a 45 year old woman presents with fatigue pruritus and jaundice laboratory tests reveal elevated bilirubin and alkaline phosphatase levels imaging sho
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Nursing Elites

ATI LPN

Medical Surgical ATI Proctored Exam

1. A 45-year-old woman presents with fatigue, pruritus, and jaundice. Laboratory tests reveal elevated bilirubin and alkaline phosphatase levels. Imaging shows a normal common bile duct but dilated intrahepatic bile ducts. What is the most likely diagnosis?

Correct answer: A

Rationale: Based on the symptoms of fatigue, pruritus, and jaundice, along with elevated bilirubin and alkaline phosphatase levels, and imaging findings of a normal common bile duct but dilated intrahepatic bile ducts, the most likely diagnosis is primary biliary cirrhosis. Primary sclerosing cholangitis presents with different imaging findings, often showing strictures and beading of the bile ducts. Gallstones typically cause obstruction in the biliary system, leading to different symptoms and imaging findings. Pancreatic cancer would present with different clinical features and imaging characteristics.

2. The client with chronic kidney disease (CKD) is receiving hemodialysis. Which finding should be reported to the healthcare provider immediately?

Correct answer: D

Rationale: A potassium level of 6.5 mEq/L is dangerously high, a condition known as hyperkalemia, which can lead to severe cardiac complications like arrhythmias and cardiac arrest. Immediate medical intervention is necessary to lower potassium levels to prevent life-threatening outcomes in clients undergoing hemodialysis.

3. What is the primary advantage of prescribing rivaroxaban over warfarin for a patient with a history of deep vein thrombosis (DVT)?

Correct answer: A

Rationale: The primary advantage of prescribing rivaroxaban over warfarin for a patient with a history of deep vein thrombosis (DVT) is that rivaroxaban does not require regular INR monitoring. This eliminates the need for frequent blood tests to adjust the dosage, making it more convenient for patients to manage their anticoagulant therapy.

4. A client with rheumatoid arthritis is prescribed methotrexate. Which instruction should the nurse include in the client's teaching?

Correct answer: A

Rationale: The correct instruction for the client prescribed with methotrexate is to avoid alcohol while taking this medication. Methotrexate can cause liver toxicity, and alcohol consumption can further exacerbate this risk. It is crucial for patients to abstain from alcohol to prevent adverse effects on the liver. Therefore, instructing the client to avoid alcohol is a key component of safe medication use and management of rheumatoid arthritis.

5. A patient with chronic pain is prescribed a fentanyl patch. What is the most important instruction for the nurse to provide?

Correct answer: B

Rationale: The most important instruction for the nurse to provide to a patient prescribed a fentanyl patch is to change the patch every 72 hours. This ensures consistent pain control and prevents complications. It is crucial to rotate the application sites to prevent skin irritation or reactions. Using additional heating pads over the patch should be avoided as it can increase the absorption of the medication, leading to overdose or adverse effects. Removing the patch before showering is not necessary as long as the patch is securely in place.

Similar Questions

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A client with chronic obstructive pulmonary disease (COPD) is experiencing respiratory distress. Which intervention should the nurse implement first?
A patient with chronic kidney disease (CKD) is prescribed calcium acetate. What is the primary purpose of this medication?
A 28-year-old woman presents with abdominal pain, diarrhea, and rectal bleeding. She has a history of similar episodes in the past. What is the most likely diagnosis?

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