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. What should the nurse discuss with a patient with a history of cardiovascular disease regarding the risks of hormone replacement therapy (HRT)?

A. HRT may increase the risk of cardiovascular events, including heart attack and stroke.
B. HRT may decrease the risk of osteoporosis.
C. HRT may improve mood and energy levels.
D. HRT may decrease the risk of breast cancer.

Correct answer: A

Rationale: The correct answer is A. Hormone replacement therapy (HRT) is associated with an increased risk of cardiovascular events, including heart attack and stroke, especially in patients with a history of cardiovascular disease. Choice B is incorrect because HRT is not typically used to decrease the risk of osteoporosis. Choice C is incorrect as mood and energy level improvements are not the primary risks associated with HRT. Choice D is incorrect because HRT may actually increase the risk of breast cancer in some individuals.

3. After sustaining a concussion, a client experiences headache, vomiting, blurred vision, and loss of consciousness. What does this indicate?

A. Increased intracranial pressure
B. Lower extremity compartment syndrome
C. Consuming too much food at once
D. Improved kidney function

Correct answer: A

Rationale: The symptoms of headache, vomiting, blurred vision, and loss of consciousness following a concussion are indicative of increased intracranial pressure. These symptoms are commonly associated with intracranial pressure elevation, which can be dangerous and requires immediate medical attention. Lower extremity compartment syndrome is characterized by severe pain and swelling in the affected limb, not the symptoms mentioned. Consuming too much food at once may lead to digestive issues but does not correlate with the symptoms described. Improved kidney function would not manifest through the symptoms mentioned after a concussion.

4. Stress-induced cortisol hormone secretion is associated with:

A. Increased growth hormone level
B. Regulation of the stress response
C. Increased thyroid-stimulating hormone
D. Depressed adrenal gland function

Correct answer: B

Rationale: The correct answer is B: Regulation of the stress response. Cortisol plays a crucial role in regulating the body's response to stress by modulating various physiological processes. Choices A, C, and D are incorrect because stress-induced cortisol hormone secretion is not directly associated with increased growth hormone levels, increased thyroid-stimulating hormone, or depressed adrenal gland function.

5. A patient has been prescribed clomiphene citrate (Clomid) for infertility. What should the nurse include in the teaching plan about the use of this medication?

A. Clomiphene is taken daily for 5 days at the beginning of the menstrual cycle.
B. Clomiphene is taken once daily throughout the menstrual cycle.
C. Clomiphene is taken twice daily for 5 days at the end of the menstrual cycle.
D. Clomiphene is taken three times daily for 10 days at the beginning of the menstrual cycle.

Correct answer: A

Rationale: Corrected Rationale: Clomiphene is typically taken daily for 5 days at the beginning of the menstrual cycle to stimulate ovulation. Choice A is the correct answer because it aligns with the standard dosing regimen for clomiphene citrate. Choices B, C, and D provide incorrect information about the dosing schedule for clomiphene, which can lead to ineffective treatment and potential side effects. Choice B suggests continuous daily intake, which is not the standard practice for clomiphene. Choice C and D mention different dosing frequencies and timings, which are not in line with the typical protocol for using clomiphene for infertility.