a client on an acute medicine unit of a hospital with a diagnosis of small bowel obstruction is reporting intense diffuse pain in her abdomen which ph

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ATI Pathophysiology Exam 2

1. A client on an acute medicine unit of a hospital with a diagnosis of small bowel obstruction is reporting intense, diffuse pain in her abdomen. Which physiologic phenomenon is most likely contributing to her complaint?

A. Somatic pain resulting from pressure on the parietal peritoneum
B. Referred pain from her small bowel
C. Visceral pain resulting from distension and ischemia
D. Neuropathic pain resulting from autonomic dysfunction

Correct answer: C

Rationale: Visceral pain is associated with distension, ischemia, and inflammation of internal organs. In the case of a small bowel obstruction, the intense, diffuse pain reported by the client is likely due to the distension and ischemia of the small bowel. Somatic pain (Choice A) would be more localized and sharp, typically arising from the parietal peritoneum. Referred pain (Choice B) is pain perceived at a site distant from the actual pathology. Neuropathic pain (Choice D) involves dysfunction or damage to the nervous system and is not typically associated with the described physiologic phenomenon of distension and ischemia in the context of a small bowel obstruction.

2. Seizures are diagnosed by which of the following?

A. Electroencephalogram (EEG) and ECG
B. Seizure symptoms and complete blood count (CBC)
C. Seizure symptoms and electrocardiogram (ECG)
D. Seizure symptoms and EEG

Correct answer: D

Rationale: Seizures are most accurately diagnosed by EEG, which measures brain activity. Choice A is incorrect as ECG (electrocardiogram) measures heart activity, not brain activity. Choice B is incorrect as CBC (complete blood count) is a blood test and not used to diagnose seizures. Choice C is incorrect as an ECG (electrocardiogram) also measures heart activity, not brain activity, and is not the primary diagnostic tool for seizures.

3. A patient with a history of breast cancer is being prescribed tamoxifen (Nolvadex). What should the nurse include in the patient education?

A. Tamoxifen may increase the risk of venous thromboembolism.
B. Tamoxifen may decrease the risk of osteoporosis.
C. Tamoxifen may cause hot flashes and other menopausal symptoms.
D. Tamoxifen may cause weight gain and fluid retention.

Correct answer: A

Rationale: The correct answer is A. Tamoxifen increases the risk of venous thromboembolism. Patients should be educated about signs and symptoms of blood clots, such as swelling, pain, or redness in the legs. Choices B, C, and D are incorrect because tamoxifen is not associated with decreasing the risk of osteoporosis, causing hot flashes and menopausal symptoms, or causing weight gain and fluid retention.

4. Which of the following are signs and symptoms of myocardial infarction?

A. Persistent chest pain which may radiate to the arm
B. Brief sternal chest pain on inspiration
C. Rapid respirations with left-sided weakness and numbness
D. Left upper quadrant abdominal pain which radiates to the back and shoulder

Correct answer: A

Rationale: The correct answer is A. Persistent chest pain that may radiate to the arm is a classic symptom of myocardial infarction. This pain is typically described as crushing, pressure-like, or squeezing. Choice B is incorrect because brief sternal chest pain on inspiration is not characteristic of myocardial infarction. Choice C is incorrect because rapid respirations with left-sided weakness and numbness are not typical symptoms of myocardial infarction. Choice D is incorrect because left upper quadrant abdominal pain that radiates to the back and shoulder is not a common presentation of myocardial infarction.

5. A 25-year-old just had a colonoscopy and was diagnosed with Crohn disease. Which of the following symptoms is consistent with this diagnosis?

A. Right lower quadrant cramping
B. Severe bloody diarrhea
C. Nausea and vomiting
D. Mostly affects the rectum

Correct answer: A

Rationale: The correct answer is A: Right lower quadrant cramping. Crohn's disease commonly presents with abdominal pain, particularly in the right lower quadrant. Choice B, severe bloody diarrhea, is more characteristic of ulcerative colitis, another type of inflammatory bowel disease. Choice C, nausea and vomiting, are not typical symptoms of Crohn's disease. Choice D is incorrect as Crohn's disease can affect any part of the gastrointestinal tract, not just the rectum.