ATI LPN
Adult Medical Surgical ATI Questions
Question 1 of 5
Which regimen is most effective for treating H. pylori infection?
Correct Answer: C
Rationale: The correct answer is C - Metronidazole, lansoprazole, and clarithromycin for 14 days. This regimen includes a proton pump inhibitor (lansoprazole) to reduce stomach acid, clarithromycin to kill the bacteria, and metronidazole as an alternative antibiotic. This combination therapy is recommended by guidelines as it targets H. pylori effectively, reducing the risk of resistance. Choice A is incorrect as bismuth subsalicylate is not included in the recommended regimen. Choice B is incorrect because omeprazole is not the preferred proton pump inhibitor, and using clarithromycin alone can lead to resistance. Choice D is incorrect as the duration of treatment is insufficient for eradication. Overall, choice C is the most effective option based on current guidelines and best practices for treating H. pylori infection.
Question 2 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 3 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 4 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.
Question 5 of 5
In a 45-year-old woman with a history of arthritis experiencing severe heartburn and indigestion refractory to antacids, which findings on an esophageal manometry study are consistent with her diagnosis?
Correct Answer: C
Rationale: The correct answer is C: Absent peristalsis and decreased LES pressure. In a patient with severe heartburn and indigestion refractory to antacids, these findings are consistent with achalasia, a motility disorder characterized by impaired esophageal peristalsis and decreased LES pressure. Absent peristalsis leads to poor esophageal clearance and retention of food, causing symptoms like heartburn. Decreased LES pressure results in inadequate closure of the LES, leading to reflux of gastric contents into the esophagus. Choices A, B, and D are incorrect because they do not match the typical findings seen in achalasia. Vigorous peristalsis and elevated LES pressure are not consistent with achalasia, while absent peristalsis with increased LES pressure is not a common presentation.