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ATI Adult Medical Surgical
1. A patient with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium. What is the primary purpose of this medication?
- A. Reduce mucus production
- B. Relieve bronchospasm
- C. Suppress cough
- D. Thin respiratory secretions
Correct answer: B
Rationale: Tiotropium is a long-acting bronchodilator used to relieve bronchospasm and improve airflow in patients with chronic obstructive pulmonary disease (COPD). It works by relaxing the muscles around the airways, leading to bronchodilation and improved breathing, making it an essential treatment in managing COPD symptoms.
2. When assessing a male client who is receiving a unit of packed red blood cells (PRBCs), the nurse notes that the infusion was started 30 minutes ago, and 50 ml of blood is left to be infused. The client's vital signs are within normal limits. He reports feeling 'out of breath' but denies any other complaints. What action should the nurse take at this time?
- A. Administer a PRN prescription for diphenhydramine (Benadryl).
- B. Start the normal saline attached to the Y-tubing at the same rate.
- C. Decrease the intravenous flow rate of the PRBC transfusion.
- D. Ask the respiratory therapist to administer PRN albuterol (Ventolin).
Correct answer: C
Rationale: In this scenario, the client is experiencing symptoms of shortness of breath, which could indicate fluid overload from the PRBC transfusion. By decreasing the intravenous flow rate of the transfusion, the nurse can slow down the rate of blood being infused, potentially alleviating the symptoms of fluid overload and shortness of breath. This intervention can help prevent further complications and promote the client's comfort and safety.
3. A client reports recent exposure to hepatitis A. What is a common mode of transmission for this virus?
- A. Blood transfusion
- B. Fecal-oral route
- C. Needle sharing
- D. Sexual contact
Correct answer: B
Rationale: Hepatitis A is commonly transmitted through the fecal-oral route, often via ingestion of contaminated food or water. This mode of transmission is why proper hygiene, sanitation, and vaccination are essential in preventing the spread of hepatitis A.
4. A client with a history of atrial fibrillation is prescribed dabigatran (Pradaxa). Which instruction should the nurse include in the client's teaching?
- A. Take the medication with food to improve absorption.
- B. Avoid foods high in vitamin K.
- C. Take the medication at the same time each day.
- D. Increase your intake of high-potassium foods.
Correct answer: C
Rationale: The correct instruction for the nurse to include in the client's teaching regarding dabigatran (Pradaxa) is to take the medication at the same time each day. This ensures a consistent blood level and effectiveness of the medication, which is crucial in managing atrial fibrillation and preventing complications. It helps maintain a steady therapeutic effect and reduces the risk of erratic drug levels in the body.
5. A patient with bipolar disorder is prescribed valproic acid. What is an important side effect for the nurse to monitor?
- A. Hypertension
- B. Liver toxicity
- C. Hyperglycemia
- D. Bradycardia
Correct answer: B
Rationale: The correct answer is B: Liver toxicity. Valproic acid is known to potentially cause liver toxicity. Monitoring liver function tests regularly in patients taking valproic acid is crucial to detect any signs of liver damage early and prevent serious complications.
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