LPN LPN
ATI Adult Medical Surgical
1. A patient with type 2 diabetes is prescribed metformin. What instruction should the nurse provide regarding this medication?
- A. Take the medication on an empty stomach.
- B. Monitor for signs of hypoglycemia.
- C. Take the medication with meals.
- D. Increase intake of simple carbohydrates.
Correct answer: C
Rationale: The correct instruction for a patient prescribed metformin is to take the medication with meals. This helps reduce gastrointestinal side effects commonly associated with metformin. Patients should also be educated about the signs of lactic acidosis, a rare but serious side effect associated with metformin use.
2. Following a CVA, the nurse assesses that a client has developed dysphagia, hypoactive bowel sounds, and a firm, distended abdomen. Which prescription for the client should the nurse question?
- A. Continuous tube feeding at 65 ml/hr via gastrostomy.
- B. Total parenteral nutrition to be infused at 125 ml/hour.
- C. Nasogastric tube connected to low intermittent suction.
- D. Metoclopramide (Reglan) intermittent piggyback.
Correct answer: A
Rationale: In a client with dysphagia and gastrointestinal symptoms such as hypoactive bowel sounds and a firm, distended abdomen, continuous tube feeding might exacerbate the symptoms. This can lead to complications and should be questioned by the nurse.
3. The nurse is administering sevelamer (RenaGel) during lunch to a client with end-stage renal disease (ESRD). The client asks the nurse to bring the medication later. The nurse should describe which action of RenaGel as an explanation for taking it with meals?
- A. Prevents indigestion associated with the ingestion of spicy foods.
- B. Binds with phosphorus in foods and prevents absorption.
- C. Promotes stomach emptying and prevents gastric reflux.
- D. Buffers hydrochloric acid and prevents gastric erosion.
Correct answer: B
Rationale: Sevelamer (RenaGel) binds with phosphorus in foods and prevents its absorption. By taking RenaGel with meals, the binding of phosphorus helps to reduce the phosphorus load absorbed from food, thus aiding in the management of hyperphosphatemia in clients with ESRD.
4. What should be monitored to evaluate the effectiveness of enoxaparin in a patient with deep vein thrombosis (DVT)?
- A. Prothrombin time (PT)
- B. Partial thromboplastin time (PTT)
- C. International normalized ratio (INR)
- D. Platelet count
Correct answer: C
Rationale: The international normalized ratio (INR) is the appropriate parameter to monitor the effectiveness of enoxaparin in preventing clot formation in patients with deep vein thrombosis (DVT). INR reflects the clotting ability of the blood and is commonly used to assess the therapeutic range of anticoagulant medications, such as enoxaparin, which is crucial in managing and preventing thrombotic events like DVT.
5. A patient with an anxiety disorder is prescribed alprazolam. What is the primary action of this medication?
- A. Increase energy levels
- B. Induce sedation
- C. Elevate mood
- D. Reduce anxiety
Correct answer: D
Rationale: Alprazolam is a benzodiazepine that primarily works by reducing anxiety. It achieves this by enhancing the inhibitory effects of the neurotransmitter GABA in the brain, which leads to a calming effect on the individual. Therefore, the primary action of alprazolam is to decrease anxiety levels rather than increase energy, induce sedation, or elevate mood.
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