ATI RN
ATI Med Surg N241 Exam Questions
Extract:
Question 1 of 5
The nurse notes these laboratory results for a client with cirrhosis: PT 20 seconds (11-12.5 sec) and serum ammonia 35 mcg/dL (15-45 mcg/dL). What action by the nurse would be a priority?
Correct Answer: C
Rationale: While important, it is not directly related to the coagulopathy indicated by the prolonged PT. Important for overall fluid management but not directly related to the risk of bleeding. With a significantly prolonged PT, assessing for signs of gastrointestinal bleeding is a priority. Important for safety, but the immediate risk of bleeding due to coagulopathy takes precedence.
Question 2 of 5
When reviewing a client's health history, which information does the nurse identify as a risk factor for development of chronic pancreatitis?
Correct Answer: A
Rationale: Chronic and excessive alcohol consumption is a well-established risk factor for the development of chronic pancreatitis. While contributing to other health issues, it is not directly linked to chronic pancreatitis. Smoking is a risk factor, but alcohol abuse is more significantly associated with chronic pancreatitis. Although it contributes to various health problems, it is not as directly linked to chronic pancreatitis as alcohol abuse.
Question 3 of 5
When planning care for a client with acute pancreatitis, which order would the nurse anticipate that will contribute to pain control?
Correct Answer: B
Rationale: Pancreatic enzymes are typically used to aid in digestion rather than pain control in acute pancreatitis. Decompression of the gastrointestinal tract through nasogastric suction can help reduce pancreatic stimulation and alleviate pain in acute pancreatitis. While ambulation may help prevent complications, it is not directly related to pain control in acute pancreatitis. A clear liquid diet may be initiated once the acute phase has resolved, but it does not directly contribute to pain control.
Question 4 of 5
A nurse is admitting a client who has acute pancreatitis. Which of the following provider prescriptions should the nurse anticipate?
Correct Answer: C
Rationale: Pancrelipase may be prescribed to aid in digestion in chronic pancreatitis but is not typically used in the acute phase. While ambulation may be encouraged as tolerated, it is not a specific prescription for acute pancreatitis. Pantoprazole, **C**. Pantoprazole, a proton pump inhibitor, is often prescribed in acute pancreatitis to reduce gastric acid secretion, thereby reducing pancreatic stimulation and promoting healing. In acute pancreatitis, dietary intake is typically restricted initially, often starting with nothing by mouth (NPO) and progressing to a clear liquid diet as tolerated; a low-residue diet is usually introduced at a later stage.
Question 5 of 5
A client with cirrhosis is scheduled to receive a third dose of lactulose (Cephulac) at 1800. Which current finding would cause the nurse to question administering this medication?
Correct Answer: D
Rationale: Breath with fecal odor could indicate hepatic encephalopathy, for which lactulose is indicated. Increasing confusion is a symptom of hepatic encephalopathy suggests a need for lactulose. Elevated ammonia levels indicate hepatic encephalopathy hence the need for lactulose. If the client already has diarrhea, additional doses of lactulose (which acts as a laxative) could exacerbate this condition and might need to be adjusted or halted based on clinical judgment.