ATI LPN
Adult Medical Surgical ATI
1. A client with chronic kidney disease (CKD) is scheduled for hemodialysis. Which pre-dialysis assessment finding should the nurse report to the healthcare provider?
- A. Serum potassium of 5.5 mEq/L.
- B. Blood pressure of 180/90 mm Hg.
- C. Heart rate of 80 beats per minute.
- D. Serum sodium of 140 mEq/L.
Correct answer: B
Rationale: The correct answer is B. A blood pressure of 180/90 mm Hg is elevated and should be reported to the healthcare provider before hemodialysis. Hypertension can have a significant impact on the effectiveness and safety of the dialysis treatment. Controlling blood pressure before the procedure is crucial to prevent complications during the dialysis session.
2. When assessing a client with a chest tube connected to suction, which observation indicates that the chest tube is functioning properly?
- A. Continuous bubbling in the water seal chamber.
- B. Intermittent bubbling in the suction control chamber.
- C. No fluctuation in the water seal chamber.
- D. Steady bubbling in the suction control chamber.
Correct answer: D
Rationale: Steady bubbling in the suction control chamber is the correct observation that indicates the chest tube is functioning properly. This steady bubbling signifies that the suction is actively maintaining the desired pressure level within the system, ensuring proper drainage and lung re-expansion. Continuous bubbling in the water seal chamber, intermittent bubbling in the suction control chamber, or no fluctuation in the water seal chamber are not indicative of optimal chest tube function and may require further assessment or intervention.
3. A 45-year-old woman presents with fatigue, weight gain, and constipation. Laboratory tests reveal high TSH and low free T4 levels. What is the most likely diagnosis?
- A. Hypothyroidism
- B. Hyperthyroidism
- C. Thyroiditis
- D. Thyroid cancer
Correct answer: A
Rationale: The combination of high TSH and low free T4 levels is consistent with hypothyroidism, which matches the patient's symptoms of fatigue, weight gain, and constipation. In hypothyroidism, the thyroid gland does not produce enough thyroid hormones, leading to a decrease in metabolic rate and resulting in these clinical findings.
4. A client with a new diagnosis of myasthenia gravis is prescribed pyridostigmine (Mestinon). Which instruction should the nurse include in the client's teaching?
- A. Take the medication with food to prevent gastrointestinal upset.
- B. Take the medication 30 minutes before meals.
- C. Avoid dairy products while taking this medication.
- D. Take the medication at bedtime.
Correct answer: B
Rationale: The correct instruction for a client with myasthenia gravis prescribed pyridostigmine (Mestinon) is to take the medication 30 minutes before meals. This timing is crucial as it helps improve muscle strength for eating and swallowing. By taking the medication before meals, the client can experience enhanced muscle function during mealtime, which is especially important for managing the symptoms of myasthenia gravis. Choices A, C, and D are incorrect. Taking the medication with food may decrease its effectiveness, avoiding dairy products is not necessary, and taking the medication at bedtime does not coincide with the optimal timing for enhancing muscle function during meals.
5. A patient with epilepsy is prescribed phenytoin. What is the primary side effect the nurse should monitor for?
- A. Hypotension
- B. Gingival hyperplasia
- C. Bradycardia
- D. Hyperkalemia
Correct answer: B
Rationale: Gingival hyperplasia, or overgrowth of the gums, is a common side effect of phenytoin. Patients should maintain good oral hygiene to minimize this effect.
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