a nurse on a postsurgical unit is providing care for a 76 year old female client who is two days post hemiarthroplasty hip replacement and who states

ATI RN

ATI Pathophysiology Final Exam

1. A nurse on a postsurgical unit is providing care for a 76-year-old female client who is two days post-hemiarthroplasty (hip replacement) and who states that her pain has been out of control for the last several hours, though she is not exhibiting signs of pain. Which guideline should the nurse use for short-term and long-term treatment of the client's pain?

A. Pain is what the client says it is, even if she is not exhibiting outward signs.
B. Pain should be treated only when it is associated with observable symptoms.
C. Long-term opioid use is generally safe for elderly clients in a hospital setting.
D. The client's pain should be reassessed after every dose of pain medication.

Correct answer: A

Rationale: Pain is a subjective experience, and the client's report of pain should be taken seriously even if there are no outward signs. Choice B is incorrect because pain can be present without observable symptoms, and waiting for observable signs may delay appropriate pain management. Choice C is incorrect because the safety of long-term opioid use in elderly clients is a complex issue and should be carefully evaluated due to the risk of adverse effects. Choice D is incorrect because while pain reassessment is important, it should not be limited to just after medication administration but should occur regularly to ensure adequate pain control.

2. What is the major effect of filgrastim (Neupogen) in a patient with chronic renal failure?

A. Decreases neutropenia related to chemotherapy
B. Decreases white blood cells related to infection
C. Decreases growth of blood vessels due to ischemia
D. Decreases platelet count related to bleeding

Correct answer: A

Rationale: The major effect of filgrastim (Neupogen) is to stimulate the production of neutrophils, thereby decreasing neutropenia in patients undergoing chemotherapy. This medication helps the bone marrow produce more white blood cells, specifically neutrophils, to reduce the risk of infections associated with low neutrophil counts. Choices B, C, and D are incorrect because filgrastim does not decrease white blood cells related to infection, growth of blood vessels, or platelet count related to bleeding.

3. A patient with severe peripheral vascular disease has developed signs of dry gangrene on the great toe of one foot. Which of the following pathophysiologic processes most likely contributed to this diagnosis?

A. Inappropriate activation of apoptosis
B. Bacterial invasion
C. Impaired arterial blood supply
D. Metaplastic cellular changes

Correct answer: C

Rationale: The correct answer is C: Impaired arterial blood supply. Dry gangrene is typically caused by impaired arterial blood supply, leading to tissue death without bacterial infection. Choices A, B, and D are incorrect. Inappropriate activation of apoptosis is not a common cause of dry gangrene. Bacterial invasion usually leads to wet gangrene, not dry gangrene. Metaplastic cellular changes are not directly associated with the development of dry gangrene.

4. What function does aldosterone serve in the body?

A. Aldosterone causes a release of sodium from the body, decreases fluid volume, and decreases blood pressure
B. Aldosterone causes a retention of sodium in the body, increases fluid volume, and increases blood pressure
C. Aldosterone causes a release of sodium from the body, increases fluid volume, and decreases blood pressure
D. Aldosterone enhances intracellular sodium production and lowers blood pressure

Correct answer: B

Rationale: Aldosterone functions by causing the retention of sodium in the body, which results in an increase in fluid volume and blood pressure. Choice A is incorrect because aldosterone actually promotes sodium retention rather than release. Choice C is incorrect as it states that aldosterone decreases fluid volume, which is not accurate. Choice D is incorrect because aldosterone does not enhance intracellular sodium production; instead, it primarily acts on sodium reabsorption in the kidneys.

5. Which of the following tests is recommended for lung cancer screening?

A. Chest X-ray
B. Pulmonary function test
C. Computed tomography (CT) scan
D. Magnetic resonance imaging

Correct answer: C

Rationale: The correct answer is Computed tomography (CT) scan. When screening for lung cancer, CT scans are recommended over chest X-rays due to their higher sensitivity in detecting lung nodules and early-stage cancers. Pulmonary function tests are not used for screening lung cancer but rather to assess lung function. Magnetic resonance imaging is not the preferred imaging modality for routine lung cancer screening, as CT scans are more commonly used.