LPN LPN
ATI PN Adult Medical Surgical 2019
1. A client who participates in a health maintenance organization (HMO) needs a bone marrow transplant for the treatment of breast cancer. The client tells the nurse that she is concerned that her HMO may deny her claim. What action by the nurse best addresses the client's need at this time?
- A. Have the client's healthcare provider write a letter to the HMO explaining the need for the transplant.
- B. Help the client place a call to the HMO to seek information about limitations of coverage.
- C. Encourage the client to contact a lawyer to file a lawsuit against the HMO if necessary.
- D. Have the social worker contact the state board of insurance to register a complaint against the HMO.
Correct answer: B
Rationale: The best action for the nurse to take in this situation is to help the client directly contact the HMO to seek information about limitations of coverage. This approach addresses the client's immediate concerns and clarifies the situation, enabling the client to understand the coverage and potential outcomes regarding the bone marrow transplant. Choice A is not the best option as having the healthcare provider write a letter may not provide immediate clarification on coverage. Choice C is inappropriate as legal action should be considered as a last resort, and choice D involving the state board of insurance is not necessary at this initial stage of addressing the client's concern.
2. A client who is receiving heparin therapy has an activated partial thromboplastin time (aPTT) of 90 seconds. What action should the nurse take?
- A. Increase the heparin infusion rate.
- B. Notify the healthcare provider.
- C. Apply pressure to the injection site.
- D. Administer protamine sulfate.
Correct answer: B
Rationale: An activated partial thromboplastin time (aPTT) of 90 seconds is elevated, indicating a risk of bleeding. The appropriate action for the nurse is to notify the healthcare provider. Increasing the heparin infusion rate can further elevate the aPTT, leading to an increased risk of bleeding. Applying pressure to the injection site is not relevant in this situation. Administering protamine sulfate is used to reverse the effects of heparin in cases of overdose or bleeding, but it is not the initial action for an elevated aPTT.
3. A client with hypertension is receiving dietary education from a nurse. Which recommendation should the nurse include?
- A. Increase your intake of saturated fats.
- B. Limit your sodium intake to less than 2 grams per day.
- C. Avoid foods high in potassium.
- D. Consume at least three alcoholic beverages daily.
Correct answer: B
Rationale: The correct recommendation for a client with hypertension is to limit sodium intake to less than 2 grams per day. High sodium intake can worsen hypertension by increasing blood pressure. Choices A, C, and D are incorrect. Increasing saturated fats (Choice A) can be detrimental to heart health and exacerbate hypertension. Avoiding foods high in potassium (Choice C) is not recommended as potassium-rich foods can actually be beneficial for managing blood pressure. Consuming three alcoholic beverages daily (Choice D) can also have a negative impact on blood pressure and overall health.
4. A client with Parkinson's disease is being cared for by a nurse. Which intervention should be included to address the client's bradykinesia?
- A. Encourage daily walking.
- B. Provide thickened liquids to prevent aspiration.
- C. Offer small, frequent meals.
- D. Teach the client to use adaptive utensils.
Correct answer: A
Rationale: Encouraging daily walking is an essential intervention to address bradykinesia in clients with Parkinson's disease. Walking helps improve mobility, flexibility, and coordination, which can help manage the slowness of movement associated with bradykinesia. Providing thickened liquids (Choice B) is more relevant for dysphagia, not bradykinesia. Offering small, frequent meals (Choice C) is related to managing dysphagia and nutritional needs but does not specifically address bradykinesia. Teaching the client to use adaptive utensils (Choice D) is more focused on addressing fine motor skills and grip strength, which are not the primary concerns in bradykinesia.
5. The nurse is caring for a client with a spinal cord injury. Which intervention should the nurse implement to prevent autonomic dysreflexia?
- A. Restrict the client's fluid intake.
- B. Keep the client's room warm.
- C. Ensure the client's bladder is emptied regularly.
- D. Limit the client's intake of high-fiber foods.
Correct answer: C
Rationale: To prevent autonomic dysreflexia in clients with spinal cord injuries, it is crucial to ensure the client's bladder is emptied regularly. Bladder distention is a common trigger for autonomic dysreflexia in these clients. Keeping the bladder empty helps prevent the complications associated with autonomic dysreflexia, such as dangerously high blood pressure. Choices A, B, and D are incorrect. Restricting fluid intake can lead to dehydration, keeping the room warm is not directly related to preventing autonomic dysreflexia, and limiting high-fiber foods is not a primary intervention for this condition.
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