ATI LPN
ATI PN Adult Medical Surgical 2019
1. A client with newly diagnosed diabetes mellitus is receiving teaching on foot care. Which instruction should the nurse include?
- A. Walk barefoot whenever possible to toughen your feet.
- B. Soak your feet in hot water daily to improve circulation.
- C. Trim your toenails straight across to prevent ingrown toenails.
- D. Use a heating pad to keep your feet warm.
Correct answer: C
Rationale: Correctly trimming toenails straight across is crucial in preventing ingrown toenails and potential infections in individuals with diabetes. Ingrown toenails can lead to complications, so it is essential for diabetic clients to practice proper nail care to avoid these issues. Choices A, B, and D are incorrect. Walking barefoot can increase the risk of foot injuries, soaking feet in hot water can cause burns or skin damage, and using a heating pad can lead to burns or injuries due to decreased sensation in the feet, which is common in diabetes.
2. During an assessment, a healthcare professional suspects a client has cholecystitis. What is a common symptom of this condition?
- A. Right upper quadrant pain
- B. Left lower quadrant pain
- C. Generalized abdominal pain
- D. Epigastric pain
Correct answer: A
Rationale: Right upper quadrant pain is a hallmark symptom of cholecystitis, indicating inflammation of the gallbladder. The gallbladder is typically located in the right upper quadrant of the abdomen, so pain in this area is characteristic of cholecystitis. This pain may be sharp or cramp-like and can be accompanied by other symptoms such as nausea, vomiting, and fever. Left lower quadrant pain (choice B) is more commonly associated with diverticulitis, generalized abdominal pain (choice C) can be seen in various conditions, and epigastric pain (choice D) is typically related to issues in the upper central part of the abdomen, such as gastritis or peptic ulcers, rather than cholecystitis.
3. While assessing a client with preeclampsia who is receiving magnesium sulfate, the nurse notes her deep tendon reflexes are 1+, respiratory rate is 12 breaths/minute, urinary output is 90 ml in 4 hours, and magnesium sulfate level is 9 mg/dl. What intervention should the nurse implement based on these findings?
- A. Continue the magnesium sulfate infusion as prescribed.
- B. Decrease the magnesium sulfate infusion by one-half.
- C. Stop the magnesium sulfate infusion immediately.
- D. Administer calcium gluconate immediately.
Correct answer: C
Rationale: The nurse should stop the magnesium sulfate infusion immediately in a client with preeclampsia exhibiting diminished reflexes, respiratory depression, and low urinary output, which indicate magnesium sulfate toxicity. This action is crucial to prevent further complications and adverse effects on the client.
4. A client with acute pancreatitis is admitted to the hospital. What is the priority nursing intervention for this client?
- A. Administering oral pancreatic enzymes
- B. Encouraging a high-protein diet
- C. Maintaining NPO status and administering IV fluids
- D. Providing a low-fat diet
Correct answer: C
Rationale: The priority nursing intervention for a client with acute pancreatitis is to maintain NPO (nothing by mouth) status and administer IV fluids. This approach helps rest the pancreas, decrease pancreatic stimulation, and prevent further exacerbation of the condition. By withholding oral intake and providing IV fluids, the pancreas is given the opportunity to recover and inflammation can be reduced. This intervention is crucial in the acute phase of pancreatitis to support the healing process and prevent complications.
5. A healthcare professional is preparing to administer digoxin 0.25 mg PO daily. The amount available is digoxin 0.125 mg tablets. How many tablets should the healthcare professional administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
- A. 1
- B. 2
- C. 3
- D. 4
Correct answer: B
Rationale: To achieve the prescribed dose of 0.25 mg, the healthcare professional should administer 2 tablets of 0.125 mg each, totaling 0.25 mg.
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