ATI LPN
ATI PN Adult Medical Surgical 2019
1. A client with cirrhosis of the liver is experiencing pruritus. Which intervention should the nurse implement to help relieve the client's symptoms?
- A. Administer acetaminophen (Tylenol).
- B. Apply lotion to the skin.
- C. Encourage a high-protein diet.
- D. Provide a warm bath.
Correct answer: B
Rationale: Pruritus is a common symptom in clients with cirrhosis due to bile salts accumulating in the skin. Applying lotion to the skin helps soothe the itching and can prevent skin breakdown. Acetaminophen can worsen liver damage in clients with cirrhosis as it is metabolized in the liver. Encouraging a high-protein diet is not directly related to relieving pruritus. Providing a warm bath may further dry the skin, exacerbating the itching. Therefore, the most appropriate intervention to help relieve pruritus in a client with cirrhosis is to apply lotion to the skin.
2. A client with a history of atrial fibrillation is prescribed warfarin (Coumadin). Which laboratory test should the nurse monitor to determine the effectiveness of the medication?
- A. Platelet count.
- B. Prothrombin time (PT) and international normalized ratio (INR).
- C. Activated partial thromboplastin time (aPTT).
- D. Fibrinogen level.
Correct answer: B
Rationale: Prothrombin time (PT) and international normalized ratio (INR) are essential laboratory tests to monitor the effectiveness of warfarin (Coumadin) therapy. These tests help assess the clotting time and the desired anticoagulant effect of the medication. Monitoring PT and INR levels is crucial to ensure that the client is within the therapeutic range, reducing the risk of bleeding or clotting complications associated with warfarin therapy. Platelet count (Choice A) measures the number of platelets in the blood and is not specific for monitoring warfarin therapy. Activated partial thromboplastin time (aPTT) (Choice C) is more commonly used to monitor heparin therapy, not warfarin. Fibrinogen level (Choice D) assesses the amount of fibrinogen in the blood and is not a specific test for monitoring warfarin therapy.
3. A healthcare professional is interested in studying the incidence of infant death in a particular city and wants to compare that city's rate to the state's rate. What state resource is most likely to provide this information?
- A. Disease registry.
- B. Department of Health.
- C. Bureau of Vital Statistics.
- D. Census data.
Correct answer: C
Rationale: The Bureau of Vital Statistics collects data on births and deaths, including infant mortality rates. This data is crucial for healthcare professionals to analyze and compare rates between different regions.
4. A patient with chronic heart failure is prescribed carvedilol. What is the primary purpose of this medication?
- A. Increase cardiac output
- B. Reduce fluid retention
- C. Decrease heart rate
- D. Lower blood pressure
Correct answer: C
Rationale: Carvedilol, a beta-blocker, is primarily prescribed in patients with chronic heart failure to decrease heart rate and reduce the workload on the heart. By lowering the heart rate, carvedilol helps the heart function more efficiently and improves symptoms in patients with heart failure.
5. What is the primary goal of care for a client experiencing esophageal varices secondary to liver cirrhosis?
- A. Preventing infection
- B. Controlling bleeding
- C. Reducing portal hypertension
- D. Maintaining nutritional status
Correct answer: B
Rationale: The primary goal of care for a client with esophageal varices secondary to liver cirrhosis is to control bleeding. Esophageal varices are fragile, enlarged veins in the esophagus that can rupture and lead to life-threatening bleeding. Controlling bleeding is crucial to prevent severe complications and ensure the client's safety and well-being. Preventing infection (Choice A) is important but not the primary goal in this case. Reducing portal hypertension (Choice C) is a long-term goal that may help prevent variceal bleeding but is not the immediate priority. Maintaining nutritional status (Choice D) is essential for overall health but is secondary to controlling bleeding in this critical situation.
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