ATI RN
ATI Pathophysiology Exam 2
1. Which of the following steps occurs first during hemostasis?
- A. Vascular spasm
- B. Platelet plug
- C. Coagulation
- D. Dissolution of the clot
Correct answer: A
Rationale: Vascular spasm is the initial step in hemostasis, where blood vessels constrict to reduce blood flow to the injured area. This constriction helps limit blood loss until further steps like platelet plug formation and coagulation can take place. Platelet plug formation and coagulation occur after the vascular spasm, making them incorrect choices. Dissolution of the clot happens much later in the healing process, after the injury has sufficiently healed.
2. A male patient is being treated with testosterone gel for hypogonadism. What important instruction should the nurse provide regarding the application of this medication?
- A. Apply the gel to the chest or upper arms.
- B. Apply the gel to the lower abdomen or thighs.
- C. Apply the gel to the face and neck.
- D. Apply the gel to the scalp and back.
Correct answer: A
Rationale: The correct answer is to apply the testosterone gel to the chest or upper arms. This is important to minimize the risk of transfer to others. Applying the gel to the lower abdomen, thighs, face, or neck can increase the risk of transfer to others, especially women and children who should avoid contact with testosterone gel. Applying it to the scalp and back is not recommended as these areas are not suitable for absorption of the medication.
3. A client with a history of tuberculosis (TB) is experiencing a recurrence of symptoms. Which diagnostic test should the nurse anticipate being ordered?
- A. Sputum culture
- B. Bronchoscopy
- C. Chest x-ray
- D. CT scan of the chest
Correct answer: C
Rationale: A chest x-ray is the most appropriate diagnostic test for a client with a history of tuberculosis experiencing a recurrence of symptoms. A chest x-ray is commonly used to visualize the lungs and check for signs of active tuberculosis, such as abnormal shadows or nodules. While a sputum culture (Choice A) can confirm the presence of TB bacteria, it may not be the initial test ordered for a recurrence. Bronchoscopy (Choice B) and CT scan of the chest (Choice D) are more invasive and usually reserved for cases where the chest x-ray is inconclusive or to further assess complications, rather than as the initial diagnostic test for a recurrence of tuberculosis.
4. A child is experiencing difficulty with chewing and swallowing. The nurse knows that which cells may be innervating specialized gut-related receptors that provide taste and smell?
- A. Special somatic afferent fibers
- B. General somatic afferents
- C. Special visceral afferent cells
- D. General visceral afferent neurons
Correct answer: C
Rationale: The correct answer is C: Special visceral afferent cells. These cells are responsible for innervating taste and smell receptors related to the gut. Special somatic afferent fibers (choice A) are involved in sensations like touch and proprioception, not taste and smell. General somatic afferents (choice B) carry sensory information from the skin and musculoskeletal system, not taste and smell. General visceral afferent neurons (choice D) transmit sensory information from internal organs, but not specifically related to taste and smell sensations.
5. During the home visit of a client with dementia, the nurse notes that an adult daughter persistently corrects her father’s misperceptions of reality, even when the father becomes upset and anxious. Which intervention should the nurse teach the caregiver?
- A. Anxiety-reducing measures
- B. Positive reinforcement
- C. Reality orientation techniques
- D. Validation techniques
Correct answer: D
Rationale: The correct answer is D: Validation techniques. In dementia care, using validation techniques involves acknowledging the person's feelings and reality, even if it differs from actual events or facts. It helps in reducing the client's anxiety and distress. In this scenario, the daughter persistently correcting her father's misperceptions can escalate his anxiety. Teaching the daughter validation techniques will encourage her to validate her father's feelings and perceptions, ultimately promoting a more supportive and less confrontational environment. Choices A, B, and C are incorrect in this context. While anxiety-reducing measures can be beneficial, the primary issue here is the father's misperceptions being consistently corrected. Positive reinforcement focuses on rewarding desired behaviors, which is not directly related to the situation described. Reality orientation techniques involve constantly reminding the person of the correct time, place, and other details, which may not be suitable for someone with dementia experiencing distress.
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