LPN LPN
ATI PN Adult Medical Surgical 2019
1. The healthcare provider is assessing a client with Raynaud's phenomenon. Which finding should the healthcare provider expect?
- A. Thickened and hardened skin.
- B. Painless ulcers on the fingertips.
- C. Episodes of cyanosis and pallor in the fingers.
- D. Red, scaly patches on the hands.
Correct answer: C
Rationale: Raynaud's phenomenon is characterized by vasospasm, leading to episodes of cyanosis (bluish discoloration) and pallor (pale color) in the fingers or toes, often triggered by cold temperatures or stress. This occurs due to the reduced blood flow during vasospastic episodes, causing the discoloration. Choices A, B, and D are incorrect findings associated with other conditions and are not typical of Raynaud's phenomenon.
2. The healthcare provider is assessing a client with Cushing's syndrome. Which clinical manifestation should the healthcare provider expect to find?
- A. Hyperpigmentation of the skin.
- B. Hypotension.
- C. Moon face and buffalo hump.
- D. Weight loss.
Correct answer: C
Rationale: The correct answer is C: Moon face and buffalo hump. In Cushing's syndrome, excess production of corticosteroids leads to redistribution of fat, particularly in the face (moon face) and between the shoulders (buffalo hump). Hyperpigmentation of the skin is actually associated with Addison's disease, not Cushing's syndrome (choice A). Hypotension is not a typical finding in Cushing's syndrome; instead, hypertension is more commonly seen due to the effects of excess cortisol (choice B). Weight gain, rather than weight loss, is a common symptom of Cushing's syndrome due to the metabolic disturbances caused by excess cortisol (choice D).
3. A client with osteoporosis is being discharged home. Which instruction should the nurse include in the discharge teaching?
- A. Avoid weight-bearing exercises.
- B. Take calcium supplements with meals.
- C. Limit vitamin D intake.
- D. Increase intake of caffeine-containing beverages.
Correct answer: B
Rationale: Taking calcium supplements with meals is a crucial instruction for a client with osteoporosis. Calcium absorption is enhanced when taken with food, and proper calcium intake is essential for managing osteoporosis effectively by promoting bone health and density. Avoiding weight-bearing exercises (Choice A) is incorrect because these exercises help improve bone strength. Limiting vitamin D intake (Choice C) is also incorrect as vitamin D is necessary for calcium absorption. Increasing caffeine intake (Choice D) is not recommended as caffeine can interfere with calcium absorption.
4. The healthcare provider is assessing a client with chronic obstructive pulmonary disease (COPD). Which finding should the provider expect?
- A. Increased anteroposterior chest diameter.
- B. Decreased respiratory rate.
- C. Dull percussion sounds over the lungs.
- D. Hyperresonance on chest percussion.
Correct answer: A
Rationale: The correct answer is A: Increased anteroposterior chest diameter. The increased anteroposterior chest diameter, often referred to as a barrel chest, is a common finding in clients with COPD due to hyperinflation of the lungs. This occurs because of the loss of lung elasticity and air trapping, leading to a more rounded chest shape. Choices B, C, and D are incorrect. Decreased respiratory rate is not typically associated with COPD; instead, an increased respiratory rate may be seen due to the body's compensatory mechanisms. Dull percussion sounds and hyperresonance on chest percussion are not characteristic findings in COPD. Dull percussion sounds may be indicative of consolidation or pleural effusion, while hyperresonance is more commonly associated with conditions like emphysema.
5. A client with severe rheumatoid arthritis is experiencing joint pain and stiffness. Which intervention should the nurse implement to help relieve the client's symptoms?
- A. Apply cold packs to the affected joints.
- B. Encourage passive range-of-motion exercises.
- C. Administer a muscle relaxant.
- D. Provide a high-calorie diet.
Correct answer: B
Rationale: Encouraging passive range-of-motion exercises is the most appropriate intervention to help relieve symptoms of joint pain and stiffness in clients with severe rheumatoid arthritis. These exercises help maintain joint mobility, prevent muscle contractures, and reduce stiffness in the affected joints. Passive range-of-motion exercises can also improve circulation to the joints, promoting healing and reducing pain. Applying cold packs may help with inflammation and pain temporarily, but it does not address the long-term joint mobility issues associated with rheumatoid arthritis. Muscle relaxants are not typically indicated for managing joint pain and stiffness in rheumatoid arthritis. While nutrition is important for overall health, providing a high-calorie diet is not a direct intervention for relieving joint pain and stiffness in this context.
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