ATI LPN
PN Adult Medical Surgical 2023 Questions
Extract:
Nurses' Notes
Day 1:
Client brought to the emergency department (ED) following a fall that occurred while downhill skiing. Client states they fell when turning to avoid hitting another skier. Client reports feeling a severe, sudden pain of right leg upon falling. Right leg was immobilized at the scene and client transported to the ED.
Client states they were wearing a helmet while skiing. Client reports no headache or loss of consciousness.
Client reports pain as 10 on a scale of 0 to 10 to the right lower leg Just below the knee and is unable to bear weight.
Right proximal tibia ecchymotic and swollen below the knee. Area is painful to touch. Open area noted on skin with bone visible. Right knee appears displaced. Left pedal pulses 3+, foot warm with intact movement and sensation. Right pedal pulses 1+, foot cool to palpation with minimal movement and reduced sensation.
Diagnostic Results
Day 1:
X-ray of right leg: open spiral tibial shaft fracture
Question 1 of 5
For each potential provider's prescription, click to specify if the potential prescription is anticipated or contraindicated for the client. Prescription: Open the splint
| Potential Prescription | Anticipated | Contraindicated | |
|---|---|---|---|
| Open the splint | |||
| Obtain a urinalysis | |||
| Place the client on NPO status | |||
| Place the client's right leg in a dependent position |
Correct Answer:
Rationale: Opening the splint relieves pressure in compartment syndrome.
Extract:
Question 2 of 5
A nurse is obtaining a sterile urine specimen from a client who has an indwelling urinary catheter. Identify the sequence the nurse should follow.
Correct Answer: E,D,C,A,B
Rationale: Order: Clamp (E), wipe port (
D), aspirate (
C), transfer (
A), document (
B) ensures sterility and proper procedure.
Extract:
Exhibit 1 Exhibit 2 Exhibit 3 Exhibit 4 Exhibit 5
Diagnostic Results
1000:
Hct 24% (37% to 47%)
Hgb 8 g/dL (12 to 16 g/dL)
RBC count 3 x 10⁶ µL (4.2 to 5.4 x 10⁶ µL)
Ferritin 8 ng/mL (10 to 150 ng/mL)
WBC count 9,000/mm³ (5,000 to 10,000/mm³)
Platelet count 180,000/mm³ (150,000 to 400,000/mm³)
Vitamin B₁₂ 159 pg/mL (160 to 950 pg/mL)
1030:
Stool for fecal occult blood negative
Question 3 of 5
A nurse is assisting in the care of the client who has iron deficiency anemia. Which of the following instructions should the nurse include?
Correct Answer: C
Rationale: Iron deficiency anemia treatment hinges on maximizing iron absorption. Taking the medication with vitamin C enhances uptake ascorbic acid converts ferric to ferrous iron, boosting bioavailability in the acidic stomach environment, a cornerstone of anemia management. Antacids raise gastric pH, binding iron and reducing absorption, counterproductive to correcting deficiency. Increasing fiber mitigates constipation, a side effect of iron, but isn't the primary administration focus. Milk and dairy, high in calcium, inhibit iron absorption by competing for uptake sites, worsening anemia if paired with supplements. Vitamin C's synergistic effect backed by dietary guidelines optimizes therapy, especially critical with low ferritin (8 ng/mL, Exhibit 1), empowering the client to improve hemoglobin efficiently while minimizing common pitfalls, making it the essential instruction.
Extract:
Question 4 of 5
A nurse is monitoring a client who has diabetes mellitus and a glucose level of 384 mg/dL. Which of the following findings should the nurse identify as an indication of metabolic acidosis?
Correct Answer: C
Rationale: Increased respiratory rate (Kussmaul breathing) compensates for acidosis in diabetic ketoacidosis.
Question 5 of 5
A nurse is collecting data from a female client who is postmenopausal. Which of the following findings should the nurse identify as a risk factor for the development of osteoporosis?
Correct Answer: B
Rationale: Osteoporosis risk rises postmenopause due to estrogen loss, but long-term prednisone use accelerates bone loss by inhibiting osteoblast activity and calcium absorption, a well-established glucocorticoid effect. Congenital heart murmur affects circulation, not bone density, unless activity is severely limited, which isn't implied. Vitamin Bâ‚â‚‚ injections treat deficiency, indirectly supporting bone health via red cell production, not increasing risk. Kidney stones relate to calcium metabolism but don't directly cause osteoporosis unless chronic disease alters bone remodeling, an uncommon link here. Prednisone's impact is direct, dose-dependent, and significant often warranting bisphosphonates making it the standout risk factor to identify, per osteoporosis screening guidelines (e.g., NOF), for preventive planning.