LPN LPN
ATI Adult Medical Surgical
1. A client with heart failure is receiving intravenous furosemide (Lasix). Which assessment finding indicates that the medication is having the desired effect?
- A. Decreased peripheral edema.
- B. Elevated blood pressure.
- C. Increased heart rate.
- D. Decreased urine output.
Correct answer: A
Rationale: The correct answer is A: 'Decreased peripheral edema.' In a client with heart failure receiving furosemide, decreased peripheral edema indicates that the medication is effectively reducing fluid overload. Furosemide is a diuretic that helps the body eliminate excess fluid and salt through increased urine output, leading to a reduction in peripheral edema, which is a common symptom of heart failure. Monitoring and recognizing this improvement in edema are crucial in managing heart failure effectively.
2. A patient with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium. What is the primary purpose of this medication?
- A. Reduce mucus production
- B. Relieve bronchospasm
- C. Suppress cough
- D. Thin respiratory secretions
Correct answer: B
Rationale: Tiotropium is a long-acting bronchodilator used to relieve bronchospasm and improve airflow in patients with chronic obstructive pulmonary disease (COPD). It works by relaxing the muscles around the airways, leading to bronchodilation and improved breathing, making it an essential treatment in managing COPD symptoms.
3. When assessing a male client who is receiving a unit of packed red blood cells (PRBCs), the nurse notes that the infusion was started 30 minutes ago, and 50 ml of blood is left to be infused. The client's vital signs are within normal limits. He reports feeling 'out of breath' but denies any other complaints. What action should the nurse take at this time?
- A. Administer a PRN prescription for diphenhydramine (Benadryl).
- B. Start the normal saline attached to the Y-tubing at the same rate.
- C. Decrease the intravenous flow rate of the PRBC transfusion.
- D. Ask the respiratory therapist to administer PRN albuterol (Ventolin).
Correct answer: C
Rationale: In this scenario, the client is experiencing symptoms of shortness of breath, which could indicate fluid overload from the PRBC transfusion. By decreasing the intravenous flow rate of the transfusion, the nurse can slow down the rate of blood being infused, potentially alleviating the symptoms of fluid overload and shortness of breath. This intervention can help prevent further complications and promote the client's comfort and safety.
4. A client with heart failure is prescribed digoxin (Lanoxin). Which instruction should the nurse include in the client's teaching plan?
- A. Take your pulse before each dose and hold the medication if your pulse is below 60 beats per minute.
- B. Increase your intake of foods high in potassium.
- C. Take the medication with a high-fiber meal to enhance absorption.
- D. Skip a dose if you feel dizzy or lightheaded.
Correct answer: A
Rationale: The correct instruction for a client prescribed digoxin is to take their pulse before each dose and hold the medication if the pulse is below 60 beats per minute. This is crucial to prevent digoxin toxicity, as digoxin can cause adverse effects when the pulse rate is too low. Monitoring the pulse regularly ensures safety and appropriate management of the medication.
5. After performing a paracentesis on a client with ascites, 3 liters of fluid are removed. Which assessment parameter is most critical for the nurse to monitor following the procedure?
- A. Pedal pulses.
- B. Breath sounds.
- C. Gag reflex.
- D. Vital signs.
Correct answer: D
Rationale: Following a paracentesis where a significant amount of fluid is removed, it is crucial to monitor the client's vital signs. This helps in detecting any signs of hypovolemia, such as changes in blood pressure, heart rate, and respiratory rate, which could indicate complications post-procedure. Monitoring the vital signs allows for prompt intervention if there are any deviations from the baseline values.
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