ATI LPN
Adult Medical Surgical ATI Questions
Question 1 of 5
Which of the following statements is true about ischemic colitis?
Correct Answer: B
Rationale: The correct answer is B: Ischemic colitis affects the watershed areas of the colon, namely, the splenic flexure, right colon, and rectum. This is because these areas have relatively poor collateral blood supply, making them more susceptible to ischemia. Ischemic colitis typically presents with abdominal pain, bloody diarrhea, and tends to affect elderly patients with cardiovascular risk factors. Choice A is incorrect as most cases of ischemic colitis can be managed conservatively without the need for colonic resection. Choice C is incorrect as ischemic colitis can occur in individuals of any age group, although it is more common in the elderly. Choice D is incorrect because colonoscopic intervention is not always necessary for the diagnosis and management of ischemic colitis.
Question 2 of 5
An 82-year-old woman with no past medical history presents to your clinic complaining of arthritic symptoms. She is not taking any medications but needs something for her arthritis. You want to start her on a nonsteroidal anti-inflammatory drug (NSAID) but are concerned about her age and the risk of peptic ulcers. As she has to pay for her medications out-of-pocket and requests the most cost-effective option, what is the most appropriate treatment plan?
Correct Answer: A
Rationale: The correct answer is A: Prescribe an inexpensive NSAID alone. This option is the most appropriate because it balances the need for cost-effectiveness with the concern for peptic ulcers in an elderly patient. Starting with a simple NSAID reduces the risk of adverse effects and minimizes the financial burden on the patient. Option B adds misoprostol, which may help protect the stomach but increases the cost. Option C, prescribing celecoxib, is more expensive and carries a higher cardiovascular risk. Option D, adding sucralfate, does not have strong evidence for preventing NSAID-induced ulcers and adds unnecessary cost. Therefore, option A is the most suitable choice for this scenario.
Question 3 of 5
The patient described in the preceding questions has a positive H. pylori antibody blood test. She is compliant with the medical regimen you prescribe. Although her symptoms initially respond, she returns to see you six months later with the same symptoms. Which of the following statements is correct?
Correct Answer: C
Rationale: Step 1: The patient has a positive H. pylori antibody blood test, indicating exposure to the bacteria. Step 2: Compliance with medical regimen suggests treatment for H. pylori infection. Step 3: Persistence of symptoms after treatment indicates possible treatment failure. Step 4: The urease breath test is ideal for detecting treatment failure as it directly measures the presence of H. pylori. Step 5: Therefore, choice C is correct as it identifies the appropriate test for confirming eradication failure. Summary: - Choice A is incorrect as reinfection risk is not the immediate concern. - Choice B is incorrect as a positive serum IgG doesn't definitively indicate eradication failure. - Choice D is incorrect as not all dyspepsia cases improve with H. pylori eradication.
Question 4 of 5
A 56-year-old woman presents to discuss the results of her recent upper endoscopy. She was having some mild abdominal pain, so she underwent the procedure, which revealed an ulcer in the antrum of the stomach. Biopsy of the lesion revealed the presence of H. pylori. All of the following statements regarding her condition are correct except
Correct Answer: B
Rationale: The correct answer is B: Reinfection is rare despite adequate treatment. H. pylori reinfection can occur, especially in high-prevalence areas or due to poor hygiene. A: Correct - H. pylori is associated with gastric MALT lymphoma. C: Correct - Triple therapy (usually with a proton pump inhibitor, clarithromycin, and amoxicillin) is more effective than dual therapy. D: Correct - H. pylori IgG antibody titer can be used to assess treatment response. Reinfection is not rare and can happen, making option B incorrect.
Question 5 of 5
A 68-year-old man with a history of diabetes, hypertension, and coronary artery disease (s/p coronary artery bypass graft two years ago) presents to the emergency room with fevers and left-sided abdominal pain. His physical examination reveals a temperature of 101.5°F, pulse 96, and blood pressure of 135/80. His abdomen is soft with moderate left lower quadrant tenderness. There is no rebound or guarding. Bowel sounds are present. A CT scan is done which reveals inflammation around an area of the left colon. The next step in his workup/management should be
Correct Answer: A
Rationale: The correct answer is A: Antibiotic therapy with ciprofloxacin and metronidazole. This patient likely has diverticulitis given his age, comorbidities, symptoms, and imaging findings. Antibiotic therapy is the initial management for uncomplicated diverticulitis to cover for common pathogens. Surgical intervention is not indicated in the absence of complications like perforation or abscess. Urgent colonoscopy or barium enema are contraindicated during an acute episode of diverticulitis due to the risk of perforation. Antibiotic therapy aims to resolve the infection and prevent complications.