ATI RN
ATI Med Surg N241 Exam Questions
Extract:
Question 1 of 5
A client with cirrhosis is scheduled to receive a third dose of lactulose (Cephulac) at 1800. Which current finding would cause the nurse to question administering this medication?
Correct Answer: D
Rationale: Breath with fecal odor could indicate hepatic encephalopathy, for which lactulose is indicated. Increasing confusion is a symptom of hepatic encephalopathy suggests a need for lactulose. Elevated ammonia levels indicate hepatic encephalopathy hence the need for lactulose. If the client already has diarrhea, additional doses of lactulose (which acts as a laxative) could exacerbate this condition and might need to be adjusted or halted based on clinical judgment.
Question 2 of 5
A client with cirrhosis is scheduled to receive a third dose of lactulose (Cephulac) at 1800. Which current finding would cause the nurse to question administering this medication?
Correct Answer: D
Rationale: Breath with fecal odor could indicate hepatic encephalopathy, for which lactulose is indicated. Increasing confusion is a symptom of hepatic encephalopathy suggests a need for lactulose. Elevated ammonia levels indicate hepatic encephalopathy hence the need for lactulose. If the client already has diarrhea, additional doses of lactulose (which acts as a laxative) could exacerbate this condition and might need to be adjusted or halted based on clinical judgment.
Question 3 of 5
The nurse is preparing to administer spironolactone (Aldactone) and furosemide (Lasix) at 0900 to a client diagnosed with ascites. Review of 0600 laboratory results shows serum sodium 130 mEq/L (136-145 mEq/L) and potassium 3.1 mEq/L (3.5-5.0 mEq/L). Which action should the nurse take first?
Correct Answer: D
Rationale: Requesting a dietary consult is useful but not the most immediate action needed. Ordering a 2 gram sodium restriction diet is important but not addressing the immediate issue of electrolyte imbalance. Fluid restriction may be considered but not before addressing the electrolyte issues. Holding the spironolactone and furosemide is the correct action, as administering these could exacerbate the existing hypokalemia and hyponatremia, increasing the risk of adverse effects.
Question 4 of 5
A client with a history of chronic pancreatitis reports weight loss of 10 pounds over the last month and foul smelling stools. What would be a priority action for the nurse to take?
Correct Answer: D
Rationale: While reviewing the diet history is important to understand nutritional intake and habits, it is not the priority action in this case. Consulting a dietitian is important but should follow an assessment that identifies the specific issue causing the symptoms. This action may be necessary if the patient is dehydrated but doesn’t address the primary concern of foul-smelling stools and weight loss. This test is crucial as it helps confirm the diagnosis of malabsorption, which is likely given the patient’s history of chronic pancreatitis and symptoms described. This would be the priority to confirm the cause of the symptoms.
Question 5 of 5
The nurse is admitting a client with liver disease who presents with dyspnea, weight gain and abdominal distention. Which order would the nurse anticipate?
Correct Answer: B
Rationale: Monitoring blood glucose is more relevant for diabetic care. A sodium diet is appropriate for managing fluid retention associated with liver disease. Bedrest may be prescribed but not as specific to the management of fluid retention. Insertion of an indwelling urinary catheter is not a standard intervention without additional justification.