ATI RN
Adult Health Med Surg Nursing Test Banks Questions
Question 1 of 5
A patient with chronic kidney disease is prescribed erythropoietin-stimulating agents (ESAs) to manage anemia. Which laboratory parameter should be monitored closely during ESA therapy?
Correct Answer: C
Rationale: Erythropoietin-stimulating agents (ESAs) are prescribed to manage anemia in patients with chronic kidney disease. Monitoring the hemoglobin level closely during ESA therapy is crucial to ensure that the treatment is effective in increasing red blood cell production without causing excessive elevation. Hemoglobin levels should be checked regularly to adjust the ESA dosage accordingly and prevent risks associated with high hematocrit levels, such as increasing blood viscosity and cardiovascular events. Monitoring serum potassium, creatinine, and platelet count are important in the management of chronic kidney disease for different reasons, but for ESA therapy, monitoring hemoglobin is the most essential parameter.
Question 2 of 5
A patient with a history of stroke is at risk for impaired skin integrity due to immobility. Which nursing intervention is most effective in preventing pressure ulcers in this patient?
Correct Answer: A
Rationale: Turning and repositioning the patient every 2 hours is the most effective nursing intervention in preventing pressure ulcers in a patient with a history of stroke and immobility. Pressure ulcers, also known as bedsores, are caused by prolonged pressure on the skin, leading to reduced blood flow and tissue damage. By regularly turning and repositioning the patient, pressure is relieved from specific areas of the body, helping to prevent the development of pressure ulcers. This intervention helps to redistribute pressure, improve blood flow, and reduce the risk of skin breakdown, thus promoting skin integrity in immobile patients.
Question 3 of 5
A patient with a history of chronic obstructive pulmonary disease (COPD) is prescribed prednisone for an acute exacerbation. Which instruction is important for the nurse to include in patient education about prednisone therapy?
Correct Answer: B
Rationale: It is crucial for patients with COPD who are prescribed prednisone to be educated about the importance of not abruptly stopping the medication. Prednisone is a type of corticosteroid that should be tapered off gradually under the guidance of a healthcare provider to prevent potential withdrawal symptoms and adrenal insufficiency. Suddenly stopping prednisone can lead to serious adverse effects, including fatigue, weakness, joint pain, fever, dizziness, and potentially life-threatening complications. Therefore, adherence to the prescribed tapering schedule is essential to ensure the safe and effective management of COPD exacerbations with prednisone therapy.
Question 4 of 5
A patient with a history of coronary artery disease is scheduled for coronary artery bypass graft (CABG) surgery. Which preoperative nursing intervention is essential for preparing the patient for surgery?
Correct Answer: C
Rationale: Preoperative nursing intervention that is essential for preparing a patient with a history of coronary artery disease for coronary artery bypass graft (CABG) surgery is assisting the patient with deep breathing and coughing exercises. These exercises are crucial to prevent postoperative complications such as atelectasis and pneumonia, which are common risks after surgery. Deep breathing exercises help to expand the lungs and improve ventilation, while coughing exercises help to clear secretions and prevent respiratory complications. By assisting the patient with these exercises preoperatively, the nurse can help optimize the patient's respiratory function and decrease the risk of complications during and after surgery. Administering aspirin, providing education about pain management, and obtaining informed consent are also important aspects of preoperative care, but assisting with deep breathing and coughing exercises is particularly essential for patients undergoing CABG surgery due to the increased risk of respiratory complications in this population.
Question 5 of 5
A patient is prescribed a nonsteroidal anti-inflammatory drug (NSAID) for the management of pain. Which adverse effect should the nurse monitor closely in the patient?
Correct Answer: C
Rationale: NSAIDs are commonly known to increase the risk of gastrointestinal adverse effects, including gastritis, ulcers, and gastrointestinal bleeding. This risk is due to the inhibition of prostaglandin synthesis, which plays a protective role in the gastrointestinal mucosa. Gastrointestinal bleeding can manifest as symptoms such as black, tarry stools, vomiting blood, or abdominal pain. Therefore, it is crucial for the nurse to closely monitor the patient for signs and symptoms of gastrointestinal bleeding while taking NSAIDs to prevent potentially serious complications. Hypotension, hyperkalemia, and hyperglycemia are not commonly associated with NSAIDs use, making them less likely adverse effects to monitor for in this scenario.