ATI RN
ATI Med Surg Woolery Q5 Questions
Extract:
Nurses Notes
0900:
Client is a 78-year-old female who was brought to the hospital via ambulance. The client's neighbor called 911 after checking on the client and finding the client confused and complaining of weakness. The neighbor states that the client has had "a thyroid problem" for years, and that the client mentioned recently that she hadn't picked up her medications due to an inability afford them. The client is lethargic, oriented to person and year, but uncertain of place and situation. S1 & S2 heard on auscultation of heart. Lungs clear in all lobes. Breathing is slow and shallow. Initial lab results show low Free T4 and elevated TSH. Provider notified, awaiting orders.
Vital Signs
0900:
Temperature: 35.6° C (96.1° F)
Heart rate: 49/min
Respiratory rate: 10/min
Blood pressure: 102/53 mm Hg
Oxygen saturation: 94% on room air
Question 1 of 5
Select the 3 interventions that the nurse should anticipate for this client.
Correct Answer: B,C,G
Rationale: The client's symptoms and lab results (low Free T4, elevated TSH) indicate hypothyroidism. PTU (
A) is for hyperthyroidism, not hypothyroidism. Warm blankets (
B) address hypothermia (35.6°
C). Cardiac monitoring (
C) is needed due to bradycardia (heart rate 49/min). A high-calorie diet (
D) is for hyperthyroidism, not hypothyroidism. Propranolol (E) manages hyperthyroid symptoms like tachycardia, not applicable here. Acetaminophen (F) is for fever, not hypothermia. Levothyroxine (G) treats hypothyroidism by replacing thyroid hormone.
Extract:
Question 2 of 5
At the beginning of the shift, a nurse receives report on the following four patients.Which patient should the nurse place priority on assessing first?
Correct Answer: B
Rationale: Confusion in a patient with Addison's disease (
B) suggests a possible adrenal crisis, a life-threatening condition requiring immediate assessment. Cushing syndrome with gynecomastia (
A) is less urgent. Graves' disease with exophthalmos (
C) is significant but not immediately life-threatening. Hypothyroidism with a request for a warm blanket (
D) indicates a stable symptom of feeling cold, which is less critical.
Question 3 of 5
A nurse is caring for a client who has hypokalemia, hyperglycemia, and hypertension. A diagnosis of Cushing syndrome is suspected.Which of the following tests would the nurse anticipate the health care provider will order to help confirm the diagnosis of Cushing syndrome?
Correct Answer: B
Rationale: The 24-hour cortisol urine study (
B) measures cortisol levels to confirm Cushing syndrome, characterized by excess cortisol. Radioactive iodine uptake (
A) is for thyroid disorders. ACTH stimulation test (
C) assesses adrenal insufficiency, not Cushing syndrome. Edrophonium test (
D) diagnoses myasthenia gravis, unrelated to Cushing syndrome.
Question 4 of 5
A client seen in the clinic with shortness of breath and fatigue is being evaluated for a possible diagnosis of heart failure. Which laboratory result will be the most useful for diagnosing heart failure?
Correct Answer: A
Rationale: BNP (
A) is the most specific marker for heart failure, elevated due to cardiac pressure and volume overload. Troponin I (
B) indicates myocardial infarction. BUN (
C) may be elevated in heart failure but is less specific. Platelet levels (
D) are unrelated to heart failure diagnosis.
Question 5 of 5
A client with a history of hypothyroidism has accidentally been taking double her prescribed dose of levothyroxine. Which assessment findings would the nurse expect due to an excess of this medication?
Correct Answer: B
Rationale: Excess levothyroxine causes hyperthyroid symptoms like nervousness and tachycardia (
B). Weight gain and lethargy (
A) indicate hypothyroidism. Facial puffiness and constipation (
C) are hypothyroid symptoms. Hypotension and cold intolerance (
D) are associated with hypothyroidism, not excess levothyroxine.