ATI LPN
PN Adult Medical Surgical 2023 Questions
Extract:
Question 1 of 5
A nurse is reviewing the results of a client's fecal occult blood screening test. Which of the following findings from the client's history should the nurse identify as potentially causing a false-positive result?
Correct Answer: B
Rationale: Fecal occult blood tests detect hidden blood in stool, often for colorectal cancer screening, but false positives can skew results. Ibuprofen, an NSAID, irritates the gastric mucosa, causing microbleeding that may appear in stool, unrelated to colonic sources. Citrus juice doesn't affect heme detection vitamin C may cause false negatives, not positives, and 3 days prior minimizes impact. A hemorrhoidectomy 1 year ago is healed, unlikely to bleed now unless complications persist, which isn't suggested. Breast cancer history doesn't influence gastrointestinal bleeding unless metastatic, an unlikely scenario here. Ibuprofen's known GI side effects align with testing guidelines (e.g., avoiding NSAIDs pre-test), making it the most likely false-positive trigger, requiring the nurse to clarify timing and adjust interpretation.
Question 2 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.
Question 3 of 5
A nurse is collecting data from an older adult client. Which of the following findings should indicate to the nurse that the client has a bladder infection?
Correct Answer: C
Rationale: Bladder infections (UTIs) in older adults often present atypically, with mental status changes like confusion being a hallmark due to systemic inflammation or bacteremia. WBC count of 9,000/mm³ is normal, not clearly indicating infection unless trending up; leukocytosis (e.g., >10,000) is more specific. Temperature of 37.3°C is a low-grade fever, possible but not definitive for UTI without other signs. Diminished reflexes relate to neurologic or age-related issues, not infection. Altered mental status, however, is a red flag older adults may lack classic UTI symptoms (e.g., dysuria), and confusion signals potential sepsis or delirium, per geriatric assessment guidelines. This finding warrants urgent reporting for urinalysis and treatment, preventing progression, making it the strongest indicator of a bladder infection.
Question 4 of 5
A nurse is reinforcing teaching with an older adult client who is postoperative following a transurethral resection of the prostate. Which of the following statements should the nurse include in the teaching?
Correct Answer: B
Rationale: Post-transurethral resection of the prostate (TURP), teaching focuses on healing and preventing complications like bleeding or infection. Waiting 6 weeks before resuming sexual intercourse allows the prostatic fossa to heal, reducing risks of hemorrhage or irritation, a standard guideline post-TURP. Ibuprofen, an NSAID, increases bleeding risk by inhibiting platelet function, contraindicated with fresh surgical sites. Tub bathing with a catheter risks introducing bacteria into the urinary tract, so showers are preferred until removal. Driving after 1 week may be premature recovery varies, and catheter presence or pain could impair safety; typically, 2-4 weeks is advised. The 6-week sexual abstinence instruction aligns with urologic care protocols, promotes safe recovery, and addresses a common patient concern, making it the most appropriate teaching point to ensure long-term outcomes and minimize rehospitalization.
Question 5 of 5
A nurse in a long-term care facility is assisting with the plan of care for a client who has late-stage Alzheimer's disease. Which of the following actions should the nurse include in the plan of care?
Correct Answer: A
Rationale: Late-stage Alzheimer's impairs mobility and cognition, increasing pressure ulcer risk from prolonged immobility. Turning the client every 2 hours redistributes pressure, maintains skin integrity, and aligns with evidence-based prevention (e.g., Braden Scale interventions). A mirror for reality orientation is ineffective late-stage patients lack recognition, and it may cause distress. Written instructions are useless due to severe cognitive decline; simplified, hands-on guidance is better for tasks like oral hygiene. Open-ended questions frustrate clients unable to process or respond, whereas yes/no prompts suit their capacity. Regular repositioning addresses a physical priority, prevents costly complications like infections or surgery, and supports dignity in care, making it the essential action for this vulnerable population.