ATI LPN
PN Adult Medical Surgical 2023 Questions
Extract:
Question 1 of 5
A nurse is collecting data from an older adult client. Which of the following findings should indicate to the nurse that the client has a bladder infection?
Correct Answer: C
Rationale: Bladder infections (UTIs) in older adults often present atypically, with mental status changes like confusion being a hallmark due to systemic inflammation or bacteremia. WBC count of 9,000/mm³ is normal, not clearly indicating infection unless trending up; leukocytosis (e.g., >10,000) is more specific. Temperature of 37.3°C is a low-grade fever, possible but not definitive for UTI without other signs. Diminished reflexes relate to neurologic or age-related issues, not infection. Altered mental status, however, is a red flag older adults may lack classic UTI symptoms (e.g., dysuria), and confusion signals potential sepsis or delirium, per geriatric assessment guidelines. This finding warrants urgent reporting for urinalysis and treatment, preventing progression, making it the strongest indicator of a bladder infection.
Question 2 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.
Question 3 of 5
A nurse in a long-term care facility is assisting with the plan of care for a client who has late-stage Alzheimer's disease. Which of the following actions should the nurse include in the plan of care?
Correct Answer: A
Rationale: Late-stage Alzheimer's impairs mobility and cognition, increasing pressure ulcer risk from prolonged immobility. Turning the client every 2 hours redistributes pressure, maintains skin integrity, and aligns with evidence-based prevention (e.g., Braden Scale interventions). A mirror for reality orientation is ineffective late-stage patients lack recognition, and it may cause distress. Written instructions are useless due to severe cognitive decline; simplified, hands-on guidance is better for tasks like oral hygiene. Open-ended questions frustrate clients unable to process or respond, whereas yes/no prompts suit their capacity. Regular repositioning addresses a physical priority, prevents costly complications like infections or surgery, and supports dignity in care, making it the essential action for this vulnerable population.
Question 4 of 5
A nurse is collecting data from a female client who is postmenopausal. Which of the following findings should the nurse identify as a risk factor for the development of osteoporosis?
Correct Answer: B
Rationale: Osteoporosis risk rises postmenopause due to estrogen loss, but long-term prednisone use accelerates bone loss by inhibiting osteoblast activity and calcium absorption, a well-established glucocorticoid effect. Congenital heart murmur affects circulation, not bone density, unless activity is severely limited, which isn't implied. Vitamin Bâ‚â‚‚ injections treat deficiency, indirectly supporting bone health via red cell production, not increasing risk. Kidney stones relate to calcium metabolism but don't directly cause osteoporosis unless chronic disease alters bone remodeling, an uncommon link here. Prednisone's impact is direct, dose-dependent, and significant often warranting bisphosphonates making it the standout risk factor to identify, per osteoporosis screening guidelines (e.g., NOF), for preventive planning.
Question 5 of 5
A nurse is reviewing vital signs obtained by an assistive personnel on a group of clients. The previous vital signs for each of the clients were obtained 4 hr earlier. Which of the following changes should the nurse identify as the priority finding?
Correct Answer: C
Rationale: Using the ABCs, blood pressure dropping from 118/78 to 86/50 mm Hg signals potential shock or hypoperfusion, a circulation emergency requiring immediate assessment. Heart rate falling from 110 to 68 could reflect recovery (e.g., post-tachycardia) or bradycardia, but without symptoms, it's less urgent. Respiratory rate rising from 12 to 20 suggests compensation or distress, but circulation trumps breathing in acuity here. Temperature jumping to 38.8°C indicates fever, possibly infection, but hemodynamic instability is more immediately life-threatening. A systolic drop to 86 mm Hg risks organ perfusion, aligning with triage priorities hypotension could stem from bleeding, dehydration, or sepsis, needing rapid provider notification. This finding drives urgent intervention, making it the nurse's top concern.