ATI LPN
PN Adult Medical Surgical 2023 Questions
Extract:
Question 1 of 5
A nurse is reinforcing teaching with a female client who has a history of urinary tract infections. Which of the following instructions should the nurse include?
Correct Answer: B
Rationale: Urinating before and after sexual intercourse flushes bacteria from the urethra, a primary UTI prevention strategy, especially in women due to their shorter urethra. Milk consumption may alkalinize urine, but this doesn't prevent infection cranberry juice is more evidence-based, reducing bacterial adhesion. Vaginal douching disrupts normal flora, increasing UTI risk by promoting pathogen growth, contrary to hygiene goals. Emptying the bladder every 6 hours helps, but more frequent voiding (e.g., every 2-3 hours) is ideal; post-coital urination targets the key risk moment. This instruction empowers the client to reduce recurrence, aligns with urologic recommendations, and addresses a common trigger, making it the most effective teaching point.
Question 2 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.
Extract:
Exhibit 1 Exhibit 2 Exhibit 3 Exhibit 4
Medical History
Today, 0700:
Admitting Diagnosis: Heart Failure
Past medical history of heart failure, coronary artery disease, sleep apnea
Client reports diarrhea, dry mouth, and unusual thirst for the past three days
Question 3 of 5
A nurse is assisting in the care of a male client who has a new prescription for furosemide. Which of the following client findings should the nurse identify as a contraindication to the administration of furosemide?
Correct Answer: A
Rationale: Furosemide, a loop diuretic, treats heart failure but depletes potassium, risking hypokalemia. A low potassium level (e.g., <3.5 mEq/L) contraindicates its use hypokalemia causes arrhythmias, especially with heart failure's cardiac strain, per pharmacology standards. Blood pressure matters hypotension may worsen with diuresis but isn't a direct contraindication unless extreme. Digoxin use heightens hypokalemia risk (enhancing toxicity), but potassium level drives the decision. The client's report of diarrhea and thirst suggests dehydration, a caution, not a strict contraindication. Low potassium demands correction (e.g., supplements) before furosemide, preventing lethal complications like ventricular fibrillation, making it the critical finding to identify.
Extract:
Question 4 of 5
A nurse is preparing to administer medications to a female client. Which of the following medications is included in the Medication Administration Record?
Correct Answer: A
Rationale: The question tests medication record accuracy, with furosemide 40 mg PO daily listed as an option. It's a diuretic for heart failure (per Exhibit 4), matching the client's diagnosis, and is correctly formatted for administration. Potassium chloride addresses diuretic-induced losses, lisinopril manages hypertension, and NPH insulin treats diabetes, all plausible, but furosemide ties directly to the heart failure noted. Its inclusion ensures fluid overload is addressed, a primary concern, aligning with MAR standards right drug, dose, route, and frequency. This choice confirms the nurse's role in verifying orders, making it the appropriate medication to recognize.
Extract:
NURSES’ NOTES
1000:
Client reports that over the past 2 months they have noticed multiple changes with their body. They have a decrease in activity tolerance, feel tired all the time, and have had difficulty remembering things. The client also states they bruise easily, are experiencing constipation, and they no longer tolerate the cold like they used to.
Client states they are concerned about exposure to seasonal viruses from other patrons.
Reports that they are currently experiencing a headache with a pain of 3 on a scale of 0 to 10.
Actions to Take
• Limit caffeine intake.
• Observe the need to administer sumatriptan.
• Withhold lithium.
Potential Condition
• Influenza
• Lithium toxicity
• Migraine
Parameters to Monitor
• Flashing lights
• Blurred vision
• Chest pain
Question 5 of 5
A nurse in a provider's office is caring for a client who reports changes in their health over the past 2 months. What condition is the client most likely experiencing?
Correct Answer: D, A
Rationale: Symptoms like decreased activity tolerance, fatigue, memory issues, bruising, constipation, and cold intolerance over 2 months suggest hypothyroidism thyroid hormone deficiency slows metabolism, causing systemic effects. Influenza is acute, with fever and respiratory symptoms, not chronic fatigue or bruising. Lithium toxicity includes tremor or confusion, but not cold intolerance or constipation as primary signs. Migraine causes headaches (here, 3/10), but not multisystem changes like bruising or memory loss. Hypothyroidism fits the gradual onset and constellation fatigue from low energy, memory fog from cerebral hypoperfusion, and constipation from sluggish gut motility requiring thyroid function tests (e.g., TSH), making it the most likely condition.