ATI RN
ATI Pathophysiology Test Bank
1. A 70-year-old client presents with weakness and sensory loss in the right hand and foot. The client also exhibits speech difficulties. Which condition is the client most likely experiencing?
- A. Transient ischemic attack (TIA)
- B. Brain tumor
- C. Cerebral infarction
- D. Multiple sclerosis
Correct answer: C
Rationale: The correct answer is C: Cerebral infarction (stroke). In this case, the client's symptoms of weakness and sensory loss in the right hand and foot, along with speech difficulties, are indicative of a stroke. These symptoms are commonly seen in individuals experiencing a cerebral infarction, where a blockage in blood flow to the brain leads to neurological deficits. Choices A, B, and D are less likely as transient ischemic attacks (TIAs) typically have temporary symptoms with no permanent damage, brain tumors may present with a different set of symptoms depending on their location, and multiple sclerosis usually presents with a relapsing-remitting pattern of neurological symptoms rather than sudden onset unilateral deficits.
2. A 5-year-old female takes a hike through the woods during a school field trip. Upon returning home, she hugs her father, and he later develops poison ivy. Which of the following immune reactions is he experiencing?
- A. IgE-mediated
- B. Tissue-specific
- C. Immune complex
- D. Cell-mediated
Correct answer: D
Rationale: The father's immune reaction to poison ivy is an example of cell-mediated immunity, specifically a type IV hypersensitivity reaction. In this type of reaction, sensitized T cells react to antigens, leading to inflammation and tissue damage. IgE-mediated reactions involve antibodies of the IgE class, commonly seen in allergic responses like anaphylaxis. Tissue-specific reactions target specific organs or tissues. Immune complex reactions involve immune complexes formed by antigens and antibodies that can deposit in tissues, leading to inflammation.
3. A nurse practitioner is seeing a client in the clinic with a suspected diagnosis of bacterial meningitis. What should the nurse anticipate as the priority action?
- A. Administer the first dose of antibiotics immediately after blood cultures are drawn.
- B. Start an IV line and administer corticosteroids to reduce inflammation.
- C. Isolate the client to prevent the spread of infection.
- D. Perform a lumbar puncture to confirm the diagnosis.
Correct answer: A
Rationale: The correct answer is to administer the first dose of antibiotics immediately after blood cultures are drawn for suspected bacterial meningitis. This is crucial to initiate treatment promptly and improve patient outcomes. Starting an IV line and administering corticosteroids (Choice B) may be part of the treatment plan but administering antibiotics is the priority. Isolating the client (Choice C) is important to prevent the spread of infection but not the priority over initiating antibiotic therapy. Performing a lumbar puncture (Choice D) may confirm the diagnosis, but treatment should not be delayed for this step in suspected cases of bacterial meningitis.
4. What type of immunity will the hepatitis B series provide a nursing student scheduled to receive it?
- A. Active immunity
- B. Passive immunity
- C. Innate immunity
- D. Natural immunity
Correct answer: A
Rationale: The correct answer is active immunity. The hepatitis B series immunization will provide active immunity, where the individual's immune system is stimulated to produce antibodies against the hepatitis B virus. This type of immunity is long-lasting and provides protection against future exposures. Passive immunity (choice B) involves the transfer of pre-formed antibodies and is temporary. Innate immunity (choice C) is the body's natural defense mechanisms, present at birth. Natural immunity (choice D) refers to immunity acquired through normal life processes, such as recovering from an infection.
5. 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.
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