ATI RN
Final Exam Pathophysiology
1. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What key contraindication should the nurse review with the patient?
- A. Use of nitrates
- B. History of hypertension
- C. Use of antihypertensive medications
- D. Use of antihypertensive medications
Correct answer: A
Rationale: The correct answer is A: Use of nitrates. Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, so their combined use can lead to a dangerous drop in blood pressure. Choices B, C, and D are incorrect because while a history of hypertension or use of antihypertensive medications may influence treatment decisions, they are not the key contraindication specifically related to sildenafil use.
2. A patient taking hormonal contraceptives will soon turn 35 years of age. She is moderately obese and has smoked for 15 years. Which of the following is most important?
- A. Begin an exercise regimen.
- B. Begin smoking cessation.
- C. Begin daily aspirin therapy.
- D. Begin taking a loop diuretic to aid weight loss.
Correct answer: B
Rationale: The most important action for a patient taking hormonal contraceptives, who is nearing 35 years of age, moderately obese, and has a history of smoking for 15 years, is to begin smoking cessation. Women over 35, especially smokers, are at an increased risk of blood clots and cardiovascular issues when using hormonal contraceptives. Smoking cessation is crucial to reduce this risk. Beginning an exercise regimen may be beneficial for overall health but is not as critical as stopping smoking in this scenario. Daily aspirin therapy or taking a loop diuretic are not indicated in this situation and may not address the primary risk associated with hormonal contraceptives and smoking.
3. Which patient is most likely to be diagnosed with complex regional pain syndrome II (CRPS II)?
- A. A patient who has experienced a spinal cord injury and reports severe, burning pain in his legs.
- B. A patient who reports severe pain in her hand following a surgery for carpal tunnel syndrome.
- C. A patient who develops pain in his foot following a fracture and immobilization with a cast.
- D. A patient who experiences chronic pain and swelling in his arm following a brachial plexus injury.
Correct answer: D
Rationale: Complex regional pain syndrome II (CRPS II) typically occurs after an injury to a peripheral nerve. In this case, a brachial plexus injury involves damage to the nerves that control muscles in the arm and hand, leading to chronic pain and swelling. Choices A, B, and C describe pain related to other conditions such as spinal cord injury, carpal tunnel surgery, and fracture immobilization, which are not typically associated with CRPS II.
4. Two people experience the same stressor yet only one is able to cope and adapt adequately. An example of the person with an increased capacity to adapt is the one with:
- A. A sense of purpose in life
- B. Circadian rhythm disruption
- C. Age-related renal dysfunction
- D. Excessive weight gain or loss
Correct answer: A
Rationale: A strong sense of purpose in life is associated with better stress coping mechanisms, which can enhance a person's capacity to adapt. Having a clear sense of purpose provides individuals with motivation, direction, and resilience to face challenges. Choices B, C, and D are not directly related to an increased capacity to adapt to stress. Circadian rhythm disruption, age-related renal dysfunction, and excessive weight gain or loss may have negative impacts on overall well-being and stress management.
5. What typically causes contact dermatitis?
- A. Fungal infection
- B. Long-term disorder from gout
- C. Contact with a skin allergen
- D. Staphylococcal infection
Correct answer: C
Rationale: Contact dermatitis is typically caused by contact with a skin allergen that triggers an allergic reaction. Choice A, fungal infection, is incorrect as contact dermatitis is not caused by fungi. Choice B, long-term disorder from gout, is also incorrect as gout is not typically associated with contact dermatitis. Choice D, Staphylococcal infection, is incorrect as contact dermatitis is primarily an allergic reaction rather than a bacterial infection.
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