ATI LPN
PN Adult Medical Surgical 2023 Questions
Extract:
History and Physical
1000:
Client reports generalized weakness and increased fatigue over the past few months.
Client states they become short of breath after climbing a flight of stairs and are having difficulty keeping up with their grandchildren.
History of rheumatoid arthritis. Reports taking naproxen 500 mg twice a day.
Client reports they follow a vegan diet.
Denies pain or discomfort.
Bilateral breath sounds clear and present throughout.
Mucous membranes pale.
Apical pulse rapid, regular.
Diagnostic Results
1000:
Hct 24% (37% to 47%)
Hgb 8 g/dL (12 to 16 g/dL)
RBC count 3 x 10 ⁶ pL (4.2 to 5.4 x 10 ⁶ pL)
Ferritin 8 ng/mL (10 to 150 ng/mL)
WBC count 9,000/mm ³ (5,000 to 10,000/mm ³)
Platelet count 180,000/mm ³ (150,000 to 400,000/mm ³)
Vitamin B ₁₂ 159 pg/mL (160 to 950 pg/mL)
Question 1 of 5
Complete the following sentence by using the lists of options.The first action the nurse should take is to followed by (Client with low Hct, Hgb, vegan diet)
Correct Answer: B,A
Rationale: Collecting nutritional data identifies deficiencies (e.g., B12, iron from vegan diet), followed by education on supplements.
Extract:
Exhibit 1 Exhibit 2 Exhibit 3 Exhibit 4
Medical History
Today, 0700:
Admitting Diagnosis: Heart Failure
Past medical history of heart failure, coronary artery disease, sleep apnea
Client reports diarrhea, dry mouth, and unusual thirst for the past three days
Question 2 of 5
A nurse is assisting in the care of a male client who has a new prescription for furosemide. Which of the following client findings should the nurse identify as a contraindication to the administration of furosemide?
Correct Answer: A
Rationale: Furosemide, a loop diuretic, treats heart failure but depletes potassium, risking hypokalemia. A low potassium level (e.g., <3.5 mEq/L) contraindicates its use hypokalemia causes arrhythmias, especially with heart failure's cardiac strain, per pharmacology standards. Blood pressure matters hypotension may worsen with diuresis but isn't a direct contraindication unless extreme. Digoxin use heightens hypokalemia risk (enhancing toxicity), but potassium level drives the decision. The client's report of diarrhea and thirst suggests dehydration, a caution, not a strict contraindication. Low potassium demands correction (e.g., supplements) before furosemide, preventing lethal complications like ventricular fibrillation, making it the critical finding to identify.
Extract:
Question 3 of 5
A nurse in a provider's office is assisting in the care of a client. For each potential provider's prescription, which is anticipated for the client?
Correct Answer: A
Rationale: Given the client's vegan diet, fatigue, weakness, pale mucous membranes, and rapid pulse (Exhibit 1), iron deficiency anemia is likely. Administering an iron supplement is anticipated it corrects low hemoglobin, a common vegan shortfall without meat or fortified sources, directly addressing the suspected etiology. Nutritional consultation helps long-term, but immediate supplementation is urgent for symptom relief and oxygen delivery. A low-sodium diet suits heart failure or hypertension, not anemia blood pressure (132/60 to 102/50 mm Hg) reflects orthostasis, not sodium issues. Fluid restriction applies to fluid overload, not here, where hydration supports circulation. Iron supplementation aligns with anemia management guidelines (e.g., ferrous sulfate), offering rapid hematologic improvement, making it the expected prescription for this presentation.
Question 4 of 5
A nurse is reinforcing teaching with a client who has diabetes mellitus about reducing the risk for a stroke. Which of the following statements by the client indicates an understanding of the teaching?
Correct Answer: D
Rationale: Losing excess weight reduces stroke risk by improving cardiovascular health, a key factor in diabetes management. High cholesterol, uncontrolled HbA1c, and glucocorticoids increase, not decrease, stroke risk.
Question 5 of 5
A nurse is collecting data from a client who had a bronchoscopy. Which of the following findings should the nurse report to the provider?
Correct Answer: D
Rationale: Post-bronchoscopy, nurses monitor for complications like bleeding, infection, or airway issues. Option A, sore throat, is a common, benign side effect from the scope, not requiring immediate reporting. Option B, blood pressure 110/78 mm Hg, is normal and stable, needing no action. Option C, presence of gag reflex, is reassuring it indicates airway protection is intact post-sedation, a positive sign. Option D, facial edema, is correct to report it's abnormal and could signal an allergic reaction to sedation, airway swelling, or trauma from the procedure, potentially compromising breathing. This finding demands urgent provider evaluation to rule out anaphylaxis or obstruction, aligning with airway management priorities. While sore throat and gag reflex are expected, facial edema deviates from the norm, requiring swift intervention to prevent escalation, making it the critical finding to escalate.