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ATI N200 Med Surg Exam 5 Questions

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Question 1 of 5

What clinical manifestation(s) should the nurse expect in a client with uncontrolled diabetes mellitus and ketoacidosis? (SELECT ALL THAT APPLY)

Correct Answer: A,C,E

Rationale: Lethargy can occur in DKA due to hyperglycemia, acidosis, and dehydration. An ABG showing pH 7.31 and low HCO3 indicates metabolic acidosis, characteristic of DKA. Kussmaul respirations (rapid, deep breathing) are a classic sign of DKA.

Question 2 of 5

The oncoming nurse sees that the patient is receiving IV heparin at 7 mL/hr. The concentration of the heparin is 50,000 units in 250 ml of saline. The patient is ordered 1600 units of heparin per hour. The lab calls the oncoming nurse with the result of the patient's activated partial prothrombin time (aPTT) is 37 seconds. What actions will the oncoming nurse take? (SELECT ALL THAT APPLY)

Correct Answer: A,C

Rationale: Notifying the prescriber about the dose and assessing for infiltration ensure appropriate heparin therapy management.

Question 3 of 5

The nurse is caring for a client with a diagnosis of chronic peripheral arterial disease. Which statement by the client warrants immediate intervention by the nurse?

Correct Answer: B

Rationale: Using a heating pad can cause burns in PAD due to reduced sensation, requiring immediate intervention.

Question 4 of 5

A newly admitted client has been prescribed sulfamethoxazole/trimethoprim. The nurse understands that this medication is contraindicated based on which lab result?

Correct Answer: C

Rationale: A serum creatinine level of 2.5 mg/dL indicates impaired kidney function. TMP-SMX can be contraindicated in patients with significant renal impairment due to the potential for drug accumulation and toxicity, particularly affecting renal function.

Question 5 of 5

A client is receiving heparin sodium 5000 units IV and oral warfarin sodium 2.5 mg PO for thrombophlebitis in the left leg. The nurse educated the client that heparin and warfarin are both used because:

Correct Answer: A

Rationale: Heparin provides immediate anticoagulation, while warfarin takes days to become effective, ensuring continuous protection.

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