ATI RN
ATI Med Surg N241 Exam Questions
Extract:
Question 1 of 5
A client with cirrhosis has the following current assessment data: jaundice, decreased appetite, hemoglobin 15 g/dL (14-18 g/dL) and PT of 20.6 seconds (11-12.5 sec). What does the nurse identify as the priority problem for this client?
Correct Answer: A
Rationale: Cirrhosis can lead to coagulopathy due to impaired synthesis of clotting factors by the liver, putting the client at high risk for bleeding. While clients with cirrhosis may experience fatigue, it is not the priority problem indicated by the assessment data provided. Decreased appetite and jaundice may affect nutritional status, but they do not pose an immediate threat compared to the risk of bleeding. Jaundice can lead to pruritus and increased risk of skin breakdown, but it is not the priority problem indicated by the assessment data provided.
Question 2 of 5
A nurse is admitting a client who has acute pancreatitis. Which of the following provider prescriptions should the nurse anticipate?
Correct Answer: C
Rationale: Pancrelipase may be prescribed to aid in digestion in chronic pancreatitis but is not typically used in the acute phase. While ambulation may be encouraged as tolerated, it is not a specific prescription for acute pancreatitis. Pantoprazole, **C**. Pantoprazole, a proton pump inhibitor, is often prescribed in acute pancreatitis to reduce gastric acid secretion, thereby reducing pancreatic stimulation and promoting healing. In acute pancreatitis, dietary intake is typically restricted initially, often starting with nothing by mouth (NPO) and progressing to a clear liquid diet as tolerated; a low-residue diet is usually introduced at a later stage.
Question 3 of 5
The nurse should evaluate results of which laboratory tests while caring for a client who has cirrhosis of the liver? Select all that apply.
Correct Answer: A,B,C
Rationale: PT is prolonged in cirrhosis due to impaired synthesis of clotting factors by the liver, making it important to monitor for bleeding risk. Serum albumin levels decrease in cirrhosis due to impaired liver function, reflecting the client's nutritional status and liver synthetic function. Elevated serum ammonia levels can indicate hepatic encephalopathy, a complication of cirrhosis characterized by altered mental status. Troponin is not typically evaluated in cirrhosis assessment; it is a cardiac marker used to assess for myocardial infarction. Serum lipase is not typically evaluated in cirrhosis assessment; it is a pancreatic enzyme used to diagnose pancreatitis.
Question 4 of 5
What does the nurse identify as a potential complication of chronic pancreatitis?
Correct Answer: A
Rationale: Chronic damage to the pancreas can lead to diabetes mellitus due to the destruction of insulin-producing cells. Jaundice is typically associated with liver disease, not directly linked with chronic pancreatitis. Ascites is a complication of liver disease, not typically a direct result of chronic pancreatitis. While steatorrhea is a symptom of chronic pancreatitis due to malabsorption of fats, it is not a complication but rather a direct effect of the enzyme insufficiency.
Question 5 of 5
The nurse is preparing a client presentation regarding pancrelipase (Viokase) therapy. Which information would the nurse include in the teaching session?
Correct Answer: A
Rationale: Pancrelipase is an enzyme replacement therapy used to aid in the digestion of fats, proteins, and carbohydrates, and its use may lead to steatorrhea (fatty stools) as a common side effect. Pancrelipase is typically administered with meals or snacks to aid in digestion; there is no need to administer it prior to antacids. Pancrelipase is taken with meals or snacks to assist in digestion, so this statement is incorrect. There is no need to rinse the mouth after taking pancrelipase; it is a medication designed for oral ingestion.