ATI LPN
ATI LPN Med Surg Exam 6 Questions
Extract:
Nurses notes
Patient is a 55-year-old with a history of hypertension managed by Lisinopril, recently completed a 3-day course of ciprofloxacin for a urinary tract infection prescribed one week ago. Patient reports persistent thirst, frequent urination, fatigue, and confusion over the past several days.
Assessment findings
• Respirations: Deep and labored (Kussmaul's respirations noted)
• Mental status: Altered, appears confused and lethargic
• Skin: Dry, warm to touch
• Mucous membranes: Dry
Vital signs
• Temperature: 99.0 °F (37.2 °C)
• Heart Rate: 118 bpm (tachycardia)
• Respiratory Rate: 28 breaths per minute
• Blood Pressure: 102/68 mmHg
• Oxygen Saturation: 96% on room air
Laboratory Results
• Serum Glucose: 800 mg/dL (reference range: 74-106 mg/dL)
• Serum Osmolality: 400 mOsm/kg (reference range: 285-295 mOsm/kg)
• Serum Ketones: Negative
• Arterial Blood Gas (ABG): pH 7.35 (normal range: 7.35-7.45)
• Bicarbonate (HCO3): 24 mEq/L (reference range: 22-26 mEq/L)
• Anion Gap: Normal
Provider Prescriptions
At-home prescriptions
Lisinopril 20 mg once daily by mouth for hypertension
1 week ago
Ciprofloxacin extended release 500 mg once daily by mouth for 3 days
Today
0.9% sodium chloride IV infusion at 200 mL/hr
Today, 0745;
Serum glucose 800 mg/dL (74 to 106 mg/dL)
Serum osmolality 400 mOsm/kg (285 to 295 mOsm/kg)
Question 1 of 5
A nurse is assisting in the care of a client in the emergency department 1 week after an appointment with the medical provider.
| Options | Diabetic Ketoacidosis (DKA) | Hyperosmolar Hyperglycemic Syndrome (HHS) |
|---|---|---|
| Polyuria/polydipsia | ||
| Heart rate | ||
| Respirations | ||
| Mental status | ||
| Serum glucose greater than 600mg/dl. Serum osmolality greater than 320 mOsm/kg | ||
| Insidious onset (days to weeks) | ||
| A,B,C,D,E,F,G |
Correct Answer: Polyuria/polydipsia, tachycardia, Kussmaul's respirations, altered mental status, high glucose/osmolality, insidious onset, and infection are consistent with both DKA and HHS, with Kussmaul's more specific to DKA and insidious onset to HHS.
Rationale:
Extract:
Question 2 of 5
A patient with a history of COPD Is being monitored for potential complications. Which of the following findings should the nurse report immediately as it may indicate the development of a complication?
Correct Answer: Sudden chest pain and dyspnea may indicate serious complications like pneumothorax or pulmonary embolism, requiring immediate intervention in COPD patients.
Rationale:
Question 3 of 5
The nurse is educating a patient with diabetes about long-term complications of the disease. Which of the following complications should the nurse include in the teaching?
Correct Answer: Diabetes significantly increases the risk of cardiovascular disease due to its association with atherosclerosis, hypertension, and dyslipidemia.
Rationale:
Question 4 of 5
The nurse is caring for a patient with a T-tube following gallbladder surgery. Which of the following is the most important nursing action?
Correct Answer: Monitoring T-tube drainage ensures proper biliary function and detects obstructions, which is critical post-gallbladder surgery.
Rationale:
Question 5 of 5
The nurse is providing discharge teaching to patient with infective endocarditis. Which of the following statements by the patient indicates a need for further teaching?
Correct Answer: Stopping antibiotics early risks incomplete treatment of infective endocarditis, indicating a need for further teaching.
Rationale: