ATI RN
Pathophysiology Final Exam
1. A patient is administered isoniazid (INH) for tuberculosis. Which of the following adverse effects will result in discontinuation of the medication?
- A. Weight gain
- B. Jaundice
- C. Fever
- D. Arthralgia
Correct answer: B
Rationale: The correct answer is B: Jaundice. Isoniazid (INH) is known to cause hepatotoxicity, which can manifest as jaundice. Jaundice is a serious adverse effect that warrants immediate discontinuation of the medication to prevent further liver damage. Weight gain, fever, and arthralgia are not typically associated with isoniazid use and would not necessitate discontinuation of the medication.
2. Right-sided heart failure is characterized by:
- A. Immunosuppression
- B. Pulmonary edema
- C. Peripheral edema
- D. Coughing
Correct answer: C
Rationale: Right-sided heart failure is characterized by peripheral edema, which results from the buildup of fluid in the body. This fluid accumulates in the extremities due to the heart's inability to effectively pump blood forward. Choices A, B, and D are incorrect. Immunosuppression is not a typical feature of right-sided heart failure. Pulmonary edema is more commonly associated with left-sided heart failure, where fluid accumulates in the lungs. Coughing is a symptom that can be present in various conditions but is not a defining characteristic of right-sided heart failure.
3. A patient with a history of breast cancer is being prescribed tamoxifen (Nolvadex). What should the nurse include in the patient education about the use of this medication?
- A. Tamoxifen may increase the risk of venous thromboembolism, so the patient should be aware of the signs and symptoms of blood clots.
- B. Tamoxifen may cause hot flashes, so the patient should be prepared for this side effect.
- C. Tamoxifen may decrease the risk of osteoporosis, so the patient should ensure adequate calcium intake.
- D. Tamoxifen may cause weight gain, so the patient should monitor their diet and exercise regularly.
Correct answer: A
Rationale: The correct answer is A. Tamoxifen is known to increase the risk of venous thromboembolism, a serious side effect. Patients should be educated about the signs and symptoms of blood clots, such as swelling, pain, or redness in the affected limb, and the importance of seeking immediate medical attention if they occur. Choice B is incorrect because hot flashes are a common side effect of tamoxifen but not a critical concern like venous thromboembolism. Choice C is incorrect as tamoxifen is not associated with a decreased risk of osteoporosis. Choice D is incorrect because while weight gain can occur with tamoxifen, it is not as crucial to educate the patient about as the risk of venous thromboembolism.
4. Which of the following women is at highest risk for the development of endometrial cancer?
- A. A 50-year-old postmenopausal woman with a history of high-risk human papillomavirus
- B. A 45-year-old woman who is obese and has a menstrual pattern consisting of periods of amenorrhea and infrequent periods
- C. A 40-year-old woman who is overweight and has hypertension
- D. A 55-year-old woman who smokes
Correct answer: B
Rationale: The correct answer is a 45-year-old woman who is obese and has a menstrual pattern consisting of periods of amenorrhea and infrequent periods. Obesity and prolonged exposure to estrogen unopposed by progesterone due to infrequent ovulation are significant risk factors for endometrial cancer. Choices A, C, and D do not directly correlate with the increased risk of endometrial cancer. Postmenopausal status alone (Choice A), overweight with hypertension (Choice C), and smoking (Choice D) are not the primary risk factors for endometrial cancer.
5. What causes the appearance of a barrel chest in clients with emphysema?
- A. Peripheral edema
- B. Bacterial infections in the lungs
- C. Air trapping in the alveoli
- D. Muscle atrophy of the diaphragm
Correct answer: C
Rationale: The correct answer is C: Air trapping in the alveoli. A barrel chest in emphysema results from the hyperinflation of the lungs due to air trapping in the alveoli. This leads to increased anteroposterior diameter of the chest. Choices A, B, and D are incorrect. Peripheral edema is swelling caused by fluid retention in tissues, not associated with a barrel chest in emphysema. Bacterial infections in the lungs can lead to conditions like pneumonia but do not directly cause a barrel chest. Muscle atrophy of the diaphragm could affect breathing mechanics but is not specifically linked to the development of a barrel chest in emphysema.
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