a patient is hospitalized with active tuberculosis the patient is receiving antitubercular drug therapy and is not responding to the medications what

ATI RN

ATI Pathophysiology Test Bank

1. A patient is hospitalized with active tuberculosis. The patient is receiving antitubercular drug therapy and is not responding to the medications. What do you suspect the patient is suffering from?

A. Human immunodeficiency virus
B. Drug-resistant tuberculosis
C. Methicillin-resistant Staphylococcus aureus
D. Vancomycin-resistant Staphylococcus aureus

Correct answer: B

Rationale: When a patient with active tuberculosis is not responding to antitubercular drug therapy, drug-resistant tuberculosis should be suspected. Drug-resistant tuberculosis occurs when the bacteria causing tuberculosis become resistant to the medications being used. Choices A, C, and D are incorrect because the scenario described does not align with HIV infection, methicillin-resistant Staphylococcus aureus, or vancomycin-resistant Staphylococcus aureus.

2. A patient has been prescribed raloxifene (Evista) for the prevention of osteoporosis. What effect should the nurse include in the teaching plan regarding the action of this medication?

A. Decreases calcium excretion by the kidneys.
B. Increases intestinal absorption of calcium.
C. Stimulates bone formation by increasing osteoblast activity.
D. Selectively binds to estrogen receptors, decreasing bone resorption.

Correct answer: D

Rationale: The correct answer is D: Selectively binds to estrogen receptors, decreasing bone resorption. Raloxifene is a selective estrogen receptor modulator (SERM) that works by binding to estrogen receptors, thereby decreasing bone resorption. This action helps in the prevention and treatment of osteoporosis by preserving bone density. Choices A, B, and C are incorrect because raloxifene does not directly affect calcium excretion by the kidneys, intestinal absorption of calcium, or stimulate bone formation by increasing osteoblast activity.

3. Staff at the care facility note that a woman has started complaining of back pain in recent weeks and occasionally groans in pain. She has many comorbidities that require several prescription medications. The nurse knows that which factor is likely to complicate the clinician's assessment and treatment of the client's pain?

A. Her advanced age may influence the expression and perception of pain.
B. Her polypharmacy may complicate the pain management process.
C. Her underlying conditions may mask or exacerbate the pain.
D. Her cognitive function may decline, making pain assessment difficult.

Correct answer: B

Rationale: Polypharmacy, or the use of multiple medications, can complicate pain management due to drug interactions and side effects. While advanced age can influence pain perception, it is not the most likely factor to complicate assessment and treatment in this scenario. Underlying conditions may affect pain perception but do not directly complicate the management process. Cognitive decline can hinder pain assessment, but in this case, the focus is on factors directly impacting the treatment process, making option B the most appropriate choice.

4. Innate resistance or immunity:

A. Involves 'memory'
B. Is a development of an individual's later years
C. Is a relatively slow and specific process
D. Depends on physical, mechanical, and biochemical barriers

Correct answer: D

Rationale: Innate resistance or immunity relies on the body's natural defenses like physical, mechanical, and biochemical barriers. These barriers act as the first line of defense against pathogens and do not involve memory (choice A). Innate immunity is present from birth and does not develop over an individual's later years (choice B). Additionally, innate immunity is a rapid and nonspecific process, not a slow and specific one (choice C). Therefore, the correct answer is D.

5. What is responsible for initiating clonal selection?

A. B cells
B. T cells
C. Antigens
D. Lymphocytes

Correct answer: C

Rationale: Antigens are the correct answer as they are the molecules that trigger the immune response by binding to specific B or T cells. This binding activates these cells, leading to their proliferation and differentiation to fight off the antigen. B cells and T cells are the responders to antigens, not the initiators of clonal selection. Lymphocytes is a broad term encompassing both B and T cells, so it is not the specific factor responsible for initiating clonal selection.