LPN LPN
ATI Learning System PN Medical Surgical Final Quizlet
1. A client with liver cirrhosis is prescribed lactulose. What is the purpose of this medication?
- A. To lower blood sugar levels
- B. To reduce ammonia levels
- C. To treat liver inflammation
- D. To improve bile flow
Correct answer: B
Rationale: Lactulose is prescribed to reduce ammonia levels in clients with liver cirrhosis. Elevated ammonia levels can lead to hepatic encephalopathy, a serious complication of liver cirrhosis. Lactulose works by acidifying the colon, which in turn traps ammonia in the colon and helps its elimination from the body through stool, thereby reducing the risk of hepatic encephalopathy. Choice A is incorrect because lactulose does not lower blood sugar levels. Choice C is incorrect as lactulose is not used to treat liver inflammation. Choice D is incorrect as lactulose does not improve bile flow.
2. In a patient with chronic kidney disease (CKD) receiving erythropoietin therapy, what laboratory result should the nurse monitor to evaluate the effectiveness of this therapy?
- A. Serum creatinine
- B. White blood cell count
- C. Hemoglobin level
- D. Serum potassium
Correct answer: C
Rationale: The correct answer is C: Hemoglobin level. Erythropoietin therapy is used to stimulate red blood cell production in patients with chronic kidney disease who often develop anemia due to reduced erythropoietin production by the kidneys. Monitoring the hemoglobin level is essential to evaluate the effectiveness of erythropoietin therapy as an increase in hemoglobin indicates improved red blood cell production and better management of anemia in these patients. Serum creatinine, white blood cell count, and serum potassium levels are important parameters to monitor in CKD patients but are not specific indicators of the effectiveness of erythropoietin therapy for managing anemia.
3. What action should the nurse take for a patient admitted with diabetic ketoacidosis exhibiting rapid, deep respirations?
- A. Administer the prescribed PRN lorazepam (Ativan).
- B. Start the prescribed PRN oxygen at 2 to 4 L/min.
- C. Administer the prescribed normal saline bolus and insulin.
- D. Encourage the patient to practice guided imagery for relaxation.
Correct answer: C
Rationale: The correct action for a patient with diabetic ketoacidosis and rapid, deep (Kussmaul) respirations is to administer a normal saline bolus and insulin. The rapid, deep respirations indicate a metabolic acidosis, which requires correction with a saline bolus to prevent hypovolemia and insulin to facilitate glucose re-entry into cells. Oxygen therapy is not necessary since the increased respiratory rate is compensatory and not due to hypoxemia. Encouraging relaxation techniques or administering lorazepam are inappropriate as they can worsen the acidosis by suppressing the compensatory respiratory effort.
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. The healthcare provider in the outpatient clinic has obtained health histories for these new patients. Which patient may need referral for genetic testing?
- A. 35-year-old patient whose maternal grandparents died after strokes at ages 90 and 96
- B. 18-year-old patient with a positive pregnancy test whose first child has cerebral palsy
- C. 34-year-old patient who has a sibling with newly diagnosed polycystic kidney disease
- D. 50-year-old patient with a history of cigarette smoking who is complaining of dyspnea
Correct answer: C
Rationale: The 34-year-old patient who has a sibling with newly diagnosed polycystic kidney disease may need referral for genetic testing. Polycystic kidney disease is an autosomal dominant disorder that can be asymptomatic until later in life. Presymptomatic testing can provide valuable information for guiding lifestyle and family planning decisions. The other patients do not present indications for genetic testing based on the information provided in their health histories. The 35-year-old patient's maternal grandparents' strokes are not indicative of a need for genetic testing. The 18-year-old patient's child having cerebral palsy is not a direct indication for genetic testing of the patient herself. The 50-year-old patient's symptoms are more likely related to smoking and respiratory issues, not genetic predisposition to a specific disease.
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