a public health nurse is responsible for the administration of numerous immunizations which of the following guidelines regarding anaphylaxis should t

ATI RN

Pathophysiology Final Exam

1. A public health nurse is responsible for the administration of numerous immunizations. Which of the following guidelines regarding anaphylaxis should the nurse adhere to?

A. The patient should be observed for anaphylaxis for 1 minute after administration.
B. The patient should be observed for anaphylaxis for 5 minutes after administration.
C. The patient should be observed for anaphylaxis for 30 minutes after administration.
D. The patient should be observed for anaphylaxis for 90 minutes after administration.

Correct answer: C

Rationale: The correct answer is C: 'The patient should be observed for anaphylaxis for 30 minutes after administration.' This is because anaphylaxis can occur within minutes of administration of an immunization. By observing the patient for 30 minutes, the nurse can promptly identify and manage any signs of anaphylaxis. Choices A, B, and D are incorrect as they suggest shorter or longer observation periods, which may not be sufficient to detect and respond to anaphylaxis in a timely manner.

2. A nurse is educating a client with peripheral artery disease (PAD). Which statement made by the client indicates a need for further teaching?

A. I should avoid walking for long periods to prevent leg pain.
B. I should inspect my feet daily for any sores or wounds.
C. I should wear compression stockings to improve circulation.
D. I should avoid smoking to prevent further damage to my arteries.

Correct answer: A

Rationale: The correct answer is A. Walking is crucial in improving circulation in peripheral artery disease; therefore, the client should not avoid walking for long periods. Choices B, C, and D are correct statements for a client with PAD. Inspecting feet daily helps in early detection of sores or wounds, wearing compression stockings improves circulation, and avoiding smoking helps prevent further damage to arteries in PAD.

3. The early stages of atheroma development are characterized by:

A. macrophages full of oxidized low-density lipoprotein (LDL; i.e., foam cells) in the intima
B. accumulation of lipids in the intima (i.e., fatty streak)
C. accumulation of proteins such as collagen and elastin (i.e., fibrous cap)
D. development of calcium and a necrotic lipid core

Correct answer: A

Rationale: The correct answer is A. In the early stages of atheroma development, macrophages accumulate oxidized low-density lipoprotein (LDL) and transform into foam cells, leading to the formation of fatty streaks in the intima of blood vessels. This process is a hallmark of the initial stages of atherosclerosis. Choice B is incorrect as it describes the accumulation of lipids in the intima, which is a later event following foam cell formation. Choice C is also incorrect as it refers to the accumulation of proteins forming the fibrous cap, which occurs at a later stage to stabilize the atheroma. Choice D is incorrect as it describes the development of calcium and a necrotic lipid core, typically seen in advanced atherosclerosis rather than the early stages.

4. Following cardiothoracic surgery where controlled therapeutic hypothermia was utilized to decrease metabolic demands, the nurse responsible for monitoring this client postoperatively should be assessing for which potential complication related to cold cardioplegia?

A. Thrombocytopenia
B. Hypokalemia
C. Hyperglycemia
D. Coagulopathy

Correct answer: D

Rationale: Coagulopathy is the correct answer. During therapeutic hypothermia, which lowers the body's temperature to reduce metabolic demands post-surgery, coagulopathy, or impaired blood clotting, is a potential complication due to the effects of cold cardioplegia. Thrombocytopenia (choice A) refers to a low platelet count and is not directly related to cold cardioplegia. Hypokalemia (choice B) is a condition of low potassium levels, and hyperglycemia (choice C) is high blood sugar levels, neither of which are primary complications of cold cardioplegia.

5. What is the action of amphotericin B?

A. It binds to ergosterol and forms holes in the membrane.
B. It binds to an enzyme required for the synthesis of ergosterol.
C. It disrupts the fungal cell walls rather than the cell membrane.
D. It inhibits glucan synthetase required for glucan synthesis.

Correct answer: A

Rationale: Amphotericin B is an antifungal medication that acts by binding to ergosterol, a component of fungal cell membranes, forming pores that disrupt the integrity of the membrane. This action leads to leakage of cellular contents and ultimately cell death. Choice B is incorrect as amphotericin B does not bind to an enzyme required for the synthesis of ergosterol. Choice C is incorrect as the drug primarily affects the cell membrane rather than the cell wall. Choice D is also incorrect as amphotericin B does not inhibit glucan synthetase.