ATI LPN
ATI LPN LEVEL 3 Med Surg Resp Test Questions
Extract:
Vital Signs
Day 1:
Temperature 38.6 °C (101.4 °F)
Heart rate 96/min
Respiratory rate 26/min
Blood pressure 158/88 mm Hg
SaO2 91% on room air
Day 2:
Temperature 38.4 °C (101.2 °F)
Heart rate 88/min
Respiratory rate 24/min
Blood pressure 152/82 mm Hg
Sa0: 92% on 05 at 4 L/min
Day 3:
Temperature 37.8 °C (100.1 °F)
Heart rate 82/min
Respiratory rate 22/min
Blood pressure 130/78 mm Hg
Provider Prescriptions
Day 1:
Purified protein derivative 0.1 mL intradermal to right forearm
Day 1 through Day 3:
Isoniazid 300 mg PO daily
Rifampin 600 mg PO daily
Acetaminophen 500 mg 1-2 tablets PO every 4 to 6 hr PRN fever, pain
Medical History
No previous surgeries
No known allergies
No previous hospitalizations
No chronic illnesses
Traveled out of the country 2 months ago
Diagnostic Results
Day 1:
ALT 36 SI/L (4 to 36 SI/L)
AST 35 units/L (0 to 35 units/L)
Alkaline phosphatase 158 units/L (30 to 120 units/L)
Chest x-ray pending results
Day 3:
Mantoux Test: 12 mm induration (negative reaction less than 5 mm
ALT: 38 SI/L (4 to 36 SI/L)
AST: 36 units/L (0 to 35 units/L)
Alkaline phosphatase: 129 units/L (30 to 120 units/L)
Nurses' Notes
0900:
Client admitted from emergency department with hemoptysis, dull chest pain, increasing fatigue, anorexia, nausea, chest tightness, and 3.2 kg (7 Ib) weight loss in 2 weeks. Heart rate regular, lung sounds with crackles in bilateral upper lobes. No edema. Airborne precautions initiated upon admission.
Day 2:
1100:
Client reports shortness of breath, nausea, and fatigue. Crackles auscultated bilaterally throughout lung fields. Productive cough, with thick, blood-streaked sputum. Bowel sounds active, no edema.
Day 3:
0900
Client reports some improvement in dyspnea. Client coughing up thick, yellow blood-streaked sputum. Crackles auscultated in bilateral upper lobes of lungs. Sclera noted to be yellow. Clients weight is 0.7 kg (1.66) less than at admission. Preborrazed to increase intake of ora firmas Client reports urine appears recoish-orange in color.
Question 1 of 5
A nurse on a medical-surgical unit is caring for a newly admitted client who has a diagnosis of pulmonary tuberculosis. Which of the following findings should the nurse report to the charge nurse?
Correct Answer: A,E
Rationale: A. Yellow sclera indicates jaundice, suggesting potential hepatotoxicity from TB medications, requiring urgent reporting. E. Pending chest x-ray results are critical for assessing TB progression and should be reported once available.
Extract:
Question 2 of 5
A nurse is assisting with the care of a client who has respiratory alkalosis and is hyperventilating. Which of the following actions should the nurse take?
Correct Answer: C
Rationale: Breathing into a paper bag helps increase carbon dioxide levels, correcting respiratory alkalosis caused by hyperventilation.
Extract:
Nurses' Notes
Client presents to emergency department with report of shortness of breath for 2 days, with headache, chills, fever, sore throat, and cough. States went to a music concert recently "and probably picked up some kind of virus."
Oriented to person, place, and time. Appears lethargic, difficulty answering questioning due to shortness of breath. Follows simple commands, moves all extremities with weakness.
Client's face is flushed, sinus tachycardia, rate of 109/min. S1 and S2 heart sounds heard on auscultation. Pulses palpable.
Breath sounds with crackles to right lower lobe, tachypnea. rate of 28/min. Frequent productive cough with thick rusty sputum. Client denies hemoptysis. Unable to lie down, states "more comfortable to sit up."
Bowel sounds active x 4 quadrants. Denies diarrhea, last bowel movement yesterday. States "no appetite since I've been sick."
Reports decreased urination over past 24 hr. "Haven't been drinking as much water as I should because my throat hurts."
Client reports they have not had a pneumococcal vaccine and do not get annual influenza vaccinations. States "I just hate needles.
Vital Signs
1200:
Temperature 38.6° C (101.5° F)
Heart rate 109/min
Respiratory rate 28/min
Blood pressure 106/54 mm Hg
Oxygen saturation 94% on room air
Medical History
1215:
70 years of age
No significant medical history other than primary concern
Well-nourished
Home Medications
Daily multivitamin
Vitamin D
Social History
Lives alone partner died 5 years ago
Drinks 1 to 2 glasses of red wine daily
Has never smoked
Walks 2 to 3 miles 6 days/week
Diagnostic Results
1230
Chest x-ray: Areas of increased density and white infiltrates to lower right lobe indicative of pneumonia
Question 3 of 5
A nurse is caring for a client who has pneumonia. Select the 4 findings in the client's medical record that places them at risk for pneumonia.
Correct Answer: A,B,C,G
Rationale: A. Age: The client is 70 years old, which places them at a higher risk for pneumonia due to a weakened immune system. B. Fluid intake: Decreased fluid intake can lead to thicker respiratory secretions, increasing pneumonia risk. C. Influenza vaccine: Not receiving an influenza vaccine increases the risk of influenza-related pneumonia. G. Pneumococcal vaccine: Lack of pneumococcal vaccination increases the risk of pneumococcal pneumonia.
Extract:
Question 4 of 5
A client is receiving oxygen therapy via a nasal cannula. When the client asks the nurse why he needs to have oxygen tubing in his nose, which of the following explanations about the cannula should the nurse give him?
Correct Answer: C
Rationale: A nasal cannula delivers low concentrations of oxygen (24-44%), suitable for clients needing supplemental oxygen without requiring high concentrations.
Question 5 of 5
A nurse is caring for a client who is postoperative following a tracheostomy, and has copious and tenacious secretions. Which of the following is an acceptable method for the nurse to use to thin this client's secretions?
Correct Answer: B
Rationale: Humidified oxygen moistens secretions, making them easier to suction, which is critical for tracheostomy care.