ATI RN
ATI Pathophysiology Exam
1. While assessing a critically ill client in the emergency department, the nurse notes on the cardiac monitor an R-on-T premature ventricular beat that develops into ventricular tachycardia (VT). Immediately, the client became unresponsive. The nurse knows that based on pathophysiologic principles, the most likely cause of the unresponsiveness is:
- A. metabolic acidosis that occurs spontaneously following any dysrhythmias.
- B. interruption of the blood/oxygen supply to the brain.
- C. massive cerebrovascular accident (CVA) resulting from increased perfusion.
- D. a blood clot coming from the heart and occluding the carotid arteries.
Correct answer: B
Rationale: The correct answer is B. Ventricular tachycardia (VT) can disrupt the normal heart function, leading to a decreased cardiac output. This decreased output can interrupt the blood supply to the brain, causing the client to become unresponsive. Metabolic acidosis (Choice A) is not the most likely cause of unresponsiveness in this scenario. A massive cerebrovascular accident (CVA) (Choice C) would not result from increased perfusion. A blood clot occluding the carotid arteries (Choice D) may lead to a stroke but is not the most likely cause of sudden unresponsiveness in this situation.
2. Which scenario would be an example of a child born with congenital insensitivity to pain?
- A. A child who does not cry when injured and fails to respond to painful stimuli.
- B. A child who cries excessively and has a heightened response to pain.
- C. A child who experiences pain but has difficulty expressing it.
- D. A child who is sensitive to minor stimuli but has a delayed response to severe pain.
Correct answer: A
Rationale: The correct scenario depicting a child with congenital insensitivity to pain is when the child does not cry when injured and fails to respond to painful stimuli. This condition is characterized by the inability to feel and react to pain, resulting in a lack of typical responses such as crying or withdrawal when hurt. Choice B is incorrect as it describes a child with heightened pain sensitivity, opposite to the insensitivity seen in the condition. Choice C is incorrect as it suggests the child feels pain but struggles to communicate it, which is not the case with congenital insensitivity to pain. Choice D is incorrect as it describes a child who is sensitive to minor stimuli and has delayed responses to severe pain, which is not indicative of congenital insensitivity to pain.
3. 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.
4. When assessing a patient experiencing breakthrough bleeding while taking oral contraceptives, what should the nurse consider?
- A. The possibility of pregnancy
- B. The patient's adherence to the medication schedule
- C. The need for an increased dosage
- D. The effectiveness of the current oral contraceptive
Correct answer: B
Rationale: When a patient on oral contraceptives experiences breakthrough bleeding, it is crucial for the nurse to consider the patient's adherence to the medication schedule. Breakthrough bleeding is often a sign of missed doses or inconsistent use, which can decrease the effectiveness of the oral contraceptive. Considering the possibility of pregnancy (Choice A) is important but secondary to assessing adherence. The need for an increased dosage (Choice C) is not typically the first consideration for breakthrough bleeding. Evaluating the effectiveness of the current oral contraceptive (Choice D) is relevant but should come after assessing adherence to the medication schedule.
5. A patient is being treated with amphotericin B. Which of the following statements indicates that the patient has understood the patient teaching?
- A. “The medication may cause diabetes.”
- B. “The medication will cause liver necrosis.”
- C. “The medication may cause kidney damage.”
- D. “The medication will cause pancreatitis.”
Correct answer: C
Rationale: The correct answer is C: 'The medication may cause kidney damage.' Amphotericin B is known for its potential to cause nephrotoxicity, which can manifest as kidney damage. It is crucial for the patient to be aware of this possible adverse effect. Choices A, B, and D are incorrect because amphotericin B is not typically associated with causing diabetes, liver necrosis, or pancreatitis. Therefore, these statements do not reflect an accurate understanding of the medication's side effects.
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