ATI LPN
PN Adult Medical Surgical 2023 Questions
Extract:
Question 1 of 5
A nurse is reviewing the laboratory data of a client who is scheduled for a liver biopsy. Which of the following values should the nurse report to the provider?
Correct Answer: D
Rationale: Liver biopsy carries bleeding risk due to the organ's vascularity, so clotting ability is critical. Platelets at 60,000/mm³ are severely low (normal 150,000-400,000/mm³), increasing hemorrhage risk post-procedure. Bilirubin (1.0 mg/dL) and AST (34 units/L) are within normal limits, reflecting liver function but not bleeding tendency. Ammonia (55 mcg/dL) is normal, relevant to encephalopathy, not biopsy safety. Thrombocytopenia below 100,000/mm³ often prompts transfusion or delay per procedural protocols, as platelets are vital for hemostasis. Reporting this to the provider ensures risk assessment potentially canceling or modifying the biopsy prioritizing patient safety over proceeding with normal liver markers, making it the critical value to escalate.
Extract:
Exhibit 1 Exhibit 2 Exhibit 3 Exhibit 4 Exhibit 5
Diagnostic Results
1000:
Hct 24% (37% to 47%)
Hgb 8 g/dL (12 to 16 g/dL)
RBC count 3 x 10⁶ µL (4.2 to 5.4 x 10⁶ µL)
Ferritin 8 ng/mL (10 to 150 ng/mL)
WBC count 9,000/mm³ (5,000 to 10,000/mm³)
Platelet count 180,000/mm³ (150,000 to 400,000/mm³)
Vitamin B₁₂ 159 pg/mL (160 to 950 pg/mL)
1030:
Stool for fecal occult blood negative
Question 2 of 5
A nurse is assisting in the care of the client who has iron deficiency anemia. Which of the following instructions should the nurse include?
Correct Answer: C
Rationale: Iron deficiency anemia treatment hinges on maximizing iron absorption. Taking the medication with vitamin C enhances uptake ascorbic acid converts ferric to ferrous iron, boosting bioavailability in the acidic stomach environment, a cornerstone of anemia management. Antacids raise gastric pH, binding iron and reducing absorption, counterproductive to correcting deficiency. Increasing fiber mitigates constipation, a side effect of iron, but isn't the primary administration focus. Milk and dairy, high in calcium, inhibit iron absorption by competing for uptake sites, worsening anemia if paired with supplements. Vitamin C's synergistic effect backed by dietary guidelines optimizes therapy, especially critical with low ferritin (8 ng/mL, Exhibit 1), empowering the client to improve hemoglobin efficiently while minimizing common pitfalls, making it the essential instruction.
Extract:
Question 3 of 5
A nurse is preparing to perform a blood glucose test. After performing hand hygiene and donning gloves, in which order should the nurse perform the following actions to obtain a capillary blood sample?
Correct Answer: D,A,B,C,E
Rationale: The order is: Cleanse with antiseptic (
D), allow to dry (
A), pierce (
B), squeeze for blood (
C), and apply to strip (E) for an accurate, sterile sample.
Question 4 of 5
A nurse is reinforcing teaching about risk factors for colorectal cancer with a client. Which of the following risk factors should the nurse include in the teaching?
Correct Answer: B
Rationale: Colorectal cancer risk factors are well-documented, with family history being a major non-modifiable contributor due to genetic predisposition (e.g., Lynch syndrome). Physical inactivity increases risk by slowing bowel motility, allowing carcinogen exposure, but it's less definitive than genetics. A high-fiber diet reduces risk by promoting regular bowel movements, not increasing it, so it's incorrect here. Age over 50 is a strong risk factor as incidence rises with age, but family history often trumps it in teaching specificity due to its hereditary link. Emphasizing family history educates the client on screening needs (e.g., earlier colonoscopy), aligning with guidelines like those from the American Cancer Society. It's a critical, actionable factor, driving personalized prevention and surveillance, making it a standout choice for inclusion in teaching.
Question 5 of 5
A nurse in a long-term care facility is providing care for a client who has Alzheimer's disease and is agitated. Which of the following interventions should the nurse implement?
Correct Answer: A
Rationale: Trazodone, if prescribed, can calm agitation in Alzheimer's safely. Ambulation may help but isn't immediate, isolation can worsen agitation, and restraints are a last resort.