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ATI Learning System PN Medical Surgical Final Quizlet
1. The healthcare professional is caring for a client with heart failure who is receiving digoxin (Lanoxin). Which assessment finding requires immediate intervention?
- A. Heart rate of 58 beats per minute.
- B. Nausea and vomiting.
- C. Blood pressure of 130/80 mm Hg.
- D. Shortness of breath.
Correct answer: B
Rationale: The correct answer is B. Nausea and vomiting are common signs of digoxin toxicity, which can lead to serious complications like dysrhythmias. Prompt intervention is crucial to prevent further harm to the client. Choice A, a heart rate of 58 beats per minute, although slightly lower than normal, may be appropriate for a client on digoxin. Choice C, a blood pressure of 130/80 mm Hg, is within normal limits and does not indicate an immediate need for intervention. Choice D, shortness of breath, is a common symptom in heart failure and requires monitoring but is not as indicative of digoxin toxicity as nausea and vomiting.
2. The sister of a patient diagnosed with BRCA gene-related breast cancer asks the nurse, 'Do you think I should be tested for the gene?' Which response by the nurse is most appropriate?
- A. In most cases, breast cancer is not caused by the BRCA gene.
- B. It depends on how you will feel if the test is positive for the BRCA gene.
- C. There are many things to consider before deciding to have genetic testing.
- D. You should decide first whether you are willing to have a bilateral mastectomy.
Correct answer: C
Rationale: The most appropriate response by the nurse is C: 'There are many things to consider before deciding to have genetic testing.' Genetic testing for BRCA gene mutations is a complex decision that involves various factors such as emotional readiness, potential impact on insurance and employability, and the implications of test results. Option A is incorrect because although most breast cancers are not related to BRCA gene mutations, individuals with these mutations have a significantly higher risk. Option B is not ideal as it oversimplifies the decision-making process by focusing solely on emotional aspects. Option D is incorrect as it implies a predetermined course of action (mastectomy) before even undergoing genetic testing, which is not appropriate.
3. A patient with rheumatoid arthritis is prescribed methotrexate. What should the nurse include in the patient teaching?
- A. Take folic acid supplements as prescribed.
- B. Avoid alcohol completely.
- C. Expect to see immediate results.
- D. Limit fluid intake to 1 liter per day.
Correct answer: A
Rationale: Patients prescribed methotrexate should be advised to take folic acid supplements as prescribed. Methotrexate can deplete folic acid levels, leading to side effects. By taking folic acid supplements as directed, the patient can reduce the risk of experiencing adverse effects associated with methotrexate therapy. It is important to note that the effects of methotrexate may not be immediate, so realistic expectations should be set with the patient. Alcohol should be avoided while taking methotrexate due to potential interactions and increased risk of liver toxicity. There is no specific recommendation to limit fluid intake to 1 liter per day in relation to methotrexate therapy.
4. What side effect should be monitored for in a patient with chronic heart failure taking spironolactone?
- A. Hypokalemia
- B. Hyperkalemia
- C. Hyponatremia
- D. Hypernatremia
Correct answer: B
Rationale: The correct answer is B: Hyperkalemia. Spironolactone is a potassium-sparing diuretic commonly used in patients with heart failure. One of the potential side effects of spironolactone therapy is hyperkalemia, which is an elevated level of potassium in the blood. Hyperkalemia can lead to serious cardiac arrhythmias, making it crucial for healthcare providers to monitor potassium levels closely. Choices A, C, and D are incorrect because hypokalemia (low potassium levels), hyponatremia (low sodium levels), and hypernatremia (high sodium levels) are not typically associated with spironolactone use in patients with chronic heart failure.
5. The healthcare provider is caring for a client who has just undergone a thyroidectomy. Which assessment finding requires immediate intervention?
- A. Hoarse voice.
- B. Difficulty swallowing.
- C. Numbness and tingling around the mouth.
- D. Sore throat.
Correct answer: C
Rationale: Numbness and tingling around the mouth can indicate hypocalcemia, a potential complication after thyroidectomy. Hypocalcemia can occur due to inadvertent injury or removal of the parathyroid glands during the thyroidectomy, leading to decreased calcium levels. As a result, the client may experience symptoms such as numbness, tingling, muscle cramps, or spasms. Prompt intervention is necessary to prevent severe complications like tetany or seizures. Therefore, the healthcare provider should address numbness and tingling around the mouth immediately to prevent further deterioration of calcium levels and potential serious outcomes. Choices A, B, and D are not typically associated with immediate post-thyroidectomy complications and can be addressed after ensuring the client's calcium levels are stable.
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