ATI RN
Pathophysiology Practice Questions
1. A 45-year-old woman presents with fatigue, weight gain, and cold intolerance. Her thyroid function tests reveal low T3 and T4 levels and elevated TSH levels. Which of the following is the most likely diagnosis?
- A. Hyperthyroidism
- B. Hypothyroidism
- C. Euthyroid sick syndrome
- D. Subclinical hyperthyroidism
Correct answer: B
Rationale: The scenario describes a 45-year-old woman with fatigue, weight gain, cold intolerance, low T3 and T4 levels, and elevated TSH levels, which are indicative of hypothyroidism. In hypothyroidism, there is decreased production of thyroid hormones (T3 and T4) leading to elevated TSH levels as the pituitary gland tries to stimulate the thyroid gland to produce more hormones. Therefore, the correct answer is hypothyroidism (Choice B). Choice A, Hyperthyroidism, is incorrect as the patient's symptoms and thyroid function tests point towards decreased thyroid hormone levels, which is characteristic of hypothyroidism, not hyperthyroidism. Choice C, Euthyroid sick syndrome, is incorrect because this condition typically presents with normal to low T3 and T4 levels in the setting of non-thyroid illness, unlike the elevated TSH levels observed in this case. Choice D, Subclinical hyperthyroidism, is also incorrect as the patient has low T3 and T4 levels, which is not consistent with hyperthyroidism, whether clinical or subclinical.
2. A nurse manager is discussing electronic medical records with a newly licensed nurse. Which of the following actions should the nurse take to maintain client confidentiality?
- A. Log out of the computer terminal before leaving.
- B. Share passwords for computer access with colleagues.
- C. Change computer access passwords on a regular basis.
- D. Avoid accessing information about clients admitted to other units.
Correct answer: A
Rationale: The correct answer is A: Log out of the computer terminal before leaving. Logging out before leaving the computer terminal is crucial to ensuring patient data remains confidential and to prevent unauthorized access. Choice B is incorrect because sharing passwords compromises confidentiality. Choice C is incorrect as changing passwords regularly, although a good practice for security, is not directly related to maintaining client confidentiality. Choice D is incorrect as it does not address the immediate concern of maintaining client confidentiality through proper access to electronic medical records.
3. A school nurse is assessing a school-age child�s blood pressure while he is seated in a chair. The child starts to experience a tonic-clonic seizure. Which of the following actions should the nurse take first?
- A. Clear the immediate area around the child of hazardous objects
- B. loosen the child�s restrictive clothing
- C. assist the child to a side-lying position on the floor
- D. apply an oxygen mask to the child
Correct answer: C
Rationale: The greatest risk to this child is aspiration, occlusion of the airway, and bodily injury from falling out of the chair. The nurse should ease the child down to the floor in a side-lying position immediately.
4. A patient is considering options to manage his/her coronary artery disease. The nurse explains a coronary artery bypass graft procedure will:
- A. Cure the patient's coronary artery disease.
- B. Replace the leaking valve in the heart.
- C. Connect grafts to aorta to improve blood flow.
- D. Place a permanent pacemaker on the heart muscle.
Correct answer: C: Connect grafts to aorta to improve blood flow.
Rationale: The correct answer is C. A coronary artery bypass graft procedure involves connecting grafts to the aorta to improve blood flow to the heart muscle by bypassing blocked or narrowed coronary arteries. This procedure does not cure coronary artery disease but helps improve blood supply to the heart. Choices A, B, and D are incorrect because a bypass graft procedure does not cure the underlying disease, replace heart valves, or involve the placement of a pacemaker.
5. In the emergency department, a nurse is assessing a client involved in a motor vehicle crash. Findings include absent breath sounds in the left lower lobe with dyspnea, blood pressure 118/68 mm Hg, heart rate 124/min, respirations 38/min, temperature 38.6 C (101.4 F), and SaO2 92% on room air. What action should the nurse take first?
- A. Obtain a chest X-ray.
- B. Prepare for chest tube insertion.
- C. Administer oxygen via high-flow mask.
- D. Initiate IV access.
Correct answer: C: Administer oxygen via high-flow mask.
Rationale: In this scenario, the client is presenting with signs of respiratory distress, including absent breath sounds, dyspnea, and a low SaO2 level. The priority action should be to improve oxygenation by administering oxygen via a high-flow mask. This intervention aims to increase the oxygen supply to the client's lungs, helping to address the hypoxemia. Once oxygenation is optimized, further interventions, such as obtaining a chest X-ray, preparing for chest tube insertion, or initiating IV access, can be considered based on the client's condition and healthcare provider's orders.
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