ATI LPN
ATI PN Adult Medical Surgical 2023 III Questions
Extract:
Nurses Notes
Diagnostic Results
Medical History
Vital Signs
Provider’s Prescriptions
Over the past 2 months, the client has noticed a significant decrease in his ability to perform daily activities due to fatigue. He also reports a 24-hour history of fever, chills, and weakness. There is erythema around the arteriovenous fistula (AVF) site on his right arm. The client states, “I’ve been having difficulty breathing.” On examination, his breath sounds are clear. He reports no cough. Bowel sounds are active in all four quadrants. He reports no diarrhea and had his last bowel movement yesterday. The client also reports anuria.
A nurse in a provider’s office is caring for a 68-year-old male client who reports changes in activity tolerance, feeling tired all the time, and difficulty remembering things. The client also states they bruise easily.
Question 1 of 5
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, what actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.
Action to Take
Potential Condition
Parameter to Monitor
Correct Answer: D,E,F
Rationale: The client's symptoms of fever, chills, weakness, erythema around the AVF site, and anuria suggest sepsis, likely related to an infection at the fistula site. The nurse should administer IV fluids to maintain circulation and monitor oxygen saturation to ensure adequate oxygenation, addressing potential septic shock. Monitoring blood pressure and temperature assesses hemodynamic stability and infection control progress.
Extract:
Nurse’s Notes
Vital Signs
Diagnostic Results
1300hrs
The client appears restless and complains of feeling weak. He reports difficulty in breathing and has a persistent cough. His skin is cool and clammy to touch. He is oriented to time, place, and person but appears anxious.
At 1300hrs, a nurse is preparing to administer medications to a 68-year-old male client in the cardiac unit. The client’s medications include Furosemide 40 mg PO daily, Potassium chloride 10 mEq/L PO twice daily, Lisinopril 10 mg PO daily, NPH insulin 26 units SUBQ daily, and Atorvastatin 20 mg PO daily.
Question 2 of 5
Based on the findings above, complete the following sentence by using the list of options. The nurse should clarify the prescription for...... due to the client's.......
Correct Answer: A,F
Rationale: The client's cool, clammy skin, weakness, and respiratory distress suggest potential fluid overload or worsening cardiac status. Furosemide, a diuretic, should be clarified due to the client's condition, as it may exacerbate dehydration or hypotension if not carefully monitored.
Extract:
Nurse’s Notes at 0800hrs
Physical Examination Results
Vital Signs at 0800hrs
Provider’s Prescriptions
Diagnostic Results at 0800hrs
The client appears uncomfortable and restless. He is guarding his abdomen, which is distended and tympanic to percussion. His skin is warm and dry to touch, with no signs of jaundice. He continues to deny any tobacco use and admits to drinking 1 to 2 glasses of wine daily.
A nurse is caring for a 52-year-old male client in the emergency department. It’s now 0800hrs. The client reports worsening mid- abdominal pain, rating it as 8 on a scale of 0 to 10. He states, “I haven’t had a bowel movement in 5 days now.” He also mentions that he has vomited twice since the last assessment.
Question 3 of 5
For each finding, specify if the finding is consistent with small bowel obstruction or acute pancreatitis. Each finding may support more than one disease process.
| Options | Small Bowel Obstruction | Acute Pancreatitis |
|---|---|---|
| Abdominal Pain | ||
| No Bowel Movement for 5 days | ||
| Vomiting | ||
| Abdominal Distention | ||
| Increased Heart Rate | ||
| Elevated Temperature | ||
| Distention with fluid and gas in the small bowel (CT Scan) |
Correct Answer: A
Rationale: Abdominal pain is consistent with both small bowel obstruction (due to blockage) and acute pancreatitis (due to inflammation). However, the constellation of findings (no bowel movement, vomiting, distention) leans toward small bowel obstruction, confirmed by CT scan findings.
Extract:
Day 1, 1000
Day 1, 1100
Day 1, 1000 - Physical Exam
Day 1, 1030 - Diagnostic Results
• Blood pressure: 92/60 mm Hg
• Pulse: 106/min
• Temperature: 38.3 C (101F)
• Oxygen saturation: 95%
Question 4 of 5
The nurse is collecting data on the client. Which of the following findings require follow-up?
Correct Answer: A,B,C,F
Rationale: Blood pressure of 92/60 mm Hg (hypotension), elevated BUN, abdominal findings, and potassium levels require follow-up due to potential shock, renal dysfunction, or electrolyte imbalance, especially with fever and tachycardia.
Extract:
Nurse’s Notes
Vital Signs
Medical History
Provider’s Prescriptions
Physical Examination Results
The client reports that over the past 2 months they have noticed multiple changes with their body. They have a decrease in activity tolerance, feel tired all the time, and have had difficulty remembering things. The client also states they bruise easily, are experiencing constipation, and they no longer tolerate the cold like they used to. The client is concerned about exposure to seasonal viruses from other patrons. Reports that they are currently experiencing a headache with a pain of 3 on a scale of 0 to 10.
A nurse in a provider’s office is caring for a 68-year-old male client who reports changes in their health over the past 2 months. The client has been on medication for bipolar disorder and has been taking Lithium 300 mg PO three times daily, Levothyroxine 50 mcg PO daily, and Sumatriptan 25 mg PO PRN for migraine pain.
Question 5 of 5
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.
Action to Take
Potential Condition
Parameter to Monitor
Correct Answer: A,E,F
Rationale: Symptoms of fatigue, cold intolerance, constipation, and bruising suggest hypothyroidism. Monitoring constipation and reinforcing levothyroxine education address symptoms and adherence. Blood pressure and weight changes monitor thyroid function improvement.