ATI LPN
PN Adult Medical Surgical 2023 Questions
Extract:
Question 1 of 5
A nurse is assisting in the care of the client who is postoperative following a fasciotomy. The nurse is reviewing the client's electronic medical record (EMR). Which of the following statements in the EMR indicate the client's condition is improving since implementing interventions?
Correct Answer: C
Rationale: Fasciotomy relieves compartment syndrome pressure, so improvement hinges on limb perfusion and wound stability. Right leg warm to touch with a dry, intact dressing indicates good circulation and no excessive bleeding or infection key recovery signs post-fasciotomy. Pain at 4/10 may suggest improvement if previously higher, but it's subjective and less specific without baseline comparison. Clear breath sounds are reassuring but unrelated to the surgical site unless pulmonary complications were a concern, not implied here. Small serosanguinous drainage is normal initially, but small' alone doesn't confirm progress without prior volume context. Warmth and a stable dressing directly reflect surgical success restored blood flow and wound healing making it the strongest EMR indicator of improvement, per postoperative assessment priorities.
Extract:
• Exhibit 1 Exhibit 2 Exhibit 3
• History and Physical
• 1000:
• Client reports generalized weakness and increased fatigue over the past few months.
Client states they become short of breath after climbing a flight of stairs and are having difficulty keeping up with their grandchildren.
History of rheumatoid arthritis. Reports taking naproxen 500 mg twice a day.
Client reports they follow a vegan diet.
Denies pain or discomfort.
Bilateral breath sounds clear and present throughout.
Mucous membranes pale.
Apical pulse rapid, regular.
• For each finding, click to specify if the finding is consistent with sickle cell disease, iron deficiency anemia, and/or pernicious anemia. Each finding may support more than 1 disease process.
Question 2 of 5
A nurse in a provider's office is assisting in the care of a client. For each finding, click to specify if the finding is consistent with sickle cell disease, iron deficiency anemia, and/or pernicious anemia. Which finding is most consistent with iron deficiency anemia?
| Findings | Sicklecell Disease | Iron Deficiency Anemia | PerniciousAnemia |
|---|---|---|---|
| Ferritin level | |||
| Fatigue | |||
| Vitamin B level | |||
| Orthostatic hypotension |
Correct Answer: A
Rationale: Iron deficiency anemia stems from low iron, reducing hemoglobin synthesis, while sickle cell disease involves abnormal hemoglobin shape, and pernicious anemia results from Bâ‚â‚‚ malabsorption. Ferritin, the iron storage protein, is low in iron deficiency (e.g., <15 ng/mL), directly reflecting depleted reserves, as seen in the vegan client with fatigue and pale mucous membranes from Exhibit 1. Fatigue occurs across all three conditions nonspecific due to reduced oxygen delivery but isn't unique. Vitamin Bâ‚â‚‚ levels drop in pernicious anemia, not iron deficiency, unless dual deficiency exists, which isn't suggested. Orthostatic hypotension could arise in severe anemia from hypovolemia, but it's not specific to iron deficiency over others. Low ferritin aligns with iron deficiency's pathophysiology, distinguishing it from sickle cell's vaso-occlusion or pernicious anemia's megaloblastic changes, making it the most consistent finding per diagnostic criteria.
Extract:
Question 3 of 5
A nurse in a provider's office is assisting in the care of a client. Complete the following sentence: The first action the nurse should take is to reinforce education about...
Correct Answer: A
Rationale: The client's generalized weakness, fatigue, shortness of breath, and pale mucous membranes (Exhibit 1) with a vegan diet suggest anemia, likely iron deficiency. Reinforcing education about nutritional supplements (e.g., iron, Bâ‚â‚‚) addresses potential deficiencies vegans risk low iron and Bâ‚â‚‚ without fortified foods while collecting intake data identifies dietary gaps, guiding tailored therapy. Increasing fluids and monitoring respiration might help hydration or respiratory distress, but anemia is the primary issue, not fluid status. Checking blood pressure (132/60 to 102/50 mm Hg) shows orthostasis, a symptom, not the cause oxygen isn't indicated with 94% saturation. Assessing fatigue is ongoing, but a chest X-ray targets lungs, not anemia. Education and data collection tackle the root nutritional cause, aligning with holistic care and prevention, making it the nurse's first action.
Question 4 of 5
A nurse in a provider's office is assisting in the care of a client. For each potential provider's prescription, which is anticipated for the client?
Correct Answer: A
Rationale: Given the client's vegan diet, fatigue, weakness, pale mucous membranes, and rapid pulse (Exhibit 1), iron deficiency anemia is likely. Administering an iron supplement is anticipated it corrects low hemoglobin, a common vegan shortfall without meat or fortified sources, directly addressing the suspected etiology. Nutritional consultation helps long-term, but immediate supplementation is urgent for symptom relief and oxygen delivery. A low-sodium diet suits heart failure or hypertension, not anemia blood pressure (132/60 to 102/50 mm Hg) reflects orthostasis, not sodium issues. Fluid restriction applies to fluid overload, not here, where hydration supports circulation. Iron supplementation aligns with anemia management guidelines (e.g., ferrous sulfate), offering rapid hematologic improvement, making it the expected prescription for this presentation.
Question 5 of 5
A nurse is assisting in the care of the client who has iron deficiency anemia. Which of the following statements indicate the client understands the instructions?
Correct Answer: B
Rationale: Iron supplements oxidize in the gut, often turning stools black due to unabsorbed iron a normal, expected effect clients should recognize to avoid alarm. Green leafy vegetables (e.g., spinach) boost dietary iron, but oxalates limit absorption, making this less indicative of supplement-specific teaching. Swelling in feet isn't a typical iron effect edema suggests heart or kidney issues, not anemia treatment. Taking iron 1 hour before meals aids absorption, a good practice, but the question emphasizes understanding therapy outcomes. Black stools confirm the client grasps a common, visible side effect, aligning with education goals (e.g., managing expectations), ensuring adherence and reducing unnecessary worry, making it the clearest sign of comprehension.