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 d

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. Which of the following is found in clients with Parkinson’s disease?

A. Mobility and functioning
B. The liver and kidneys
C. Too much dopamine in the brain
D. Skeletal muscle flaccidity

Correct answer: C

Rationale: The correct answer is C: Too much dopamine in the brain. Parkinson's disease is characterized by a deficiency of dopamine in the brain, not an excess. This deficiency leads to the motor symptoms associated with the disease. Choices A, B, and D are incorrect. Mobility and functioning are affected in Parkinson's disease due to the lack of dopamine, not an excess. The liver and kidneys are not directly related to Parkinson's disease. Skeletal muscle flaccidity is not typically a primary symptom of Parkinson's disease, which is more characterized by rigidity and tremors.

3. A male patient with benign prostatic hyperplasia (BPH) is prescribed finasteride (Proscar). What is the expected therapeutic effect of this medication?

A. Decreased urinary frequency and urgency
B. Decreased blood pressure
C. Increased urinary output
D. Increased hair growth

Correct answer: A

Rationale: The correct answer is A: Decreased urinary frequency and urgency. Finasteride is used to reduce the size of the prostate gland in patients with BPH, which helps alleviate symptoms such as urinary frequency and urgency. Choice B, decreased blood pressure, is incorrect because finasteride is not indicated for lowering blood pressure. Choice C, increased urinary output, is incorrect as finasteride does not typically increase urine production. Choice D, increased hair growth, is incorrect as the primary use of finasteride is not for promoting hair growth but rather for treating BPH.

4. A client has experienced a pontine stroke which has resulted in severe hemiparesis. What priority assessment should the nurse perform prior to allowing the client to eat or drink from the food tray?

A. Evaluate the client's gag reflex.
B. Assess the client's bowel sounds.
C. Check the client's pupil reaction.
D. Monitor the client's heart rate.

Correct answer: A

Rationale: The correct answer is to evaluate the client's gag reflex. When a client has experienced a stroke resulting in severe hemiparesis, assessing the gag reflex is crucial before allowing them to eat or drink. This assessment helps prevent aspiration, a serious complication that can occur due to impaired swallowing ability. Assessing bowel sounds (Choice B), pupil reaction (Choice C), or heart rate (Choice D) are important assessments but are not the priority in this situation where the risk of aspiration is higher.

5. What condition is a result of Polycythemia Vera, which involves excess red blood cells?

A. Tissue ischemia & necrosis
B. Chronic pancreatitis
C. Low blood pressure & heart rate
D. Increased numbers of infections

Correct answer: A

Rationale: Polycythemia Vera, characterized by excess red blood cells, can cause tissue ischemia and necrosis due to the increased blood viscosity. This condition restricts blood flow, leading to inadequate oxygen delivery to tissues and subsequent tissue damage. Choices B, C, and D are incorrect because they are not directly associated with the pathophysiology of Polycythemia Vera.