ATI LPN
PN Adult Medical Surgical 2023 Questions
Extract:
Question 1 of 5
A nurse is assisting with the plan of care for an older adult client who has a new prescription for transdermal clonidine. Which of the following information should the nurse include in the plan of care?
Correct Answer: A
Rationale: Dry mouth is a common side effect of clonidine; diarrhea and hypopigmentation aren't typical.
Question 2 of 5
A nurse is reinforcing teaching with a client about breast self-examinations. Which of the following statements by the client indicates an understanding of the teaching?
Correct Answer: D
Rationale: Asymmetry in breast size is normal; exams should be monthly, post-period, and dimpling is a concern.
Extract:
VITAL SIGNS
Day 1:
TEMPERATURE 36° C (96.8° F)
BLOOD PRESSURE 140/80 mm Hg
HEART RATE 98/min
RESPIRATORY RATE 24/min
OXYGEN SATURATION 97% on room air
Day 2, 0800:
TEMPERATURE 37° C (98.6° F)
BLOOD PRESSURE 122/60 mm Hg
HEART RATE 85/min
RESPIRATORY RATE 18/min
OXYGEN SATURATION 98% on room air
Day 2, 1600:
Findings
• Dyspnea
• Tingling sensation to right foot
• Increased pain at incision site
• Swelling at incision site
Acute compartment syndrome
• Dyspnea
• Tingling sensation to right foot
• Increased pain at incision site
• Swelling at incision site
Infection
• Dyspnea
• Tingling sensation to right foot
• Increased pain at incision site
• Swelling at incision site
Fat embolism syndrome
• Dyspnea
• Tingling sensation to right foot
• Increased pain at incision site
• Swelling at incision site
Question 3 of 5
A nurse is assisting in the care of a client who is postoperative following an open reduction internal fixation of the right tibia. Which finding is consistent with acute compartment syndrome?
Correct Answer: A, C
Rationale: Acute compartment syndrome post-ORIF arises from pressure buildup in muscle compartments, impairing perfusion. Increased pain at the incision site severe, unrelieved by analgesics, and disproportionate to the procedure is a hallmark, reflecting nerve and tissue ischemia. Dyspnea suggests fat embolism syndrome, a separate complication from marrow release, not compartment pressure. Tingling indicates nerve compression, a later sign, but pain precedes it in the 6 Ps (pain, pallor, pulselessness, paresthesia, paralysis, poikilothermia). Swelling occurs, but pain's intensity and persistence distinguish compartment syndrome from normal postoperative edema. Early recognition of escalating pain prompts fasciotomy, preventing necrosis, making it the most consistent finding per orthopedic emergency protocols.
Extract:
Question 4 of 5
A nurse is assisting in the care of a client who is postoperative following an open reduction internal fixation of the right tibia. The first action the nurse should take is to...
Correct Answer: A
Rationale: Post-ORIF, increased pain (Day 2, 1600) suggests compartment syndrome, a surgical emergency requiring immediate provider notification to evaluate for fasciotomy. Elevating the extremity at heart level balances perfusion without worsening pressure, unlike high elevation which reduces blood flow. Checking oxygen saturation and medicating pain address symptoms, not the cause pain here signals ischemia, not hypoxia. Assessing the incision (e.g., swelling) supports suspicion, but notification trumps delay; cold packs may mask signs. Monitoring vital signs is routine, but pain's acuity demands action over documentation. Prompt reporting aligns with the 6 Ps, prioritizing limb salvage, making it the critical first step.
Question 5 of 5
A nurse is reinforcing teaching with a client who is starting to take metformin extended release. Which of the following instructions should the nurse include in the instructions?
Correct Answer: A
Rationale: Metformin requires glucose monitoring to assess efficacy and prevent hypoglycemia; muscle pain isn't typical, it's taken with food to reduce GI upset, and it's not chewed.