionally pretending to be someone else (Choice B), denying confusion by being jovial (Choice A), or rationalizing various behaviors (Choice C). Confabulation is not a deliberate act but a memory error that results in the creation of false memories.
5. A 65-year-old man is admitted to the intensive care unit from the operating room after a triple coronary artery bypass graft. He is intubated and on a ventilator. Lactic acid levels were normal postoperatively, but now they are rising. The increased level could be an indication of:
- A. excessive sedation
- B. bowel ischemia
- C. excessive volume infusion in the operating room
- D. mild hypothermia postoperatively
Correct answer: B
Rationale: In this scenario, the rising lactic acid levels in a 65-year-old man after a coronary artery bypass graft could indicate bowel ischemia. Bowel ischemia can lead to anaerobic metabolism, causing an increase in lactic acid levels. Excessive sedation may cause respiratory depression but would not directly lead to rising lactic acid levels. Excessive volume infusion in the operating room might cause fluid overload but would not typically result in rising lactic acid levels. Mild hypothermia postoperatively could lead to shivering and increased oxygen consumption, but it is less likely to be the primary cause of rising lactic acid levels in this context.
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