ATI RN
ATI Pathophysiology Exam
1. While assessing a critically ill client in the emergency department, the nurse notes on the cardiac monitor an R-on-T premature ventricular beat that develops into ventricular tachycardia (VT). Immediately, the client became unresponsive. The nurse knows that based on pathophysiologic principles, the most likely cause of the unresponsiveness is:
- A. metabolic acidosis that occurs spontaneously following any dysrhythmias.
- B. interruption of the blood/oxygen supply to the brain.
- C. massive cerebrovascular accident (CVA) resulting from increased perfusion.
- D. a blood clot coming from the heart and occluding the carotid arteries.
Correct answer: B
Rationale: The correct answer is B. Ventricular tachycardia (VT) can disrupt the normal heart function, leading to a decreased cardiac output. This decreased output can interrupt the blood supply to the brain, causing the client to become unresponsive. Metabolic acidosis (Choice A) is not the most likely cause of unresponsiveness in this scenario. A massive cerebrovascular accident (CVA) (Choice C) would not result from increased perfusion. A blood clot occluding the carotid arteries (Choice D) may lead to a stroke but is not the most likely cause of sudden unresponsiveness in this situation.
2. How does stress impact brain function?
- A. Stress has no effect on brain function.
- B. Stress can lead to changes in brain structure and function.
- C. Stress can improve brain function.
- D. Stress has no long-term impact on brain function.
Correct answer: B
Rationale: Stress can lead to changes in brain structure and function, affecting mental health and increasing the risk of disorders. Choice A is incorrect as stress does affect brain function. Choice C is incorrect as stress generally has negative impacts on brain function rather than improving it. Choice D is incorrect because stress can have long-term impacts on brain function through structural and functional changes.
3. A client with chronic renal disease is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?
- A. The leukocyte count
- B. The platelet count
- C. The hematocrit (Hct)
- D. The erythrocyte sedimentation rate (ESR)
Correct answer: C
Rationale: The correct answer is C: The hematocrit (Hct). Monitoring the hematocrit is essential to assess the therapeutic effect of epoetin alfa because this medication stimulates red blood cell production in clients with chronic renal disease. The leukocyte count (choice A) and platelet count (choice B) are not directly affected by epoetin alfa therapy. The erythrocyte sedimentation rate (ESR) (choice D) is a non-specific marker of inflammation and is not used to monitor the therapeutic effect of epoetin alfa.
4. A nurse must do a venipuncture on a 6-year-old child. What consideration is important in providing atraumatic care?
- A. Use an 18-gauge needle if possible.
- B. Show the child the equipment to be used before the procedure.
- C. If not successful after four attempts, have another nurse try.
- D. Restrain the child completely.
Correct answer: B
Rationale: Showing the child the equipment before the procedure helps build trust and reduces fear. Using an 18-gauge needle is too large for a child, and multiple attempts can increase trauma. Restraining completely can increase fear and anxiety.
5. A client with diabetes mellitus receiving regular insulin should be monitored for which of the following manifestations of hypoglycemia?
- A. Bradycardia.
- B. Dry skin.
- C. Increased thirst.
- D. Increased urinary output.
Correct answer: A
Rationale: The correct answer is A, Bradycardia. Bradycardia is a common sign of hypoglycemia, which can occur as a complication of insulin therapy in clients with diabetes mellitus. Dry skin (choice B) is not typically associated with hypoglycemia. Increased thirst (choice C) and increased urinary output (choice D) are symptoms more commonly seen in conditions like hyperglycemia or diabetes insipidus, not hypoglycemia.
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