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ATI Adult Medical Surgical
1. A patient with an anxiety disorder is prescribed alprazolam. What is the primary action of this medication?
- A. Increase energy levels
- B. Induce sedation
- C. Elevate mood
- D. Reduce anxiety
Correct answer: D
Rationale: Alprazolam is a benzodiazepine that primarily works by reducing anxiety. It achieves this by enhancing the inhibitory effects of the neurotransmitter GABA in the brain, which leads to a calming effect on the individual. Therefore, the primary action of alprazolam is to decrease anxiety levels rather than increase energy, induce sedation, or elevate mood.
2. A 28-year-old woman presents with abdominal pain, bloating, and diarrhea. She notes that her symptoms improve with fasting. She has a history of iron deficiency anemia. What is the most likely diagnosis?
- A. Irritable bowel syndrome
- B. Celiac disease
- C. Lactose intolerance
- D. Crohn's disease
Correct answer: B
Rationale: The symptoms of abdominal pain, bloating, diarrhea improving with fasting, and a history of iron deficiency anemia are characteristic of celiac disease. Celiac disease is an autoimmune disorder triggered by gluten consumption, leading to damage in the small intestine. The improvement with fasting may be due to the temporary avoidance of gluten-containing foods. Irritable bowel syndrome, lactose intolerance, and Crohn's disease do not typically present with improvement of symptoms with fasting or have a clear association with iron deficiency anemia.
3. A client with diabetes has a new prescription for 14 units of regular insulin and 28 units of NPH insulin subcutaneously at breakfast daily. What is the total number of units of insulin that should be prepared in the insulin syringe?
- A. 42 units
- B. 14 units
- C. 28 units
- D. 32 units
Correct answer: A
Rationale: To calculate the total number of units of insulin, you need to add the 14 units of regular insulin to the 28 units of NPH insulin, which equals 42 units. Therefore, the nurse should prepare 42 units of insulin in the syringe for the client.
4. In a patient with a history of chronic iron deficiency anemia requiring a recent blood transfusion and an extensive GI work-up, which statement is true based on their medications?
- A. A dedicated small bowel series has a high likelihood of being positive
- B. 81 mg of aspirin per day decreases the benefit of using a COX II inhibitor
- C. The patient should have a provocative arteriogram with heparin infusion to identify the source of blood loss
- D. Hormonal therapy has been shown to be effective in decreasing blood loss due to arteriovenous malformations
Correct answer: B
Rationale: The correct answer is B. Taking even a low dose of aspirin per day, such as 81 mg, can reduce the protective effect on the gastrointestinal mucosa that is gained from using a COX II selective inhibitor. Aspirin can increase the risk of gastrointestinal bleeding, which can counteract the benefits of COX II inhibitors in protecting the stomach lining.
5. A client with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium (Spiriva). Which instruction should the nurse include in the client's teaching?
- A. Use this medication only during acute exacerbations.
- B. Rinse your mouth after using the inhaler.
- C. Take this medication with food.
- D. Increase your fluid intake to at least 3 liters per day.
Correct answer: B
Rationale: The correct instruction for the nurse to include in the teaching for a client prescribed tiotropium (Spiriva) is to rinse the mouth after using the inhaler. Rinsing the mouth helps prevent oral thrush, a common side effect of inhaled medications. This action reduces the risk of developing oral fungal infections, promoting better oral health for the client.
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