ATI LPN
ATI Medical Surgical Proctored Exam 2019 Quizlet Questions
Question 1 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 2 of 9
The healthcare provider is planning care for a non-potty-trained child with nephrotic syndrome. Which intervention provides the best means of determining fluid retention?
Correct Answer: A
Rationale: The correct answer is A: Weigh the child daily. Daily weight monitoring is the most accurate way to determine fluid retention in a child with nephrotic syndrome as it provides real-time data on fluid status. Weight gain is a key indicator of fluid retention in these patients. Observing lower extremities for pitting edema (B) is subjective and may not accurately reflect fluid status. Measuring abdominal girth weekly (C) may not provide timely information on fluid retention. Weighing wet diapers (D) does not give a comprehensive picture of total fluid retention and may not be as accurate as daily weight monitoring.
Question 3 of 9
The healthcare provider prescribes naproxen (Naprosyn) 500 mg PO twice a day for a client with osteoarthritis. During a follow-up visit one month later, the client tells the nurse, 'The pills don't seem to be working. They are not helping the pain at all.' Which factor should influence the nurse's response?
Correct Answer: D
Rationale: Step 1: NSAID response is variable - Different individuals respond differently to NSAIDs like naproxen due to genetic and physiological differences. Step 2: Trying another NSAID may be more effective - If the current NSAID is not effective, switching to a different one with a different mechanism of action may provide better pain relief. Step 3: Individualized approach - Tailoring the treatment to the individual's response is key in managing osteoarthritis pain effectively. Summary: Choice D is correct as it acknowledges the variability in NSAID response and suggests trying another NSAID if the current one is ineffective. Choices A, B, and C are incorrect as they do not address the variable response to NSAIDs and do not provide a solution to address the lack of pain relief.
Question 4 of 9
A client with schizophrenia is prescribed haloperidol (Haldol). The nurse should monitor the client for which potential side effect?
Correct Answer: A
Rationale: The correct answer is A: Tardive dyskinesia. Haloperidol is a first-generation antipsychotic known to cause extrapyramidal side effects, including tardive dyskinesia, which is characterized by involuntary repetitive movements of the face and body. This side effect is a serious concern due to its potential to be irreversible. Monitoring for tardive dyskinesia is crucial in clients taking haloperidol to detect and manage symptoms promptly. Explanation for incorrect choices: B: Orthostatic hypotension - This side effect is more commonly associated with other antipsychotic medications, particularly second-generation ones. C: Photosensitivity - Haloperidol does not typically cause photosensitivity as a side effect. D: Hyperglycemia - While some antipsychotic medications may lead to metabolic side effects like hyperglycemia, haloperidol is not typically associated with this specific side effect.
Question 5 of 9
During an admission physical assessment, the nurse is examining a newborn who is small for gestational age (SGA). Which finding should the nurse report immediately to the pediatric healthcare provider?
Correct Answer: C
Rationale: The correct answer is C: Widened, tense, bulging fontanel. This finding is concerning as it can indicate increased intracranial pressure, potentially leading to serious complications in a newborn. The fontanel should be flat or slightly depressed, not bulging. Immediate reporting is necessary for timely intervention. Incorrect choices: A: Heel stick glucose of 65 mg/dL is slightly low but not an immediate concern; can be managed with feeding. B: Head circumference of 35 cm is within the normal range for a newborn and does not require immediate action. D: High-pitched shrill cry can be a sign of distress but not as urgent as a bulging fontanel in this context.
Question 6 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.
Question 7 of 9
The mother of a 9-month-old who was diagnosed with respiratory syncytial virus (RSV) yesterday calls the clinic to inquire if it will be all right to take her infant to the first birthday party of a friend's child the following day. What response should the nurse provide this mother?
Correct Answer: D
Rationale: The correct answer is D: Do not expose other children. RSV is very contagious even without direct oral contact. Rationale: RSV is highly contagious and can spread through respiratory droplets, making it important to prevent exposing other children to the virus. Even without direct oral contact, the virus can be transmitted. Therefore, it is crucial to avoid putting other children at risk of contracting RSV. Summary of other choices: A: Wearing a mask may not be practical for an infant and may not provide sufficient protection against RSV transmission. B: RSV can still be contagious for several days after symptoms appear, so the child may still be able to spread the virus. C: While avoiding infants under 6 months can be a good precaution, all children should be protected from exposure to RSV due to its high contagiousness.
Question 8 of 9
A male client in the day room becomes increasingly angry and aggressive when denied a day-pass. Which action should the nurse implement?
Correct Answer: D
Rationale: The correct answer is D because instructing the client to sit down and be quiet is a non-confrontational and calming approach to de-escalate the situation. It helps redirect the client's focus and encourages self-regulation. Choice A may reinforce the aggressive behavior by rewarding it. Choice B (putting behavior on extinction) may escalate the situation further. Choice C (decreasing TV volume) does not address the client's behavior directly.
Question 9 of 9
A recently widowed middle-aged female client presents to the psychiatric clinic for evaluation and tells the nurse that she has 'little reason to live.' She describes one previous suicidal gesture and admits to having a gun in her home. To maintain the client's confidentiality and to help ensure her safety, which action is best for the nurse to implement?
Correct Answer: C
Rationale: The correct answer is C: Contact a person of the client's choosing to remove the weapon from the home. This option respects the client's autonomy and confidentiality while ensuring her safety. 1. Encouraging the client to remove the gun (Option A) may not guarantee immediate action and could potentially escalate the situation. 2. Notifying the client's healthcare provider (Option B) could breach confidentiality and may not result in immediate intervention. 3. Calling the police (Option D) could lead to a loss of trust and may not be necessary if the situation can be handled discreetly by someone the client trusts. Therefore, option C is the best course of action as it respects the client's autonomy, maintains confidentiality, and ensures prompt removal of the weapon to enhance the client's safety.