ATI LPN
ATI PN Adult Medical Surgical 2019
1. A client with peptic ulcer disease is prescribed omeprazole (Prilosec). Which instruction should the nurse include in the client's teaching plan?
- A. Take the medication with food.
- B. Take the medication at bedtime.
- C. Take the medication on an empty stomach.
- D. Take the medication as needed for pain relief.
Correct answer: C
Rationale: The correct instruction for a client prescribed omeprazole (Prilosec) is to take the medication on an empty stomach. This is important for optimal absorption and effectiveness of the medication in treating peptic ulcer disease. Choice A ('Take the medication with food') is incorrect because omeprazole should be taken on an empty stomach. Choice B ('Take the medication at bedtime') is incorrect as it does not align with the optimal timing for omeprazole administration. Choice D ('Take the medication as needed for pain relief') is incorrect because omeprazole is not typically used for immediate pain relief but rather for long-term management of peptic ulcer disease.
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. The charge nurse observes that a client with a nasogastric tube on low intermittent suction is drinking a glass of water immediately after the unlicensed assistive personnel (UAP) left the room. What action should the nurse take?
- A. Remove the glass of water and speak to the UAP.
- B. Discuss the incident with the UAP at the end of the day.
- C. Write an incident report and notify the healthcare provider.
- D. Remind the client of the potential for electrolyte imbalance.
Correct answer: A
Rationale: The correct action for the charge nurse to take is to remove the glass of water and speak to the UAP. This ensures immediate correction and education to prevent further issues with the nasogastric tube. Addressing the situation promptly can prevent harm to the client and reinforces the importance of following proper protocols.
4. A client with chronic renal failure is prescribed epoetin alfa (Epogen). Which outcome indicates that the medication is effective?
- A. Increased urine output.
- B. Decreased blood pressure.
- C. Improved hemoglobin levels.
- D. Stable potassium levels.
Correct answer: C
Rationale: Epoetin alfa is a medication that stimulates red blood cell production. Therefore, in a client with chronic renal failure, an effective outcome of epoetin alfa therapy would be an improvement in hemoglobin levels. This indicates that the medication is working as intended by addressing anemia, a common complication of chronic renal failure. Increased urine output (choice A) is not directly related to the action of epoetin alfa. Decreased blood pressure (choice B) is not a primary expected outcome of epoetin alfa therapy. Stable potassium levels (choice D) are important but not a direct indicator of the effectiveness of epoetin alfa in this context.
5. Aspirin is prescribed for a 9-year-old child with rheumatic fever to control the inflammatory process, promote comfort, and reduce fever. What intervention is most important for the nurse to implement?
- A. Instruct the parents to hold the aspirin until the child has first had a tepid sponge bath.
- B. Administer the aspirin with at least two ounces of water or juice.
- C. Notify the healthcare provider if the child complains of ringing in the ears.
- D. Advise the parents to question the child about seeing yellow halos around objects.
Correct answer: C
Rationale: In children, ringing in the ears (tinnitus) can be a sign of aspirin toxicity. Aspirin toxicity can be particularly concerning in children and can lead to serious complications. Therefore, it is crucial for the nurse to prioritize monitoring for signs of aspirin toxicity, such as tinnitus, and promptly notify the healthcare provider if such symptoms occur.
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