a patient with a history of osteoporosis is prescribed alendronate fosamax what instructions should the nurse provide to ensure the effectiveness of t

ATI RN

Final Exam Pathophysiology

1. A patient with a history of osteoporosis is prescribed alendronate (Fosamax). What instructions should the nurse provide to ensure the effectiveness of the medication?

A. Take the medication with a full glass of water and remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption.
B. Take the medication with milk to enhance calcium absorption.
C. Take the medication at bedtime to ensure absorption during sleep.
D. Take the medication with food to prevent nausea.

Correct answer: A

Rationale: The correct answer is A. Alendronate should be taken with a full glass of water and patients should remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption. Taking the medication with milk (choice B) is not recommended as it may interfere with the absorption of alendronate. Taking the medication at bedtime (choice C) is not necessary for optimal absorption. Taking the medication with food (choice D) is also not recommended as food can reduce the absorption of alendronate.

2. What are the signs of thyroid crisis resulting from Graves' disease?

A. Constipation with gastric distension.
B. Bradycardia and bradypnea.
C. Hyperthermia and tachycardia.
D. Constipation and lethargy.

Correct answer: C

Rationale: In a thyroid crisis resulting from Graves' disease, the patient typically experiences symptoms such as hyperthermia (elevated body temperature) and tachycardia (rapid heart rate). These symptoms are indicative of the hypermetabolic state seen in thyroid storm. Choices A and D are incorrect as constipation and lethargy are not typical signs of a thyroid crisis; instead, patients with hyperthyroidism often experience diarrhea and agitation. Choice B is incorrect because bradycardia (slow heart rate) and bradypnea (slow breathing rate) are more commonly associated with hypothyroidism rather than a thyroid crisis in Graves' disease.

3. What assessment is the nurse performing when a client is asked to stand with feet together, eyes open, and hands by the sides, and then asked to close the eyes while the nurse observes for a full minute?

A. Romberg test
B. Weber test
C. Rinne test
D. Babinski test

Correct answer: A

Rationale: The correct answer is A, Romberg test. The Romberg test is used to assess balance and proprioception. During the test, the client is asked to stand with feet together, eyes open, and hands by the sides to observe their balance. Then, the client is asked to close their eyes while the nurse continues to observe for a full minute. This test helps in detecting any issues with proprioception and balance, which may be compromised in conditions affecting the nervous system. Choices B, C, and D are incorrect because the Weber test is used to assess hearing in each ear, the Rinne test is used to compare air and bone conduction of sound, and the Babinski test is used to assess the integrity of the corticospinal tract.

4. What is a common cause of a pulmonary embolism?

A. An autoimmune disorder
B. A venous blood clot from the lower extremity
C. An increase in intracranial pressure
D. Hypotension

Correct answer: B

Rationale: A pulmonary embolism is commonly caused by a blood clot that originates in the venous system of the lower extremity and travels to the lungs, blocking blood flow. This clot is known as a venous thromboembolism. An autoimmune disorder (Choice A) is not typically associated with pulmonary embolism. Intracranial pressure (Choice C) refers to pressure inside the skull and is unrelated to pulmonary embolism. Hypotension (Choice D) is low blood pressure and is not a common cause of pulmonary embolism.

5. A 75-year-old male presents with chest pain on exertion. The chest pain is most likely due to hypoxic injury secondary to:

A. Malnutrition
B. Free radicals
C. Ischemia
D. Chemical toxicity

Correct answer: C

Rationale: The correct answer is C: Ischemia. In this scenario, the 75-year-old male experiences chest pain on exertion, which is indicative of angina. Angina is primarily caused by reduced blood flow to the heart muscle, leading to hypoxic injury. This condition is known as ischemia. Options A, B, and D are incorrect. Malnutrition does not typically cause chest pain related to exertion. Free radicals and chemical toxicity are not common causes of chest pain in the context described. Therefore, the most likely cause of chest pain in this case is ischemia due to reduced blood flow.