ATI RN
ATI Pathophysiology Test Bank
1. In Guillain-Barre syndrome, what pathophysiologic process underlies the deficits that accompany the degeneration of myelin in the peripheral nervous system (PNS)?
- A. The destruction of myelin results in a reduction in Schwann cell production in the client's PNS.
- B. The lack of myelin surrounding nerve cells compromises the axonal transport system.
- C. Without remyelination, the axon will eventually die.
- D. A deficit of myelin makes the client more susceptible to infection by potential pathogens.
Correct answer: C
Rationale: In Guillain-Barre syndrome, the destruction of myelin leads to axonal damage. If remyelination does not occur, the axon will eventually degenerate and die, impacting nerve function. Choice A is incorrect because the destruction of myelin does not affect Schwann cell production. Choice B is incorrect as the lack of myelin directly affects the conduction of nerve impulses, not the axonal transport system. Choice D is incorrect as a deficit of myelin does not predispose the client to infections by potential pathogens.
2. What are the dietary instructions for a patient with pre-dialysis end-stage kidney disease?
- A. Increase protein intake
- B. Reduce sodium intake
- C. Reduce potassium intake
- D. Restrict protein intake to 0.55-0.60 g/kg/day
Correct answer: D
Rationale: The correct answer is to restrict protein intake to 0.55-0.60 g/kg/day for a patient with pre-dialysis end-stage kidney disease. Excessive protein intake can worsen kidney function in such patients. Increasing protein intake, as mentioned in choice A, is not recommended due to the strain it puts on the kidneys. While reducing sodium intake, as in choice B, is relevant for managing blood pressure, it is not specifically related to pre-dialysis end-stage kidney disease. Choice C, reducing potassium intake, is important for patients with kidney disease, but it is not the primary dietary instruction for those with pre-dialysis end-stage kidney disease.
3. While assessing a distraught female high school student who is overly concerned because her parents can't afford horseback riding lessons, how should the nurse interpret the student's reaction to her perceived problem?
- A. The problem is endangering her well-being.
- B. The problem is personally relevant to her.
- C. The problem is based on immaturity.
- D. The problem is exceeding her capacity to cope.
Correct answer: B
Rationale: In this scenario, the student being overly concerned about not being able to afford horseback riding lessons indicates that the problem is personally relevant to her. Psychological stressors related to self-esteem and self-image are influenced by how an individual perceives a situation or event. Adolescents, in particular, place significance on self-image and feeling entitled to experiences that other adolescents have, which can lead to distress when such desires are not met. Choice A is incorrect because there is no indication that the student's physical well-being is at risk. Choice C is incorrect as it simplifies the issue by attributing it solely to immaturity. Choice D is incorrect as there is no evidence provided that the problem is beyond the student's coping abilities.
4. The nurse is evaluating the plan of care for a client with peptic ulcer disease with a nursing diagnosis of Acute Pain. The nurse would determine that the client has not met the expected outcomes if the client states
- A. That pain is relieved with histamine H2 receptor antagonists.
- B. That irritating foods have been eliminated from the diet.
- C. The client is being awakened at 2 AM with heartburn.
- D. The client has absence of pain before meals.
Correct answer: C
Rationale: Expected outcomes for the client with peptic ulcer disease experiencing pain include elimination of irritating foods from the diet, ability to take prescribed medications that will reduce pain, reporting that the pain is relieved or prevented with medication, and an ability to sleep through the night without pain. The client who continues to be awakened by pain requires further modification of medication therapy, which may include adjustment of timing of histamine H2 receptor antagonist or an additional dose of antacid before the time when pain awakens the client.
5. While reviewing notes from a previous shift, a nurse finds incomplete documentation. What is the most appropriate action?
- A. Complete the missing documentation
- B. Notify the nurse manager of the issue
- C. Ask the nurse to complete the documentation
- D. Confront the nurse about the incomplete notes
Correct answer: B
Rationale: The most appropriate action when finding incomplete documentation is to notify the nurse manager of the issue. This ensures that accurate records are maintained and the situation can be addressed properly. Completing the missing documentation on behalf of someone else may lead to inaccuracies, asking the nurse to complete it may not guarantee timely correction, and confronting the nurse could create a confrontational situation that is not conducive to effective teamwork.
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