ATI LPN
ATI PN Adult Medical Surgical 2019 Questions
Question 1 of 9
The healthcare provider is assessing a client with chronic obstructive pulmonary disease (COPD). Which finding should the provider expect?
Correct Answer: A
Rationale: The correct answer is A: Increased anteroposterior chest diameter. In COPD, the chronic airway obstruction leads to air trapping, causing the chest to become hyperinflated. This results in an increase in the anteroposterior chest diameter, often referred to as "barrel chest." Explanation for why other choices are incorrect: B: Decreased respiratory rate is not typically seen in COPD; patients often exhibit an increased respiratory rate due to difficulty breathing. C: Dull percussion sounds over the lungs are associated with conditions like pneumonia or pleural effusion, not COPD. D: Hyperresonance on chest percussion is typically found in conditions like emphysema, a type of COPD, but it is not specific to COPD as a whole.
Question 2 of 9
A client with chronic kidney disease (CKD) is experiencing hyperkalemia. Which intervention should the nurse implement to address this condition?
Correct Answer: A
Rationale: The correct answer is A: Administer calcium gluconate. Calcium gluconate is used to stabilize the cardiac membrane in hyperkalemia, preventing dangerous cardiac arrhythmias. It does not lower potassium levels but helps protect the heart. B: Encouraging a diet high in potassium would worsen hyperkalemia. C: Providing potassium supplements would further elevate potassium levels. D: Restricting sodium intake does not directly address hyperkalemia.
Question 3 of 9
A client with a history of chronic heart failure is experiencing severe shortness of breath and has pink, frothy sputum. Which action should the nurse take first?
Correct Answer: B
Rationale: The correct action for the nurse to take first is to place the client in a high Fowler's position (Choice B). This position helps improve lung expansion and oxygenation by reducing pressure on the diaphragm and improving ventilation. With severe shortness of breath and pink, frothy sputum, the priority is to optimize respiratory function. Administering morphine sulfate (Choice A) may be indicated later for pain and anxiety but is not the immediate priority. Initiating continuous ECG monitoring (Choice C) is important but not as urgent as addressing the respiratory distress. Preparing the client for intubation (Choice D) should be considered if respiratory distress worsens, but initial interventions should focus on improving oxygenation through positioning.
Question 4 of 9
A client with chronic renal failure is scheduled to receive epoetin alfa (Epogen). Which laboratory result should the nurse review before administering the medication?
Correct Answer: C
Rationale: The correct answer is C: Hemoglobin level. In chronic renal failure, the kidneys may not produce enough erythropoietin, leading to anemia. Epoetin alfa stimulates red blood cell production. Therefore, reviewing the hemoglobin level is crucial to determine the need for the medication. Incorrect choices: A: Blood urea nitrogen (BUN) and B: Creatinine clearance are indicators of kidney function but not directly related to monitoring the effectiveness of epoetin alfa. D: Serum potassium is important in renal failure but not specifically needed to review before administering epoetin alfa.
Question 5 of 9
During the initial assessment of a client with a history of substance abuse admitted for detoxification, which intervention is most important?
Correct Answer: C
Rationale: The correct answer is C: Evaluate the client's physical health status. This is crucial during detoxification as substance withdrawal can lead to serious physical health complications such as seizures or cardiac issues. Assessing physical health status allows for prompt intervention if needed. Obtaining a detailed substance use history (A) can provide valuable information but is not immediate priority during initial assessment. Establishing a trusting nurse-client relationship (B) is important but ensuring physical safety comes first. Determining client's readiness for change (D) is important for long-term treatment planning but not as urgent as assessing physical health status.
Question 6 of 9
A client with a history of hypertension is prescribed hydrochlorothiazide. Which instruction should the nurse include in the client's teaching?
Correct Answer: C
Rationale: The correct answer is C: "Monitor your blood pressure regularly." This instruction is crucial for a client with hypertension prescribed hydrochlorothiazide because the medication helps lower blood pressure. By monitoring their blood pressure regularly, the client can track the effectiveness of the medication and ensure it is within the target range. This allows for early detection of any potential issues or the need for medication adjustments. Option A is incorrect because while it is generally recommended to take hydrochlorothiazide in the morning, it is not the most critical instruction for this scenario. Option B is incorrect as hydrochlorothiazide can cause hypokalemia, so avoiding high potassium foods is not necessary. Option D is also important but not as crucial as monitoring blood pressure, as reducing high-sodium foods can help manage hypertension but is not specific to hydrochlorothiazide.
Question 7 of 9
A client with type 2 diabetes mellitus presents to the clinic with a foot ulcer. Which instruction should the nurse provide to the client to promote healing of the ulcer?
Correct Answer: C
Rationale: The correct answer is C: Keep the ulcer clean and dry. This instruction is essential for promoting healing of the foot ulcer in a client with type 2 diabetes mellitus. Keeping the ulcer clean helps prevent infection, while keeping it dry promotes a better environment for healing. A: Applying a heating pad can increase the risk of burns and should be avoided. B: Wearing tight-fitting shoes can cause further damage and hinder healing. D: Limiting walking may reduce pressure on the ulcer, but mobility is important for circulation and overall health. Keeping the ulcer clean and dry is the most critical instruction.
Question 8 of 9
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 9 of 9
A client with chronic pain is prescribed a fentanyl (Duragesic) patch. Which instruction should the nurse provide to the client?
Correct Answer: A
Rationale: The correct answer is A. Applying the fentanyl patch to a clean, dry, and hairless area of the skin ensures proper absorption and effectiveness. Moisture, oils, and hair can interfere with absorption. Option B is incorrect as heating pads can increase drug absorption and lead to overdose. Option C is incorrect because fentanyl patches are usually changed every 72 hours, not daily. Option D is incorrect because rotating application sites helps prevent skin irritation and tolerance development.