ATI LPN
Adult Medical Surgical ATI Questions
Question 1 of 5
A client in acute renal failure has a serum potassium level of 6.3 mEq/L. What intervention can the nurse expect the healthcare provider to prescribe?
Correct Answer: C
Rationale: The correct answer is C: Kayexalate retention enema. In acute renal failure with high serum potassium levels, the priority is to lower potassium levels to prevent cardiac complications. Kayexalate works by exchanging sodium ions for potassium ions in the intestines, promoting potassium excretion in the feces. This intervention helps reduce serum potassium levels quickly. A: Nitrofurantoin is an antibiotic used to treat urinary tract infections, unrelated to managing hyperkalemia. B: Erythropoietin is a hormone used to stimulate red blood cell production, not indicated for reducing potassium levels. D: Azathioprine is an immunosuppressant used for various conditions like autoimmune diseases, not for managing hyperkalemia. In summary, the correct intervention is to administer a Kayexalate retention enema to lower serum potassium levels effectively in acute renal failure. Other options are not appropriate for managing hyperkalemia.
Question 2 of 5
A 32-year-old woman presents with a 10-month history of an intermittent burning sensation in the epigastrium that is sometimes related to eating. She has heard about bacteria that can cause gastrointestinal (GI) symptoms. She has had no change in her weight and denies dysphagia. Her laboratory tests are normal. Which of the following would you recommend?
Correct Answer: A
Rationale: Rationale: 1. Given the symptoms of epigastric burning, testing for H. pylori is appropriate as it is a common cause of such symptoms. 2. The serum qualitative test for H. pylori can detect the presence of the bacteria in the patient's system. 3. If positive, treatment for H. pylori (such as antibiotics) would be indicated. 4. Referral for endoscopy or upper GI series is not the initial step as they are more invasive and costly. Summary: - A: Correct, as it targets the potential cause of the symptoms. - B: Not recommended initially, as it is more invasive and not necessary as the first step. - C: Not recommended initially, as it is less specific for H. pylori detection. - D: Premature without confirming the presence of H. pylori.
Question 3 of 5
The patient described in the preceding question has a positive H. pylori antibody blood test. She is compliant with the medical regimen you prescribe. Although her symptoms initially respond, she returns to see you six months later with the same symptoms. Which of the following statements is correct?
Correct Answer: C
Rationale: The correct answer is C because the urease breath test is the ideal test to document failure of H. pylori eradication. This test directly measures the presence of the H. pylori bacterium in the stomach by detecting the enzyme urease produced by the bacterium. If the patient still has symptoms after treatment, a positive urease breath test would indicate that the bacterium is still present, leading to treatment failure. Choice A is incorrect because a positive antibody test does not indicate low risk for reinfection. Choice B is incorrect because a positive serum IgG may persist even after successful eradication. Choice D is incorrect because dyspepsia can improve after successful H. pylori eradication rather than worsen.
Question 4 of 5
An otherwise healthy 45-year-old man presents with severe hematochezia and moderate abdominal cramping since this morning. A barium enema one year ago was normal. On examination, his blood pressure is 120/78 and pulse is 100 while lying; when standing, the blood pressure is 110/76 and pulse is 136. His hematocrit is 34. What is the most likely cause of bleeding?
Correct Answer: B
Rationale: The most likely cause of bleeding in this case is a duodenal ulcer (Choice B). The key clues are severe hematochezia, moderate abdominal cramping, normal barium enema a year ago, and orthostatic changes in blood pressure and pulse. Severe hematochezia suggests a significant upper gastrointestinal bleed. Normal barium enema rules out lower GI sources. Orthostatic changes in blood pressure and pulse are indicative of acute blood loss. Duodenal ulcers are a common cause of upper GI bleeding and can present with hematochezia. In contrast, diverticular bleeds (Choice A) typically present with painless rectal bleeding, inflammatory bowel disease (Choice C) often presents with chronic blood loss and anemia, and vascular ectasia (Choice D) typically causes chronic, slow bleeding.
Question 5 of 5
A 56-year-old woman with rheumatoid arthritis has severe joint pain and swelling in her hands. She has a history of peptic ulcer disease five years ago but presently has no GI symptoms. You elect to start her on an NSAID. Which of the following is correct?
Correct Answer: B
Rationale: Step 1: Misoprostol is a prostaglandin analog that helps protect the gastric mucosa by increasing mucus production. This mechanism of action makes it effective in preventing NSAID-related GI toxicity. Step 2: H2-blockers (Choice A) and PPIs are not as effective as misoprostol in preventing NSAID-related GI toxicity. Step 3: Sucralfate (Choice C) is not as effective as misoprostol in preventing NSAID-related GI toxicity due to its different mechanism of action. Step 4: H. pylori infection (Choice D) can increase the risk of NSAID-induced ulcers but is not directly related to the prophylactic treatment with misoprostol.