ATI RN
Adult Health Nursing Quizlet Final Questions
Question 1 of 5
A patient with chronic obstructive pulmonary disease (COPD) presents with acute exacerbation and severe dyspnea. Arterial blood gas (ABG) analysis reveals pH 7.28, PaO2 55 mmHg, PaCO2 65 mmHg, and HCO3- 30 mEq/L. Which of the following acid-base disturbances is most likely present in this patient?
Correct Answer: A
Rationale: In this case, the patient is experiencing respiratory acidosis as indicated by the low pH (7.28), elevated PaCO2 (65 mmHg), and elevated HCO3- (30 mEq/L). The primary acid-base disturbance is respiratory acidosis due to the retention of carbon dioxide (PaCO2 >45 mmHg) leading to an increase in HCO3- as a compensatory mechanism to maintain pH within normal limits. The elevated HCO3- levels (metabolic compensation) are trying to counterbalance the increased PaCO2 levels (respiratory acidosis) by increasing bicarbonate to attempt to normalize the pH. Overall, the ABG analysis shows respiratory acidosis with metabolic compensation in this COPD patient with an acute exacerbation and severe dyspnea.
Question 2 of 5
A patient presents with abdominal pain, fever, and peripheral blood smear showing fragmented red blood cells (schistocytes). Laboratory tests reveal elevated lactate dehydrogenase (LDH), decreased haptoglobin, and increased indirect bilirubin. Which of the following conditions is most likely to cause these findings?
Correct Answer: B
Rationale: Thrombotic thrombocytopenic purpura (TTP) is a rare blood disorder characterized by microangiopathic hemolytic anemia, thrombocytopenia, fever, neurological abnormalities, and renal dysfunction. The peripheral blood smear in TTP typically shows fragmented red blood cells (schistocytes) due to mechanical destruction within small blood vessels. Laboratory findings in TTP commonly include elevated lactate dehydrogenase (LDH), decreased haptoglobin (as it is consumed in the clearance of free hemoglobin), and increased indirect bilirubin due to increased red blood cell breakdown. This combination of clinical presentation and laboratory abnormalities is classic for TTP. Hemolytic uremic syndrome (HUS) may present similarly but is more commonly associated with renal dysfunction and is often triggered by infection with Shiga toxin-producing E. coli.
Question 3 of 5
A patient presents with tremors, rigidity, bradykinesia, and postural instability. On examination, the patient demonstrates a shuffling gait, stooped posture, and a masked facies. Which of the following neurological conditions is most likely responsible for these symptoms?
Correct Answer: B
Rationale: The symptoms described in the patient, such as tremors, rigidity, bradykinesia (slow movement), and postural instability, along with the presence of a shuffling gait, stooped posture, and masked facies, are classic features of Parkinson's disease. These motor symptoms are primarily caused by the degeneration of dopamine-producing neurons in the substantia nigra region of the brain. This results in an imbalance of neurotransmitters, particularly dopamine, leading to motor dysfunction and characteristic movement abnormalities seen in Parkinson's disease.
Question 4 of 5
A patient presents with gradual-onset weakness, spasticity, hyperreflexia, and positive Babinski sign. Imaging reveals demyelinating plaques in the white matter of the brain and spinal cord. Which of the following neurological conditions is most likely responsible for these symptoms?
Correct Answer: B
Rationale: The symptoms described - gradual-onset weakness, spasticity, hyperreflexia, positive Babinski sign, and demyelinating plaques in the white matter of the brain and spinal cord - are indicative of multiple sclerosis (MS). MS is an autoimmune disease where the body's immune system attacks the myelin sheath, leading to the formation of plaques in the central nervous system. The characteristic symptoms of MS include weakness, spasticity (stiffness in muscles), hyperreflexia (exaggerated reflex responses), and positive Babinski sign (upward movement of the big toe). While ALS (Amyotrophic lateral sclerosis) presents with progressive muscle weakness and atrophy without sensory involvement and demyelinating plaques, Guillain-Barré syndrome (GBS) is typically an acute inflammatory demyelinating polyneuropathy affecting peripheral nerves rather than the central nervous system, and myast
Question 5 of 5
A patient presents with sudden-onset severe headache, vomiting, and altered mental status. Imaging reveals a hyperdense lesion within the brain parenchyma, suggestive of acute bleeding. Which of the following neurological conditions is most likely responsible for these symptoms?
Correct Answer: C
Rationale: Intracerebral hemorrhage is characterized by bleeding directly into the brain parenchyma, leading to the sudden onset of severe headache, vomiting, altered mental status, and neurological deficits. The hyperdense lesion seen on imaging is caused by the presence of blood within the brain tissue. This condition is often associated with hypertension and can be life-threatening if not promptly diagnosed and managed. Subdural hematoma is an accumulation of blood between the brain and its outermost covering (dura mater), typically presenting with a slower onset of symptoms compared to intracerebral hemorrhage. Subarachnoid hemorrhage involves bleeding into the space between the arachnoid membrane and the pia mater (subarachnoid space), commonly caused by the rupture of an aneurysm. Ischemic stroke results from the blockage of a blood vessel supplying the brain, leading to a lack of oxygen and nutrients to