ATI LPN
ATI LPN Med Surg Level 3 II Questions
Extract:
Question 1 of 5
A nurse is reviewing the prescriptions for a newly admitted client who is to undergo cardiac testing. For which of the following procedures should the nurse verify that the client has given written informed consent?
Correct Answer: D
Rationale: A nuclear stress test is invasive, involving radioactive substances and stress induction, requiring written informed consent.
Question 2 of 5
A nurse is planning care for a group of clients on a medical-surgical unit. Which of the following actions should the nurse take first?
Correct Answer: B
Rationale: Unilateral calf pain may indicate deep vein thrombosis (DVT), a potentially life-threatening condition requiring immediate assessment to prevent pulmonary embolism.
Extract:
Medical History
Client has a history of left-sided heart failure, hypertension, chronic atrial fibrillation with controlled rate, coronary artery disease (coronary bypass surgery 5 years ago).
Client was admitted to hospital directly from provider office visit. Reports increasing weakness and shortness of breath with minimal exertion.
Diagnostic Results
Basic Metabolic Profile (BMP):
Glucose 148 mg/dL (200 mg/dL)
BUN 18 mg/dL (10 to 20 mg/dL)
Creatinine 0.94 mg/dL (0.05 to 1.3 mg/dL)
Sodium 142 mEq/L (136 to 145 mEq/L)
Potassium 4.4 mEq/L (3.5 to 5 mEq/L)
Chloride 100 mEq/L (98 to 106 mEq/L)
Calcium 9.6 mg/dL (9 to 10.5 mg/dL)
Phosphorus 4,2 mg/dL (3 to 4.5 mg/dL)
Cardiac Enzyme Laboratory Report:
TROPONIN T 0.06 ng/mL (less than 0.1 ng/mL)
TROPONIN 10.1 ng/mL (less than 0.3 ng/mL)
B-natriuretic peptide (BNP) 800 ng/mL (less than 100 ng/mL)
ECG Report: Atrial fibrillation, rate 135/min
Chest x-ray Report: Cardiomegaly with bilateral pleural chest effusions indicative of heart failure.
Nurses Notes
Physical Assessment:
Neurological: Client is alert, oriented x 3. Follows simple commands, responds to questions appropriately, moves all extremities well.
Cardiac: Heart rate is elevated at 138 beats/min, irregular rhythm. Pulses to lower extremities irregular and weak. Telemetry monitor showing atrial fib with rapid ventricular response (RVR). Client denies chest pain or discomfort.
Respiratory: Respirations at 28/min, O2 saturation 93% on 2 L via nasal cannula. Frequent cough noted with pink-tinged sputum. Client denies shortness of breath at this time.
Gastrointestinal: Bowel sounds active x 4 quadrants. States last bowel movement this morning with no irregularities.
Genitourinary: States no problems voiding. Urine clear, yellow.
Vital Signs
Temperature 37.2° C (98.9° F)
Heart rate 138/min
Respiratory rate 28/min
Blood pressure 96/75 mm Hg
O2 saturation 93% on 2 L/min via nasal cannula
Question 3 of 5
A nurse is assisting with the admission of a client who has a history of heart failure. Which of the following findings require immediate follow-up by the nurse? Select all that apply.
Correct Answer: B,D,E,F,G
Rationale: Vital signs (elevated heart and respiratory rates, low BP) indicate instability. Elevated troponin (10.1 ng/mL) suggests myocardial injury. High BNP (800 ng/mL) confirms worsening heart failure. Respiratory findings (pink-tinged sputum, high respiratory rate) suggest pulmonary congestion. ECG showing atrial fibrillation with RVR (135/min) requires rate control to prevent complications.
Extract:
Question 4 of 5
A nurse is preparing to administer morning insulin to a client who has a prescription for 14 units of regular insulin and 28 units of NPH insulin subcutaneous daily. What is the total number of units of insulin that the nurse should prepare in the insulin syringe?
Correct Answer: A
Rationale: Adding 14 units (regular) and 28 units (NPH) gives a total of 42 units, which can be combined in one syringe.
Question 5 of 5
A nurse is reinforcing teaching with a client about following a low-cholesterol diet after coronary artery bypass grafting. Which of the following food choices reflects the client's understanding of these dietary instructions?
Correct Answer: B
Rationale: Beans are low in cholesterol and high in fiber, making them ideal for a low-cholesterol diet post-CABG.