ATI LPN
PN Adult Medical Surgical 2023 Questions
Extract:
Question 1 of 5
A nurse is caring for a client who is 3 days postoperative following an ileostomy placement. Which of the following findings should the nurse report to the provider?
Correct Answer: A
Rationale: A retracted stoma is a complication requiring intervention; cherry red is normal, scant blood and dark green stool are expected early post-op.
Question 2 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 3 of 5
A nurse is reinforcing teaching with an older adult client who is postoperative following a transurethral resection of the prostate. Which of the following statements should the nurse include in the teaching?
Correct Answer: B
Rationale: Post-transurethral resection of the prostate (TURP), teaching focuses on healing and preventing complications like bleeding or infection. Waiting 6 weeks before resuming sexual intercourse allows the prostatic fossa to heal, reducing risks of hemorrhage or irritation, a standard guideline post-TURP. Ibuprofen, an NSAID, increases bleeding risk by inhibiting platelet function, contraindicated with fresh surgical sites. Tub bathing with a catheter risks introducing bacteria into the urinary tract, so showers are preferred until removal. Driving after 1 week may be premature recovery varies, and catheter presence or pain could impair safety; typically, 2-4 weeks is advised. The 6-week sexual abstinence instruction aligns with urologic care protocols, promotes safe recovery, and addresses a common patient concern, making it the most appropriate teaching point to ensure long-term outcomes and minimize rehospitalization.
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
Question 4 of 5
A nurse is assisting in the plan of care for the client who has compartment syndrome. Which potential prescription is anticipated?
Potential Prescription | Anticipated | Contraindicated |
---|---|---|
Open the splint | ||
Obtain a urinalysis | ||
Place the client on NPO status | ||
Place the client's right leg in a dependent position |
Correct Answer: A, D
Rationale: Compartment syndrome requires relieving pressure to restore perfusion. Opening the splint (or cast) reduces external compression, an anticipated step pre-fasciotomy if tightness contributes to ischemia, per orthopedic protocols. Urinalysis checks for myoglobinuria from muscle breakdown, a diagnostic aid, but not immediate relief. NPO status prepares for surgery, a later consideration after pressure relief. A dependent leg position increases venous pooling, worsening swelling and pressure contraindicated here. Opening the splint directly addresses the mechanical cause, buying time for surgical evaluation, aligning with emergency management (e.g., AAOS guidelines), making it the expected prescription to prioritize limb viability.
Extract:
Question 5 of 5
A nurse is reinforcing dietary teaching with an older adult client who has an increased LDL level. Which of the following foods should the nurse encourage the client to limit?
Correct Answer: B
Rationale: Swiss cheese is high in saturated fat, raising LDL; canola oil, avocados, and walnuts are heart-healthy.