ATI LPN
ATI PN Adult Medical Surgical 2019 Questions
Question 1 of 5
A client with Addison's disease is being treated with fludrocortisone (Florinef). Which electrolyte imbalance should the nurse monitor for?
Correct Answer: C
Rationale: The correct answer is C: Hypernatremia. Fludrocortisone is a mineralocorticoid that promotes sodium retention and potassium excretion, leading to an increase in sodium levels. Addison's disease involves low levels of cortisol and aldosterone, so fludrocortisone is used to replace aldosterone. Monitoring for hypernatremia is crucial to prevent complications like hypertension and fluid retention. Hyperkalemia (A) is not expected due to the drug's potassium-excreting effect. Hyponatremia (B) is unlikely as the drug promotes sodium retention. Hypocalcemia (D) is not directly related to fludrocortisone therapy.
Question 2 of 5
The healthcare provider is assessing a client with Raynaud's phenomenon. Which finding should the healthcare provider expect?
Correct Answer: C
Rationale: The correct answer is C: Episodes of cyanosis and pallor in the fingers. Raynaud's phenomenon is characterized by vasospasms of small arteries, leading to reduced blood flow and color changes in the digits. Cyanosis (bluish discoloration) and pallor (pale color) are common during episodes. Thickened and hardened skin (A) is associated with scleroderma. Painless ulcers on the fingertips (B) are seen in advanced stages of systemic sclerosis. Red, scaly patches on the hands (D) are indicative of psoriasis, not Raynaud's phenomenon.
Question 3 of 5
A client with a history of asthma is prescribed salmeterol (Serevent). Which instruction should the nurse provide?
Correct Answer: C
Rationale: The correct instruction is C: Use this medication twice daily for long-term control. Salmeterol is a long-acting beta-agonist used for maintenance therapy in asthma to provide long-term control of symptoms and prevent exacerbations. It should not be used for acute asthma attacks as it does not provide quick relief like rescue inhalers such as albuterol (choice A). It is not meant to replace albuterol, so it should not be used before using albuterol (choice B). Using salmeterol as needed for wheezing (choice D) is not appropriate as it is a maintenance medication and not a rescue medication.
Question 4 of 5
A client with a history of chronic alcohol use is admitted with confusion and an unsteady gait. Which deficiency should the nurse suspect?
Correct Answer: A
Rationale: The correct answer is A: Thiamine (Vitamin B1). Chronic alcohol use can lead to thiamine deficiency, causing neurological symptoms like confusion and unsteady gait (Wernicke's encephalopathy). Thiamine is crucial for brain function and alcohol interferes with its absorption. Vitamin B12 (choice B) deficiency can also cause neurological symptoms but is less likely in this case. Folic acid (choice C) deficiency can lead to anemia and neural tube defects, not directly related to the symptoms described. Vitamin D (choice D) deficiency typically presents with bone pain and muscle weakness, not confusion and gait issues.
Question 5 of 5
A client is scheduled for a colonoscopy. Which instruction should the nurse provide?
Correct Answer: B
Rationale: The correct answer is B because drinking a bowel preparation solution helps clear the colon for better visualization during the colonoscopy. This step is crucial to ensure accuracy of the procedure. Choice A is incorrect as the client should have a clear liquid diet the day before the procedure. Choice C is incorrect as hydration is important, but clear liquids are allowed. Choice D is incorrect because blood thinners may need to be adjusted prior to the procedure to reduce bleeding risk.