ATI LPN
Medical Surgical ATI Proctored Exam
1. A healthcare provider is providing dietary teaching to a client with cholecystitis. Which type of diet should the healthcare provider recommend?
- A. High-fiber, low-fat diet
- B. Low-fiber, high-protein diet
- C. Low-fat, low-cholesterol diet
- D. High-protein, high-fat diet
Correct answer: C
Rationale: In cholecystitis, a low-fat, low-cholesterol diet is recommended to manage symptoms and reduce inflammation by reducing the workload on the gallbladder. This diet helps prevent gallbladder attacks and complications.
2. The nurse is planning care for a client with cirrhosis of the liver. Which intervention should the nurse include to reduce the risk of bleeding?
- A. Monitor for signs of infection.
- B. Limit the client's dietary protein intake.
- C. Administer vitamin K as prescribed.
- D. Encourage the client to increase fluid intake.
Correct answer: C
Rationale: Administering vitamin K as prescribed can help reduce the risk of bleeding in clients with cirrhosis by promoting clotting factor production. Cirrhosis often leads to impaired liver function, affecting the synthesis of clotting factors. Vitamin K supplementation helps in the production of these essential clotting factors, thus reducing the risk of bleeding in clients with cirrhosis. Monitoring for signs of infection (Choice A) is important for overall care but not directly related to reducing the risk of bleeding in cirrhosis. Limiting dietary protein intake (Choice B) may be necessary in some cases of cirrhosis but does not directly address the risk of bleeding. Encouraging increased fluid intake (Choice D) is beneficial for various aspects of health but does not specifically target the risk of bleeding in cirrhosis.
3. While assessing a client with diabetes mellitus, the nurse observes an absence of hair growth on the client's legs. What additional assessment provides further data to support this finding?
- A. Palpate for the presence of femoral pulses bilaterally.
- B. Assess for the presence of a positive Homan's sign.
- C. Observe the appearance of the skin on the client's legs.
- D. Watch the client's posture and balance during ambulation.
Correct answer: C
Rationale: The absence of hair growth on the legs in a client with diabetes mellitus can be indicative of poor circulation due to compromised blood flow. Assessing the appearance of the skin on the client's legs is crucial as it can reveal additional signs of impaired circulation, such as changes in color, temperature, and the presence of ulcers or wounds. This information aids in the comprehensive evaluation of the client's vascular status and guides appropriate interventions to prevent potential complications.
4. 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.
5. A client with coronary artery disease (CAD) is prescribed atorvastatin (Lipitor). Which laboratory value requires immediate intervention?
- A. Total cholesterol of 180 mg/dL.
- B. Low-density lipoprotein (LDL) of 200 mg/dL.
- C. Triglycerides of 150 mg/dL.
- D. High-density lipoprotein (HDL) of 40 mg/dL.
Correct answer: B
Rationale: An LDL level of 200 mg/dL is significantly elevated and requires immediate intervention to reduce the risk of cardiovascular events in a client with coronary artery disease (CAD). High LDL levels contribute to the development and progression of atherosclerosis, which can lead to complications like heart attacks and strokes. Lowering LDL levels is a key goal in managing CAD and preventing further cardiovascular damage. Total cholesterol of 180 mg/dL, triglycerides of 150 mg/dL, and HDL of 40 mg/dL are within acceptable ranges and do not pose an immediate risk that necessitates urgent intervention.
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