ATI LPN
ATI LPN Med Surg Exam 3 Questions
Extract:
Nurses’ Notes at 0700 hrs
The client has a history of diverticulitis and is allergic to penicillin. The client states that the pain started yesterday and has been worsening. He also reports nausea and vomiting, and he is unable to eat or drink anything without vomiting.
• Client presents with left lower quadrant (LLQ) pain, rated 9 on a 0 to 10 pain scale.
• Client is nauseous and has vomited twice since arrival.
• Client states he has not had a bowel movement in two days.
• Abdomen is distended and tender to palpation in the LLQ.
• Bowel sounds are hypoactive in all four quadrants.
• Client is oriented to person, place, and time.
• Client is able to move all extremities without difficulty.
Vital Signs at 0700 hrs
Temperature: 37.4°C (99.3°F)
• Heart rate: 100/min
• Respiratory rate: 20/min
• Blood pressure: 148/76 mm Hg
• Oxygen saturation: 97% on room air
Diagnostic Results at 0715 hrs
Sodium: 140 mEq/L (136-145 mEq/L)
• Potassium: 3.5 mEq/L (3.5-5.0 mEq/L)
• BUN: 19 mg/dL (10-20 mg/dL)
• Creatinine: 1.1 mg/dL (0.6-1.3 mg/dL)
• White Blood Cell Count: 28,000/mm³ (5,000-10,000/mm³)
Question 1 of 5
Based on the information provided, which of the following provider's prescriptions are anticipated, nonessential, or contraindicated for the client?
| Options | Anticipated | Nonessential | Contraindicated |
|---|---|---|---|
| Increase fiber intake | |||
| CT of the abdomen with contrast | |||
| Flexible sigmoidoscopy | |||
| Change IV fluids to 0.9% sodium chloride with KCl | |||
| Type and crossmatch blood | |||
| Administer IV piperacillin-tazobactam |
Correct Answer: B,C,D,E,F
Rationale: A: Nonessential. A high-fiber diet can prevent future diverticulitis but is not helpful during the acute phase, especially with vomiting. B: Anticipated. A CT scan confirms diverticulitis diagnosis and assesses severity. C: Anticipated. Sigmoidoscopy visualizes diverticula and inflammation extent. D: Anticipated. IV fluids with KCl address dehydration and maintain potassium levels. E: Anticipated. Blood typing is needed due to possible bleeding indicated by occult blood test and low hemoglobin. F: Contraindicated. Piperacillin-tazobactam is penicillin-based, and the client is allergic to penicillin.
Extract:
Question 2 of 5
After a diagnostic work-up, a 56-year-old male client was diagnosed with a duodenal ulcer caused by Helicobacter pylori infection. After treatment, the client is to have an esophagogastroduodenoscopy (EGD). Which teaching should the nurse reinforce?
Correct Answer: D
Rationale: Waiting for the gag reflex to return prevents aspiration post-EGD.
Question 3 of 5
A nurse is contributing to the care plan for a patient who has acute pancreatitis. Which of the following interventions should the nurse include?
Correct Answer: C
Rationale: NPO status rests the pancreas, reducing enzyme production in acute pancreatitis.
Question 4 of 5
The nurse is taking a medication history for a patient with liver disease. Which medication would be of most concern to the nurse?
Correct Answer: D
Rationale: Acetaminophen risks liver damage in high doses, especially in liver disease.
Question 5 of 5
A nurse is assisting in the plan of care for a client who had surgery for a bowel obstruction. The client has a nasogastric tube in place. Which of the following actions should the nurse include in the client's plan of care?
Correct Answer: A,B,C
Rationale: A: Bed rest for 48 hours aids healing post-surgery. B: Irrigating the NG tube prevents blockages. C: Incentive spirometer use prevents respiratory complications like pneumonia. D: Leg exercises are not typically prioritized for bowel obstruction recovery.