ATI RN
Adult Health Nursing Test Bank Questions
Question 1 of 5
A patient with a history of multiple myeloma demonstrates hypogammaglobulinemia. Which of the following immunoglobulin classes is most likely to be deficient in this patient?
Correct Answer: B
Rationale: The correct answer is B: IgA. In multiple myeloma, there is a proliferation of abnormal plasma cells, leading to a decrease in normal antibody production. IgA is the most abundant immunoglobulin in mucosal secretions and plays a crucial role in mucosal immunity. Therefore, a deficiency in IgA is common in patients with multiple myeloma. IgG is the most abundant immunoglobulin in the blood and is typically less affected in multiple myeloma. IgM is the first antibody produced in response to an infection and is less likely to be deficient in this case. IgE is primarily involved in allergic responses and is not typically affected in multiple myeloma.
Question 2 of 5
A patient with suspected community-acquired pneumonia (CAP) is empirically started on antibiotic therapy pending culture results. Which of the following antibiotic regimens provides appropriate coverage for typical bacterial pathogens commonly implicated in CAP?
Correct Answer: A
Rationale: The correct answer is A: Ceftriaxone and azithromycin. Ceftriaxone covers Streptococcus pneumoniae, the most common pathogen in CAP, while azithromycin covers atypical pathogens like Mycoplasma pneumoniae. Vancomycin and piperacillin/tazobactam (choice B) are not first-line treatments for CAP. Ampicillin-sulbactam and levofloxacin (choice C) cover some pathogens but not as comprehensively as ceftriaxone and azithromycin. Clindamycin and cefepime (choice D) do not provide adequate coverage for typical CAP pathogens.
Question 3 of 5
Which of the following clinical manifestations is most indicative of acute respiratory distress syndrome (ARDS)?
Correct Answer: C
Rationale: Rationale: - ARDS is characterized by severe hypoxemia and respiratory distress. - Tachypnea is a hallmark sign of ARDS due to the body's compensatory mechanism to increase oxygenation. - Hypoxemia refractory to supplemental oxygen signifies the inability to improve oxygen levels despite intervention. - Choices A, B, and D do not align with typical manifestations of ARDS, as they do not directly reflect severe hypoxemia or respiratory distress.
Question 4 of 5
A patient presents with petechiae, ecchymoses, and gingival bleeding. Laboratory tests reveal prolonged bleeding time, normal platelet count, and normal PT and aPTT. Which of the following conditions is most likely to cause these findings?
Correct Answer: C
Rationale: The correct answer is C: Acquired von Willebrand syndrome. This condition is characterized by a defect in von Willebrand factor function, leading to prolonged bleeding time and mucocutaneous bleeding. Normal platelet count rules out Glanzmann thrombasthenia and Bernard-Soulier syndrome which are platelet disorders. Normal PT and aPTT rule out Hemophilia A, a coagulation factor deficiency. Acquired von Willebrand syndrome is the most likely cause based on the clinical presentation and laboratory findings.
Question 5 of 5
A patient with a history of chronic liver disease presents with ecchymoses, mucosal bleeding, and altered mental status. Laboratory tests reveal prolonged PT and aPTT, low fibrinogen levels, and elevated D-dimer. Which of the following conditions is most likely to cause these findings?
Correct Answer: B
Rationale: The correct answer is B: Disseminated intravascular coagulation (DIC). In DIC, there is widespread activation of coagulation leading to consumption of clotting factors, resulting in prolonged PT and aPTT, low fibrinogen levels, and elevated D-dimer. This pattern matches the laboratory findings in the patient. In liver cirrhosis (choice A), there is a decrease in clotting factors synthesis, leading to prolonged PT but not aPTT. Hemophilia A (choice C) is a genetic disorder that affects specific clotting factors, typically leading to prolonged aPTT but not PT. Vitamin K deficiency (choice D) impairs the synthesis of clotting factors, leading to prolonged PT but not aPTT and low levels of factors II, VII, IX, and X.