ATI LPN
ATI Adult Medical Surgical Questions
Question 1 of 9
A patient with hypertension is prescribed lisinopril. What side effect should the nurse monitor for?
Correct Answer: A
Rationale: The correct answer is A: Hyperkalemia. Lisinopril is an ACE inhibitor that can cause potassium retention, leading to hyperkalemia. Monitoring potassium levels is crucial to prevent serious complications like cardiac arrhythmias. Hypoglycemia (B) is not a common side effect of lisinopril. Bradycardia (C) and constipation (D) are also not typically associated with lisinopril use. Hyperkalemia is the most critical side effect to monitor in this case.
Question 2 of 9
A client with peptic ulcer disease is prescribed ranitidine (Zantac). Which statement by the client indicates the need for further teaching?
Correct Answer: C
Rationale: Rationale: C is the correct answer. Ranitidine is usually taken on an empty stomach to maximize its effectiveness in reducing stomach acid production. Therefore, taking it with meals would decrease its efficacy. A, B, and D are incorrect because taking ranitidine at bedtime is common practice, smoking can worsen ulcer symptoms, and ranitidine does indeed reduce stomach acid.
Question 3 of 9
While assessing a client with preeclampsia who is receiving magnesium sulfate, the nurse notes her deep tendon reflexes are 1+, respiratory rate is 12 breaths/minute, urinary output is 90 ml in 4 hours, and magnesium sulfate level is 9 mg/dl. What intervention should the nurse implement based on these findings?
Correct Answer: C
Rationale: The correct answer is C: Stop the magnesium sulfate infusion immediately. The client is showing signs of magnesium toxicity, as evidenced by decreased deep tendon reflexes, bradypnea (respiratory rate of 12 breaths/minute), oliguria (urinary output of 90 ml in 4 hours), and elevated magnesium sulfate level of 9 mg/dl. Stopping the infusion is crucial to prevent further complications such as respiratory depression, cardiac arrest, and central nervous system depression. Continuing the infusion (choice A) would worsen the toxicity. Decreasing the infusion (choice B) may not be sufficient to address the toxicity. Administering calcium gluconate (choice D) is not the immediate priority; stopping the magnesium sulfate infusion is essential to prevent further harm.
Question 4 of 9
What is an important teaching point for a patient prescribed dabigatran for atrial fibrillation?
Correct Answer: B
Rationale: Correct Answer: B Rationale: 1. Dabigatran is an anticoagulant medication that comes in capsules, which should not be crushed or chewed to maintain its extended-release formulation. 2. Crushing or chewing the capsules can lead to an increased risk of bleeding due to rapid release of the medication. 3. Therefore, advising the patient not to crush or chew the capsules is crucial to ensure the safety and efficacy of dabigatran therapy. Summary: A: Taking with food is not necessary for dabigatran absorption. C: Green leafy vegetables are high in vitamin K, which can interfere with anticoagulant therapy. D: There is no need to avoid all dairy products while taking dabigatran.
Question 5 of 9
The healthcare provider prescribes 15 mg/kg of Streptomycin for an infant weighing 4 pounds. The drug is diluted in 25 ml of D5W to run over 8 hours. How much Streptomycin will the infant receive?
Correct Answer: A
Rationale: To calculate the dose of Streptomycin, we first need to convert the infant's weight from pounds to kg (4 lbs = 1.81 kg). Then, we multiply the weight in kg by the prescribed dose (15 mg/kg) to get the total dose (1.81 kg * 15 mg/kg = 27.15 mg). Since the drug is diluted in 25 ml of D5W, the infant will receive 27.15 mg in 25 ml solution. To find how much Streptomycin the infant actually receives, we need to calculate the amount in 1 ml (27.15 mg / 25 ml = 1.086 mg/ml). Finally, to determine how much the infant will receive over 8 hours, we multiply the concentration by the infusion rate (1.086 mg/ml * 25 ml * 8 hours = 217.2 mg). Therefore, the correct answer is A: 9 mg, as it represents the amount
Question 6 of 9
A patient with atrial fibrillation is prescribed warfarin. Which laboratory test should the nurse monitor to assess the effectiveness of the medication?
Correct Answer: B
Rationale: The correct answer is B: Prothrombin time (PT)/INR. This is because warfarin is a medication that affects the clotting ability of the blood by inhibiting vitamin K-dependent clotting factors. PT/INR is the specific laboratory test used to monitor the effectiveness of warfarin therapy. PT measures how long it takes for blood to clot, while INR standardizes the PT results. Monitoring PT/INR helps to ensure that the patient is within the target therapeutic range for anticoagulation. Incorrect choices: A: Complete blood count (CBC) - CBC does not directly assess the effectiveness of warfarin therapy. C: Partial thromboplastin time (PTT) - PTT is used to monitor the effectiveness of heparin therapy, not warfarin. D: Serum potassium level - Monitoring serum potassium level is not directly related to assessing the effectiveness of warfarin therapy.
Question 7 of 9
A client's telemetry monitor indicates the sudden onset of ventricular fibrillation. Which assessment finding should the nurse anticipate?
Correct Answer: D
Rationale: The correct answer is D: No palpable pulse. Ventricular fibrillation is a life-threatening arrhythmia where the heart quivers and doesn't effectively pump blood. This results in the absence of a palpable pulse. The nurse should anticipate this finding as it indicates a severe cardiac emergency requiring immediate intervention. Choices A, B, and C are incorrect because ventricular fibrillation leads to ineffective heart contractions, causing a lack of pulse rather than bounding, irregular, or thready pulses. It is crucial for the nurse to recognize the absence of a palpable pulse to initiate prompt resuscitative measures.
Question 8 of 9
A client with a history of peptic ulcer disease is admitted with severe abdominal pain. Which assessment finding should the nurse report to the healthcare provider immediately?
Correct Answer: C
Rationale: The correct answer is C: Rigid, board-like abdomen. This finding suggests peritonitis, a serious complication of peptic ulcer disease, requiring immediate medical intervention. A: Active bowel sounds are expected. B: Blood pressure is within normal range. D: Heart rate is slightly elevated but not a critical finding. In summary, a rigid abdomen indicates peritonitis and requires urgent attention compared to the other choices.
Question 9 of 9
The nurse is administering sevelamer (RenaGel) during lunch to a client with end-stage renal disease (ESRD). The client asks the nurse to bring the medication later. The nurse should describe which action of RenaGel as an explanation for taking it with meals?
Correct Answer: B
Rationale: The correct answer is B. Sevelamer (RenaGel) is a phosphate binder used in ESRD to bind with phosphorus in foods, preventing its absorption in the gastrointestinal tract. This is important as ESRD patients often have high levels of phosphorus in their blood, which can lead to complications like cardiovascular disease. Taking RenaGel with meals ensures that it binds with phosphorus in the food, reducing its absorption. Choice A is incorrect as RenaGel does not prevent indigestion associated with spicy foods. Choice C is incorrect as RenaGel does not promote stomach emptying or prevent gastric reflux. Choice D is incorrect as RenaGel does not buffer hydrochloric acid or prevent gastric erosion.