ATI LPN
Medical Surgical ATI Proctored Exam
1. A client with a newly created ileostomy has not had ostomy output for the past 12 hours and reports worsening nausea. What is the nurse's priority action?
- A. Facilitate a referral to the wound-ostomy-continence (WOC) nurse
- B. Report signs and symptoms of obstruction to the health care provider
- C. Encourage the client to mobilize to enhance mobility
- D. Contact the health care provider to obtain a swab of the stoma for culture
Correct answer: B
Rationale: The nurse's priority action in this situation is to report signs and symptoms of possible obstruction to the healthcare provider. Lack of ostomy output and worsening nausea can indicate a potential obstruction, which requires immediate attention and intervention to prevent complications.
2. A patient with Parkinson's disease is prescribed levodopa. What dietary modification should the nurse suggest to the patient?
- A. Increase intake of vitamin C.
- B. Limit foods high in protein.
- C. Avoid foods rich in fiber.
- D. Increase sodium intake.
Correct answer: B
Rationale: The correct answer is to limit foods high in protein. Patients taking levodopa should restrict their intake of protein-rich foods because protein can interfere with the absorption of the medication. Levodopa competes with dietary proteins for absorption in the small intestine, potentially reducing the effectiveness of the medication. Therefore, by reducing protein intake, the patient can enhance the absorption and therapeutic effects of levodopa. Increasing vitamin C intake is not necessary for patients prescribed with levodopa. Avoiding foods rich in fiber or increasing sodium intake are not directly related to optimizing levodopa therapy and might not benefit the patient's condition.
3. The mother of a 9-month-old who was diagnosed with respiratory syncytial virus (RSV) yesterday calls the clinic to inquire if it will be all right to take her infant to the first birthday party of a friend's child the following day. What response should the nurse provide this mother?
- A. The child can be around other children but should wear a mask at all times.
- B. The child will no longer be contagious, no need to take any further precautions.
- C. Make sure there are no children under the age of 6 months around the infected child.
- D. Do not expose other children. RSV is very contagious even without direct oral contact.
Correct answer: D
Rationale: The correct response is to advise the mother not to expose other children to the infected child. RSV is highly contagious, and transmission can occur even without direct oral contact. It is crucial to prevent the spread of the virus to protect other children from getting infected.
4. Following a CVA, the nurse assesses that a client developed dysphagia, hypoactive bowel sounds, and a firm, distended abdomen. Which prescription for the client should the nurse question?
- A. Continuous tube feeding at 65 ml/hr via gastrostomy.
- B. Total parenteral nutrition to be infused at 125 ml/hour.
- C. Nasogastric tube connected to low intermittent suction.
- D. Metoclopramide (Reglan) intermittent piggyback.
Correct answer: A
Rationale: In a client with dysphagia, hypoactive bowel sounds, and a firm, distended abdomen post-CVA, continuous tube feeding at 65 ml/hr via gastrostomy may exacerbate abdominal distension and hypoactive bowel sounds. This situation requires immediate assessment and reevaluation before continuing with the prescription.
5. A client's healthcare provider has ordered a 'liver panel' in response to the client's development of jaundice. When reviewing the results of this laboratory testing, the nurse should expect to review what blood tests? Select one that doesn't apply.
- A. Alanine aminotransferase (ALT)
- B. C-reactive protein (CRP)
- C. Gamma-glutamyl transferase (GGT)
- D. Aspartate aminotransferase (AST)
Correct answer: B
Rationale: A 'liver panel' is a group of blood tests used to evaluate liver function. The components typically include ALT, GGT, and AST. While C-reactive protein (CRP) is a marker of inflammation and not part of a standard liver panel, it may be ordered for other diagnostic purposes.
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