ATI RN
ATI Med Surg N241 Exam Questions
Extract:
Question 1 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 2 of 5
While assessing the client with acute pancreatitis the nurse notes the following: skin warm and dry with inelastic turgor, hypoactive bowel sounds, nausea and vomiting for 24 hours, and amber-colored urine. Which action would the nurse take next?
Correct Answer: B
Rationale: Monitoring intake and output (I&O) is crucial for understanding the patient's fluid balance, especially after 24 hours of vomiting, which could lead to dehydration. However, it is important for fluid balance but not the immediate next step. Checking blood pressure can provide immediate information on the patient's hemodynamic status and potential hypovolemia due to fluid loss; thus, it should be assessed immediately. Assessing pain level is important for comfort, but stabilization of vital signs takes precedence. Measuring oxygen saturation is useful but less critical than assessing for potential hypotension due to dehydration.
Question 3 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 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 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.