the unique clinical presentation of a 3 month old infant in the emergency department leads the care team to suspect botulism which assessment question

ATI RN

WGU Pathophysiology Final Exam

1. The unique clinical presentation of a 3-month-old infant in the emergency department leads the care team to suspect botulism. Which assessment question posed to the parents is likely to be most useful in the differential diagnosis?

A. Has your child received all recommended vaccinations?
B. Has your child been feeding poorly or showing signs of constipation?
C. Has your child been exposed to any sick individuals?
D. Has your child been displaying signs of respiratory distress?

Correct answer: B

Rationale: The correct answer is B. Poor feeding and constipation are common early symptoms of infant botulism, which is caused by a neurotoxin that impairs muscle function. Option A is unrelated to the presentation of botulism. Option C does not directly relate to the symptoms of botulism. Option D is more indicative of respiratory issues rather than the constellation of symptoms seen in botulism.

2. Thrombocytopenia is which disorder below?

A. Increased blood coagulation
B. Increased platelet production
C. Increased number of infections
D. Decreased platelet production

Correct answer: D

Rationale: Thrombocytopenia is a disorder characterized by a decreased platelet count or decreased platelet production, which affects blood clotting. Choice A, 'Increased blood coagulation,' is incorrect as thrombocytopenia is associated with decreased platelets, leading to impaired clotting. Choice B, 'Increased platelet production,' is incorrect as thrombocytopenia is characterized by a decrease in platelet production. Choice C, 'Increased number of infections,' is unrelated to thrombocytopenia, which primarily involves low platelet levels.

3. What key contraindication should the nurse emphasize to a patient prescribed sildenafil (Viagra) for erectile dysfunction?

A. Sildenafil is contraindicated in patients taking nitrates due to the risk of severe hypotension.
B. Sildenafil should not be taken with food as it can reduce its effectiveness.
C. Sildenafil is contraindicated in patients with a history of hypertension.
D. Sildenafil should not be taken with grapefruit juice as it can lead to dangerous side effects.

Correct answer: A

Rationale: The correct answer is A. Sildenafil is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, leading to a synergistic effect that can result in a dangerous drop in blood pressure. Choices B, C, and D are incorrect because there is no specific contraindication for taking sildenafil with food, having a history of hypertension, or taking it with grapefruit juice. The main concern is the concurrent use of nitrates with sildenafil.

4. A patient arrives at her follow-up appointment 1 month post-hysterectomy and complains to the nurse that her scars do not seem to be healing properly. Upon inspection, the nurse notices that the scars are raised but still within the boundaries of the original incisions. The nurse tells the patient this kind of dysfunctional wound healing is called:

A. Hypertrophic scarring
B. Dehiscence
C. Contracture
D. A keloid

Correct answer: A

Rationale: Hypertrophic scarring occurs when a scar is raised but remains within the boundaries of the original wound, unlike keloids, which extend beyond the wound edges. Dehiscence refers to the separation of wound edges, while contracture involves the tightening or constriction of a scar, leading to limited mobility.

5. A 17-year-old woman has come to the clinic requesting emergency contraception after having unprotected sex 24 hours ago. What medication is the clinician most likely to prescribe?

A. Levonorgestrel (Plan B)
B. Mifepristone (RU-486)
C. Ulipristal acetate (ella)
D. Estradiol (Estrace)

Correct answer: A

Rationale: The correct answer is A: Levonorgestrel (Plan B). Levonorgestrel is the most commonly prescribed medication for emergency contraception within 72 hours of unprotected intercourse. It is effective when taken within 72 hours after intercourse, with better efficacy the sooner it is taken. Choice B, Mifepristone (RU-486), is not indicated for emergency contraception but is used for medical abortion. Choice C, Ulipristal acetate (ella), is another option for emergency contraception that is effective up to 120 hours after unprotected intercourse. Choice D, Estradiol (Estrace), is not used for emergency contraception.