ATI RN
ATI Med Surg Woolery Q5 Questions
Extract:
Question 1 of 5
A nurse is caring for a client who has a diagnosis of Cushing syndrome. After performing magnetic resonance imaging (MRI), the underlying cause of the condition is found to be an ectopic ACTH-secreting tumor on the liver. Which of the following lab results would the nurse anticipate with this condition?
Correct Answer: A
Rationale: Ectopic ACTH-secreting tumors cause elevated ACTH and cortisol (
A). Elevated ACTH with low cortisol (
B) is unlikely. Low ACTH with high cortisol (
C) suggests adrenal issues. Low ACTH and cortisol (
D) is inconsistent with Cushing syndrome.
Question 2 of 5
A client seen in the clinic with shortness of breath and fatigue is being evaluated for a possible diagnosis of heart failure. Which laboratory result will be the most useful for diagnosing heart failure?
Correct Answer: A
Rationale: BNP (
A) is the most specific marker for heart failure, elevated due to cardiac pressure and volume overload. Troponin I (
B) indicates myocardial infarction. BUN (
C) may be elevated in heart failure but is less specific. Platelet levels (
D) are unrelated to heart failure diagnosis.
Extract:
Nurses Notes
0900:
Client is a 78-year-old female who was brought to the hospital via ambulance. The client's neighbor called 911 after checking on the client and finding the client confused and complaining of weakness. The neighbor states that the client has had "a thyroid problem" for years, and that the client mentioned recently that she hadn't picked up her medications due to an inability afford them. The client is lethargic, oriented to person and year, but uncertain of place and situation. S1 & S2 heard on auscultation of heart. Lungs clear in all lobes. Breathing is slow and shallow. Initial lab results show low Free T4 and elevated TSH. Provider notified, awaiting orders.
Vital Signs
0900:
Temperature: 35.6° C (96.1° F)
Heart rate: 49/min
Respiratory rate: 10/min
Blood pressure: 102/53 mm Hg
Oxygen saturation: 94% on room air
Question 3 of 5
Select the 3 interventions that the nurse should anticipate for this client.
Correct Answer: B,C,G
Rationale: The client's symptoms and lab results (low Free T4, elevated TSH) indicate hypothyroidism. PTU (
A) is for hyperthyroidism, not hypothyroidism. Warm blankets (
B) address hypothermia (35.6°
C). Cardiac monitoring (
C) is needed due to bradycardia (heart rate 49/min). A high-calorie diet (
D) is for hyperthyroidism, not hypothyroidism. Propranolol (E) manages hyperthyroid symptoms like tachycardia, not applicable here. Acetaminophen (F) is for fever, not hypothermia. Levothyroxine (G) treats hypothyroidism by replacing thyroid hormone.
Extract:
Question 4 of 5
A client who takes daily hormone replacement therapy for Addison's disease is scheduled for an outpatient surgical procedure. Which of the following instructions should the nurse include when providing discharge education to the client?
Correct Answer: C
Rationale: Surgery is a stressor requiring increased corticosteroid doses (
C) in Addison's disease to prevent adrenal crisis. Limiting sodium (
A) is inappropriate as Addison's patients need sodium. Fluid restriction (
B) is unnecessary. Avoiding hydrocortisone (
D) risks adrenal crisis.
Question 5 of 5
A client with a history of hypothyroidism has accidentally been taking double her prescribed dose of levothyroxine. Which assessment findings would the nurse expect due to an excess of this medication?
Correct Answer: B
Rationale: Excess levothyroxine causes hyperthyroid symptoms like nervousness and tachycardia (
B). Weight gain and lethargy (
A) indicate hypothyroidism. Facial puffiness and constipation (
C) are hypothyroid symptoms. Hypotension and cold intolerance (
D) are associated with hypothyroidism, not excess levothyroxine.