ATI LPN
ATI Medical Surgical Proctored Exam 2019 Quizlet Questions
Question 1 of 9
A client receiving total parenteral nutrition (TPN) through a central line suddenly develops dyspnea, chest pain, and a drop in blood pressure. What should the nurse do first?
Correct Answer: C
Rationale: The correct answer is C: Place the client in Trendelenburg position. This is the first action to take in a client with suspected air embolism, a potential complication of central line insertion. Placing the client in Trendelenburg position with the head down and the legs elevated can help prevent air from reaching the heart and lungs. This action can help stabilize the client's condition before further interventions can be implemented. Stopping the TPN infusion (choice A) can be important, but the priority in this situation is to address the potential air embolism. Notifying the healthcare provider (choice B) can be done after the immediate intervention. Administering oxygen (choice D) is important, but placing the client in Trendelenburg position takes precedence in this emergency situation.
Question 2 of 9
The client with a history of heart failure is taking furosemide (Lasix). Which laboratory result should the nurse monitor closely?
Correct Answer: B
Rationale: The correct answer is B: Serum potassium. Furosemide is a loop diuretic that can cause potassium loss, leading to hypokalemia. Hypokalemia can exacerbate cardiac arrhythmias in patients with heart failure. Monitoring serum potassium levels is crucial to prevent complications. Incorrect choices: A: Serum sodium - Furosemide may cause hyponatremia, but it is less critical compared to hypokalemia in a client with heart failure. C: Serum calcium - Furosemide does not directly affect calcium levels significantly in most cases. D: Serum magnesium - While furosemide can cause hypomagnesemia, monitoring potassium is more essential in this scenario due to its impact on cardiac function.
Question 3 of 9
A healthcare professional is interested in studying the incidence of infant death in a particular city and wants to compare that city's rate to the state's rate. What state resource is most likely to provide this information?
Correct Answer: C
Rationale: The correct answer is C: Bureau of Vital Statistics. The Bureau of Vital Statistics is responsible for maintaining records on births, deaths, and other vital events in a particular region. Therefore, it is the most likely state resource to provide information on infant death rates. Disease registry (A) typically focuses on specific diseases rather than overall mortality rates. Department of Health (B) may have some data but may not specifically focus on vital statistics. Census data (D) provides population demographics but does not specifically track infant death rates.
Question 4 of 9
A client with a history of diabetes mellitus is admitted with a foot ulcer. The nurse should recognize that which intervention is most critical in promoting healing of the foot ulcer?
Correct Answer: A
Rationale: Correct Answer: A Rationale: 1. Strict control of blood glucose levels is critical in promoting healing of foot ulcers in diabetic patients. 2. High blood glucose levels can impair wound healing by affecting circulation and immune response. 3. Maintaining normal glucose levels helps optimize tissue repair and prevent further complications. 4. Regular dressing changes (B) are important but not as critical as controlling blood glucose levels. 5. Application of antibiotic ointment (C) may be necessary for infected ulcers, but not the most critical intervention. 6. Hydrotherapy treatment (D) can help with wound cleansing, but it is not as essential as controlling blood glucose levels.
Question 5 of 9
An elderly client with congestive heart failure (CHF) is admitted to the hospital. Which laboratory test result should the nurse expect to find?
Correct Answer: C
Rationale: The correct answer is C, increased serum creatinine level. In CHF, the heart's reduced pumping ability can lead to decreased blood flow to the kidneys, resulting in impaired kidney function. This can cause an elevation in serum creatinine level, indicating decreased kidney function. Elevated serum sodium level (A) is not typically seen in CHF, as patients often have fluid retention leading to dilutional hyponatremia. Decreased BNP level (B) is not expected in CHF, as BNP is released in response to increased ventricular stretching and volume overload. Elevated hemoglobin and hematocrit levels (D) are not directly related to CHF; they may be seen in conditions like dehydration or chronic hypoxia, but not specifically in CHF.
Question 6 of 9
An elderly male client reports to the clinic nurse that he is experiencing increasing nocturia with difficulty initiating his urine stream. He reports a weak urine flow and frequent dribbling after voiding. Which nursing action should be implemented?
Correct Answer: B
Rationale: The correct answer is B: Encourage the client to schedule a digital rectal exam. This option is correct because the client's symptoms of nocturia, weak urine flow, and difficulty initiating urine stream suggest potential prostate issues, such as benign prostatic hyperplasia (BPH). A digital rectal exam can help assess the size and condition of the prostate gland. It is an essential step in diagnosing BPH or other prostate conditions. Other choices are incorrect because: A: Obtaining a urine specimen for culture and sensitivity is not the priority in this case, as the client's symptoms are more indicative of a prostate issue rather than a urinary tract infection. C: Maintaining a voiding diary may provide information on the frequency and volume of urine output, but it does not address the underlying cause of the client's symptoms. D: Instructing the client in cleansing techniques for the glans penis is not relevant to the reported symptoms and does not address the potential prostate issue.
Question 7 of 9
The client has received 250 ml of 0.9% normal saline through the IV line in the last hour. The client is now tachypneic and has a pulse rate of 120 beats/minute, with a pulse volume of +4. In addition to reporting the assessment findings to the healthcare provider, what action should the nurse implement?
Correct Answer: B
Rationale: The correct answer is B: Decrease the saline to a keep-open rate. The client is showing signs of fluid overload, indicated by tachypnea and bounding pulse. By decreasing the saline to a keep-open rate, the nurse can prevent further fluid overload while maintaining IV access. Discontinuing the IV and applying pressure (choice A) is not necessary unless there is a specific issue with the IV site. Increasing the rate of the current IV solution (choice C) would worsen the fluid overload. Changing the IV fluid to 0.45% normal saline (choice D) at the same rate may not effectively address the fluid overload concern.
Question 8 of 9
A client who has Type 1 diabetes and is at 10-weeks gestation comes to the prenatal clinic complaining of a headache, nausea, sweating, feeling shaky, and being tired all the time. What action should the nurse take first?
Correct Answer: A
Rationale: The correct answer is A: Check the blood glucose level. This is the first action the nurse should take because the client is presenting with symptoms of hypoglycemia, which can be life-threatening for a pregnant woman with Type 1 diabetes. By checking the blood glucose level, the nurse can determine if the client's symptoms are due to low blood sugar levels and take appropriate action. Drawing blood for a Hemoglobin A1C (choice B) is not the first priority in this acute situation. Assessing urine for ketone levels (choice C) is important in managing diabetes but is not the priority when the client is showing signs of hypoglycemia. Providing the client with a protein snack (choice D) may help raise blood sugar levels, but checking the blood glucose level is essential to determine the appropriate intervention.
Question 9 of 9
A 62-year-old male client with a history of coronary artery disease complains that his heart is 'racing' and he often feels dizzy. His blood pressure is 110/60, and he uses portable oxygen at 2 liters per nasal cannula. Based on the rhythm shown, which prescription should the nurse administer?
Correct Answer: C
Rationale: The correct answer is C: Administer IV adenosine (Adenocard). Rationale: 1. The ECG rhythm shows regular narrow complex tachycardia, likely supraventricular tachycardia (SVT). 2. Adenosine is the first-line medication for terminating SVT by blocking conduction through the AV node. 3. Adenosine is given rapidly as a bolus dose followed by a saline flush to ensure quick delivery to the heart. 4. Adenosine has a very short half-life, making it safe to use in this scenario. Summary: A: Magnesium is not the first-line treatment for SVT. B: Heparin is not indicated for the management of SVT. D: Synchronized cardioversion is reserved for unstable patients with hemodynamic compromise, not indicated for stable SVT.