ATI LPN
PN Adult Medical Surgical 2023 Questions
Extract:
Medication Administration Record
Ceftriaxone 2 gm IV BID
Acetaminophen 325 mg PO every 4 hr PRN fever over 39° C (102.2° F)
Guaifenesin 200 mg PO every 4 hr PRN cough
Diagnostic Results
Complete Blood Count:
Hemoglobin 15 g/dL (12 to 16 g/dL)
Hematocrit 45% (37% to 47%)
WBC count 15,000/mm* (5000 to 10,000/mm*)
Basic Metabolic Profile:
Creatinine 2.8 mg/dL (0.5 to 1.1 mg/di)
BUN 19 mg/dL (10 to 20 mg/dL)
Sputum Culture and Sensitivity:
Klebsiella pneumonia
Question 1 of 5
A nurse is reviewing the medical record of a client who has pneumonia. Which of the following information is the priority for the nurse report to the provider?
Correct Answer: B
Rationale: Elevated creatinine (2.8 mg/dL) indicates potential kidney injury, a priority over sputum (expected Klebsiella), WBC (infection), or temperature.
Extract:
Nurses' Notes Day 1: Client brought to the emergency department (ED) following a fall that occurred while downhill skiing. Client states they fell when turning to avoid hitting another skier. Client reports feeling a severe, sudden pain of right leg upon falling. Right leg was immobilized at the scene and client transported to the ED.
Client states they were wearing a helmet while skiing. Client reports no headache or loss of consciousness.
Client reports pain as 10 on a scale of 0 to 10 to the right lower leg just below the knee and is unable to bear weight.
Right proximal tibia ecchymotic and swollen below the knee. Area is painful to touch. Open area noted on skin with bone visible. Right knee appears displaced. Left pedal pulses 3+, foot warm with intact movement and sensation. Right pedal pulses 1+, foot cool to palpation with minimal movement and reduced sensation.
Question 2 of 5
The nurse is collecting data on the client. Which of the following findings require follow up? (Ski accident client)
Correct Answer: A,C,F,G
Rationale: Right leg swelling, weak pulses, pain, and X-ray (fracture) indicate urgent issues like compartment syndrome.
Extract:
Diagnostic Results
Day 1:
X-ray of right leg: open spiral tibial shaft fracture
Question 3 of 5
For each finding, click to specify if the finding is consistent with acute compartment syndrome, infection, and/or fat embolism syndrome. Finding: Dyspnea
| Findings | Acute compartment syndrome | Infection | Fat embolism syndrome |
|---|---|---|---|
| Dyspnea | |||
| Tingling sensation to right foot | |||
| Increased pain at incision site | |||
| Swelling at incision site |
Correct Answer:
Rationale: Dyspnea is a hallmark of fat embolism syndrome due to pulmonary involvement.
Extract:
Nurses Notes
Day 1:
Client brought to the emergency department (ED) following a fall that occurred while downhill skiing. Client states they fell when turning to avoid hitting another skier. Client reports feeling a severe, sudden pain of right leg upon falling. Right leg was immobilized at the scene and client transported to the ED.
Client states they were wearing a helmet while skiing. Client reports no headache or loss of consciousness.
Client reports pain as 10 on a scale of 0 to 10 to the right lower leg just below the knee and is unable to bear weight.
Right proximal tibia ecchymotic and swollen below the knee. Area is painful to touch. Open area noted on skin with bone visible. Right knee appears displaced. Left pedal pulses 3+, foot warm with intact movement and sensation. Right pedal pulses 1+, foot cool to palpation with minimal movement and reduced sensation.
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
The first action the nurse should take is to followed by (Postoperative tibia fixation)
Correct Answer: A,B
Rationale: Notifying the provider is urgent for complications like compartment syndrome, followed by elevation to reduce swelling.
Extract:
Nurses' Notes
Day 1:
Client brought to the emergency department (ED) following a fall that occurred while downhill skiing. Client states they fell when turning to avoid hitting another skier. Client reports feeling a severe, sudden pain of right leg upon falling. Right leg was immobilized at the scene and client transported to the ED.
Client states they were wearing a helmet while skiing. Client reports no headache or loss of consciousness.
Client reports pain as 10 on a scale of 0 to 10 to the right lower leg Just below the knee and is unable to bear weight.
Right proximal tibia ecchymotic and swollen below the knee. Area is painful to touch. Open area noted on skin with bone visible. Right knee appears displaced. Left pedal pulses 3+, foot warm with intact movement and sensation. Right pedal pulses 1+, foot cool to palpation with minimal movement and reduced sensation.
Diagnostic Results
Day 1:
X-ray of right leg: open spiral tibial shaft fracture
Question 5 of 5
For each potential provider's prescription, click to specify if the potential prescription is anticipated or contraindicated for the client. Prescription: Open the splint
| 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:
Rationale: Opening the splint relieves pressure in compartment syndrome.