ATI RN
Pathophysiology Exam 1 Quizlet
1. A patient underwent an open cholecystectomy 4 days ago, and her incision is now in the proliferative phase of healing. The nurse knows that the next step in the process of wound healing is:
- A. Inflammation
- B. Maturation
- C. Remodeling
- D. Coagulation
Correct answer: C
Rationale: In the context of wound healing, after the proliferative phase comes the remodeling phase. During the remodeling phase, the wound gains strength as collagen fibers reorganize, and the scar matures. Inflammation is the initial phase of healing, where the body responds to injury with redness, swelling, and warmth. Maturation is the final stage where the scar tissue continues to undergo changes but is not the immediate next step after the proliferative phase. Coagulation is the process of blood clot formation and is not a phase in wound healing.
2. A client is being assessed by a healthcare provider while taking Digoxin to manage heart failure. Which of the following findings is a manifestation of digoxin toxicity?
- A. Bruising
- B. Report of metallic taste
- C. Muscle pain
- D. Report of anorexia
Correct answer: D
Rationale: The correct manifestation of digoxin toxicity is anorexia, not bruising, metallic taste, or muscle pain. Other symptoms of digoxin toxicity include blurred vision, stomach pain, and diarrhea. It is crucial for healthcare providers to promptly identify these signs to prevent severe complications.
3. The nurse prepares to administer digoxin (Lanoxin) to a newborn with a diagnosis of heart failure and notes that the apical rate is 140 beats per minute. Which nursing action is appropriate?
- A. Hold the medication
- B. Administer the digoxin
- C. Notify the healthcare provider
- D. Recheck the apical rate in 1 hour
Correct answer: B
Rationale: An apical rate of 140 bpm is within the normal range for a newborn. Digoxin is commonly used to treat heart failure by increasing the strength and efficiency of the heart's contractions. Since the heart rate is within the normal range, there is no need to hold the medication or notify the healthcare provider. Rechecking the apical rate in an hour is unnecessary as the heart rate is not alarming. Therefore, the appropriate nursing action is to administer the digoxin.
4. T. Berry Brazelton's Neonatal Behavioral Assessment Scale (NBAS) evaluates a newborn's __________.
- A. risk for developmental problems
- B. ability to comply with parental commands and responsiveness to touch
- C. reflexes, muscle tone, state changes, and responsiveness to stimulation
- D. heart rate, respiratory effort, reflex irritability, muscle tone, and color
Correct answer: C
Rationale: T. Berry Brazelton's Neonatal Behavioral Assessment Scale (NBAS) evaluates a newborn's reflexes, muscle tone, state changes, and responsiveness to stimulation. This assessment helps healthcare providers understand the newborn's behavioral responses and capabilities in various areas, providing valuable insights into their overall development and well-being. Choices A, B, and D are incorrect because the NBAS focuses on assessing the newborn's behavioral responses and capabilities, rather than their risk for developmental problems, compliance with commands, or physiological parameters like heart rate and respiratory effort.
5. A 21-year-old male is brought to the ED following a night of partying in his fraternity. His friends found him 'asleep' and couldn't get him to respond. They cannot recall how many alcoholic beverages he drank the night before. While educating a student nurse and the man's friends, the nurse begins by explaining that alcohol is:
- A. A water-soluble compound that is easily absorbed by the gastric lining of the stomach.
- B. Very lipid-soluble and rapidly crosses the blood–brain barrier.
- C. Able to reverse the transport of some substances to remove them from the brain.
- D. Very likely to cause sedation and therefore the client just needs to sleep it off.
Correct answer: B
Rationale: The correct answer is B. Alcohol is very lipid-soluble and rapidly crosses the blood–brain barrier, leading to its effects on the central nervous system and causing symptoms like sedation and unconsciousness. Choice A is incorrect because alcohol is not water-soluble; it is lipid-soluble. Choice C is incorrect as alcohol does not reverse the transport of substances from the brain. Choice D is incorrect as sedation from alcohol is not a reason to just 'sleep it off' in cases of alcohol poisoning, which can be life-threatening and requires medical attention.
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