ATI LPN
PN Adult Medical Surgical 2023 Questions
Extract:
Question 1 of 5
A nurse is preparing to administer filgrastim 6 mcg/kg subcutaneously to a client who weighs 110 lb. Available is filgrastim solution for injection 480 mcg/0.8 mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
Correct Answer: C
Rationale:
To calculate the correct dose, convert the client's weight from pounds to kilograms (110 lb ÷ 2.2 = 50 kg). Filgrastim is dosed at 6 mcg/kg, so 6 mcg/kg × 50 kg = 300 mcg needed. The available concentration is 480 mcg in 0.8 mL. Set up the proportion: (300 mcg ÷ 480 mcg) × 0.8 mL = 0.5 mL. Option A (0.3 mL) underdoses at 180 mcg, Option B (0.4 mL) gives 240 mcg, and Option D (0.6 mL) overdoses at 360 mcg. Option C (0.5 mL) delivers exactly 300 mcg, matching the prescribed dose. Rounding to the nearest tenth, 0.5 mL is correct with no trailing zero, adhering to medication safety standards. This calculation ensures therapeutic efficacy (e.g., boosting white blood cells) while minimizing risks like overdose-related bone pain or underdose-related infection susceptibility, making C the precise and safe choice.
Extract:
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.
Question 2 of 5
For each potential provider's prescription, click to specify if the potential prescription is anticipated, nonessential, or contraindicated for the client. Prescription: Administer an iron supplement.
| Potential Prescription | Anticipated | Nonessential | Contraindicated |
|---|---|---|---|
| Administer an iron supplement | |||
| Collaborate with a nutritional consultant. | |||
| Place the client on a low sodium diet. | |||
| Restrict fluid Intake. |
Correct Answer:
Rationale: Low Hct, Hgb, and ferritin indicate iron deficiency anemia, making iron supplementation anticipated.
Extract:
Question 3 of 5
A nurse is collecting admission history data from a client who is in a semi-private room. Which of the following data is the priority for the nurse to address?
Correct Answer: B
Rationale: Recent tuberculosis exposure is a public health priority it's contagious via airborne droplets, risking spread in a semi-private room. Immediate isolation and testing (e.g., PPD, chest X-ray) protect the client, roommate, and staff, per CDC guidelines. Anxiety disorder affects mental health but isn't acutely transmissible or life-threatening here. Migraines cause discomfort, not immediate danger, manageable with later intervention. Nocturia disrupts sleep and may signal underlying issues, but it's less urgent than infection control. TB exposure triggers rapid response respiratory isolation, contact tracing due to its morbidity (e.g., pulmonary damage) and outbreak potential, making it the top priority to address on admission.
Question 4 of 5
A nurse is reinforcing teaching with a client who has a prescription for sublingual nitroglycerin for unstable angina. Which of the following instructions should the nurse include in the instructions?
Correct Answer: B
Rationale: Taking a second dose after 5 minutes for unrelieved pain is standard protocol for nitroglycerin, which is taken sublingually, not swallowed, and stored at room temperature, refilled every 6 months.
Question 5 of 5
A nurse is reinforcing teaching with a client who is newly diagnosed with dumping syndrome. Which of the following instructions should the nurse include in the teaching?
Correct Answer: D
Rationale: Dumping syndrome occurs post-gastric surgery when food moves too quickly into the small intestine, causing nausea, diarrhea, and weakness. Eliminating simple sugars is key sugars draw fluid into the gut, worsening osmotic shifts and symptoms. Remaining upright helps slow gastric emptying but isn't the primary dietary fix. Eating three large meals overloads the stomach, triggering rapid dumping, whereas small, frequent meals are recommended. Drinking water with meals dilutes stomach contents, accelerating emptying and exacerbating symptoms; fluids should be taken between meals. Cutting simple sugars (e.g., candy, soda) reduces hyperosmolarity, stabilizes digestion, and aligns with evidence-based management, improving quality of life. This instruction empowers the client to control symptoms through diet, a cornerstone of dumping syndrome care, making it the most effective teaching point.