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.
Vital Signs
Day 1:
Temperature 36° C (96.8° F)
Blood pressure 140/80 mm Hg
Heart rate 98/min
Respiratory rate 24/min
Oxygen saturation 97% on room air
Day 2, 0800:
Temperature 37° C (98.6° F)
Blood pressure 122/60 mm Hg
Heart rate 85/min
Respiratory rate 18/min
Oxygen saturation 98% on room air
Question 1 of 5
The first action the nurse should take is to followed by (Postoperative tibia fixation)
Correct Answer: A,B
Rationale: Notifying the provider is urgent for complications like compartment syndrome, followed by elevation to reduce swelling.
Extract:
Question 2 of 5
A nurse is reinforcing teaching with a client about breast self-examinations. Which of the following statements by the client indicates an understanding of the teaching?
Correct Answer: D
Rationale: Asymmetry in breast size is normal; exams should be monthly, post-period, and dimpling is a concern.
Extract:
VITAL SIGNS
Day 1:
TEMPERATURE 36° C (96.8° F)
BLOOD PRESSURE 140/80 mm Hg
HEART RATE 98/min
RESPIRATORY RATE 24/min
OXYGEN SATURATION 97% on room air
Day 2, 0800:
TEMPERATURE 37° C (98.6° F)
BLOOD PRESSURE 122/60 mm Hg
HEART RATE 85/min
RESPIRATORY RATE 18/min
OXYGEN SATURATION 98% on room air
Day 2, 1600:
Findings
• Dyspnea
• Tingling sensation to right foot
• Increased pain at incision site
• Swelling at incision site
Acute compartment syndrome
• Dyspnea
• Tingling sensation to right foot
• Increased pain at incision site
• Swelling at incision site
Infection
• Dyspnea
• Tingling sensation to right foot
• Increased pain at incision site
• Swelling at incision site
Fat embolism syndrome
• Dyspnea
• Tingling sensation to right foot
• Increased pain at incision site
• Swelling at incision site
Question 3 of 5
A nurse is assisting in the care of a client who is postoperative following an open reduction internal fixation of the right tibia. Which finding is consistent with acute compartment syndrome?
Correct Answer: A, C
Rationale: Acute compartment syndrome post-ORIF arises from pressure buildup in muscle compartments, impairing perfusion. Increased pain at the incision site severe, unrelieved by analgesics, and disproportionate to the procedure is a hallmark, reflecting nerve and tissue ischemia. Dyspnea suggests fat embolism syndrome, a separate complication from marrow release, not compartment pressure. Tingling indicates nerve compression, a later sign, but pain precedes it in the 6 Ps (pain, pallor, pulselessness, paresthesia, paralysis, poikilothermia). Swelling occurs, but pain's intensity and persistence distinguish compartment syndrome from normal postoperative edema. Early recognition of escalating pain prompts fasciotomy, preventing necrosis, making it the most consistent finding per orthopedic emergency protocols.
Extract:
Question 4 of 5
A nurse is reinforcing teaching with a client who will be wearing a Holter monitor for the next 24 hr. Which of the following information should the nurse include?
Correct Answer: A
Rationale: Recording activities helps correlate symptoms with heart activity; electrodes stay on, and bathing is avoided.
Question 5 of 5
A nurse is reinforcing teaching about liquid iron supplements with a client who has anemia. Which of the following information should the nurse include in the teaching?
Correct Answer: A
Rationale: Iron supplements treat anemia by boosting hemoglobin, but absorption and side effects guide administration. Option A is correct taking iron between meals maximizes absorption since food, especially calcium or fiber, can bind iron, reducing bioavailability. Gastric acid enhances uptake, so an empty stomach is ideal, though some tolerate it with a small snack if irritation occurs. Option B is wrong milk's calcium inhibits absorption and doesn't prevent teeth staining (diluting in juice does). Option C is incorrect antacids raise stomach pH, decreasing iron absorption, and may worsen deficiency. Option D is false iron typically causes black, not orange, stools due to unabsorbed iron oxidation; orange stools could signal another issue. Teaching about between-meal dosing empowers the client to optimize therapy, manage side effects (like constipation or nausea), and monitor for expected changes (e.g., darker stools), ensuring effective anemia treatment.