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Adult Medical Surgical ATI
1. A client with a history of myocardial infarction (MI) is prescribed nitroglycerin (Nitrostat) for chest pain. Which instruction should the nurse provide?
- A. Take the medication with food.
- B. Swallow the tablet whole.
- C. Take the medication at bedtime.
- D. Place the tablet under your tongue.
Correct answer: D
Rationale: The correct instruction for a client prescribed nitroglycerin (Nitrostat) for chest pain is to place the tablet under the tongue. This route allows for rapid absorption of the medication, providing quick relief for chest pain associated with myocardial infarction.
2. The healthcare provider is assessing a client with Cushing's syndrome. Which clinical manifestation should the healthcare provider expect to find?
- A. Hyperpigmentation of the skin.
- B. Hypotension.
- C. Moon face and buffalo hump.
- D. Weight loss.
Correct answer: C
Rationale: The correct answer is C: Moon face and buffalo hump. In Cushing's syndrome, excess production of corticosteroids leads to redistribution of fat, particularly in the face (moon face) and between the shoulders (buffalo hump). Hyperpigmentation of the skin is actually associated with Addison's disease, not Cushing's syndrome (choice A). Hypotension is not a typical finding in Cushing's syndrome; instead, hypertension is more commonly seen due to the effects of excess cortisol (choice B). Weight gain, rather than weight loss, is a common symptom of Cushing's syndrome due to the metabolic disturbances caused by excess cortisol (choice D).
3. A patient with anemia is prescribed ferrous sulfate. What advice should the nurse give regarding the administration of this medication?
- A. Take with dairy products to increase absorption.
- B. Take on an empty stomach for best absorption.
- C. Avoid vitamin C while taking this medication.
- D. Take before bedtime.
Correct answer: B
Rationale: The correct advice for the administration of ferrous sulfate is to take it on an empty stomach for best absorption. This enhances the absorption of iron. If gastrointestinal upset occurs, the medication can be taken with food. Taking ferrous sulfate with dairy products is not recommended as calcium can inhibit iron absorption. Taking it before bedtime is also not recommended. Vitamin C can actually help with the absorption of iron and is often recommended to be taken alongside iron supplements to enhance absorption. Therefore, avoiding vitamin C while taking ferrous sulfate is not correct.
4. A client with chronic obstructive pulmonary disease (COPD) is receiving prednisone (Deltasone). Which side effect should the nurse monitor for?
- A. Hypoglycemia
- B. Infection
- C. Hypotension
- D. Weight loss
Correct answer: B
Rationale: The correct answer is B: Infection. Prednisone is an immunosuppressant medication commonly used in COPD to reduce inflammation. Due to its immunosuppressive effects, clients are at an increased risk of developing infections. Therefore, nurses should closely monitor clients receiving prednisone for signs and symptoms of infections to provide timely interventions.
5. A client with type 1 diabetes mellitus is experiencing nausea and vomiting. What advice should the nurse give regarding insulin administration?
- A. Skip your insulin dose until you can eat.
- B. Take your insulin as prescribed, but monitor your blood glucose closely.
- C. Reduce your insulin dose by half.
- D. Only take your long-acting insulin.
Correct answer: B
Rationale: The correct advice for a client with type 1 diabetes mellitus experiencing nausea and vomiting is to take insulin as prescribed but monitor blood glucose closely. It is essential to continue insulin therapy even if not eating normally to prevent complications from high blood sugar levels. Skipping insulin doses can lead to dangerous fluctuations in blood glucose levels. Reducing the insulin dose without proper guidance can also result in uncontrolled blood sugar. Taking only long-acting insulin may not provide adequate coverage for mealtime blood sugar elevation. Therefore, the best course of action is to take prescribed insulin doses while closely monitoring blood glucose levels.
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