ATI RN
Pathophysiology Exam 1 Quizlet
1. A nurse recalls an example of an immune-complex-mediated disease is:
- A. Bronchial asthma
- B. Contact dermatitis
- C. Serum sickness
- D. Rheumatoid arthritis
Correct answer: C
Rationale: The correct answer is C: Serum sickness. Serum sickness is characterized by the formation of immune complexes in response to certain medications or proteins. These immune complexes can deposit in tissues, leading to inflammation and tissue damage. Bronchial asthma (Choice A) is a chronic inflammatory condition of the airways not primarily mediated by immune complexes. Contact dermatitis (Choice B) is a type IV hypersensitivity reaction mediated by T cells, not immune complexes. Rheumatoid arthritis (Choice D) is an autoimmune disease where antibodies target self-antigens, but it is not primarily mediated by immune complexes.
2. What is the most important nursing action when a patient has a central line?
- A. Monitor for infection
- B. Monitor the central line dressing
- C. Monitor for redness
- D. Monitor for swelling
Correct answer: A
Rationale: The most important nursing action when a patient has a central line is to monitor for infection. Central line-associated bloodstream infections are a serious complication that can lead to severe outcomes. Monitoring for infection involves assessing the patient for signs and symptoms such as fever, chills, and hypotension. While monitoring the central line dressing, redness, and swelling are also important aspects of care, they are secondary to monitoring for infection as the primary focus should be on preventing serious complications.
3. A nurse is preparing to apply a dressing for a client who has a stage 2 pressure injury. Which of the following types of dressing should the nurse use?
- A. Hydrocolloid
- B. Transparent
- C. Gauze
- D. Alginate
Correct answer: A
Rationale: The correct answer is A: Hydrocolloid. For a stage 2 pressure injury, a hydrocolloid dressing is recommended. Hydrocolloid dressings provide a moist environment that promotes healing and is effective for wounds with moderate exudate. Choice B (Transparent) is not typically used for stage 2 pressure injuries as it is more suitable for superficial wounds. Choice C (Gauze) is not ideal for stage 2 pressure injuries as it can adhere to the wound bed and cause trauma upon removal. Choice D (Alginate) is more appropriate for wounds with heavy exudate, not typically seen in stage 2 pressure injuries.
4. What dietary strategy would most likely be used as part of lifestyle management to reduce the risk of coronary heart disease?
- A. Avoid foods that contain polyunsaturated fat
- B. Limit saturated fat to less than 10 percent of total calories
- C. Limit alcohol intake to one drink daily for women and two drinks daily for men
- D. Avoid consumption of fish and shellfish
Correct answer: C
Rationale: Limiting alcohol intake is part of a strategy to reduce the risk of coronary heart disease by avoiding the negative cardiovascular effects associated with excessive alcohol consumption.
5. What is the typical presentation of pyloric stenosis in infants?
- A. Bilious vomiting
- B. Projectile vomiting
- C. Blood in stools
- D. Failure to thrive
Correct answer: B
Rationale: The correct answer is B: Projectile vomiting. Pyloric stenosis in infants typically presents with projectile vomiting, which is forceful and projective in nature. This occurs due to the obstruction at the pylorus, leading to the stomach being unable to empty properly. Choices A, C, and D are incorrect. Bilious vomiting is more commonly associated with intestinal obstruction, blood in stools can occur in conditions such as necrotizing enterocolitis or allergic colitis, and failure to thrive is a nonspecific finding that can be seen in various pediatric conditions.
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