LPN LPN
ATI PN Adult Medical Surgical 2019
1. A client with chronic renal failure is prescribed erythropoietin (Epogen). Which outcome indicates that the medication is effective?
- A. Increased urine output.
- B. Improved hemoglobin levels.
- C. Decreased blood pressure.
- D. Stable potassium levels.
Correct answer: B
Rationale: The correct answer is B: Improved hemoglobin levels. Erythropoietin (Epogen) stimulates red blood cell production, leading to an increase in hemoglobin levels in clients with chronic renal failure. Monitoring hemoglobin levels is crucial to assess the effectiveness of erythropoietin therapy in managing anemia associated with chronic renal failure. While increased urine output, decreased blood pressure, and stable potassium levels are important parameters to monitor in clients with renal failure, they are not direct indicators of the effectiveness of erythropoietin therapy.
2. A client with chronic obstructive pulmonary disease (COPD) is experiencing respiratory distress. Which intervention should the nurse implement first?
- A. Administer bronchodilators as prescribed.
- B. Encourage pursed-lip breathing.
- C. Position the client in a high Fowler's position.
- D. Obtain a stat arterial blood gas (ABG) sample.
Correct answer: C
Rationale: In a client with COPD experiencing respiratory distress, the priority intervention should be to position the client in a high Fowler's position. This position helps optimize lung expansion, improve oxygenation, and reduce the work of breathing. Administering bronchodilators and encouraging pursed-lip breathing are important interventions but positioning the client to enhance respiratory function takes precedence in this situation. Obtaining an ABG sample may provide valuable information but is not the initial priority when addressing respiratory distress.
3. A client with heart failure is receiving digoxin (Lanoxin). Which finding indicates that the medication is effective?
- A. Increased heart rate.
- B. Decreased pedal edema.
- C. Elevated blood pressure.
- D. Improved urine output.
Correct answer: B
Rationale: In a client with heart failure, decreased pedal edema is a positive indicator of improved cardiac output and reduced fluid retention. Digoxin works by increasing the strength of the heart's contractions, leading to improved circulation and reduced symptoms of heart failure, such as edema. Monitoring for decreased pedal edema is essential to assess the effectiveness of digoxin therapy. Choices A, C, and D are incorrect because an increased heart rate, elevated blood pressure, and improved urine output are not specific indicators of digoxin's effectiveness in managing heart failure. Instead, the focus should be on improvements related to fluid retention and cardiac function, like decreased pedal edema.
4. The client with bacterial pneumonia is receiving intravenous antibiotics. Which assessment finding indicates that the treatment is effective?
- A. Increased respiratory rate.
- B. Decreased oxygen saturation.
- C. Clear lung sounds.
- D. Elevated white blood cell count.
Correct answer: C
Rationale: Clear lung sounds indicate that the antibiotics are effectively treating the bacterial pneumonia by resolving the infection and reducing the inflammation in the lungs, leading to improved air exchange and ventilation. Increased respiratory rate (Choice A) and decreased oxygen saturation (Choice B) are indicative of ongoing respiratory distress and ineffective treatment. Elevated white blood cell count (Choice D) suggests a persistent infection rather than effective treatment.
5. A client with a history of chronic alcohol use is admitted with confusion and an unsteady gait. Which deficiency should the nurse suspect?
- A. Thiamine (Vitamin B1)
- B. Cyanocobalamin (Vitamin B12)
- C. Folic acid
- D. Vitamin D
Correct answer: A
Rationale: The correct answer is Thiamine (Vitamin B1). Chronic alcohol use can lead to thiamine deficiency, which can result in neurological symptoms such as confusion and an unsteady gait. Thiamine is essential for proper brain function and nerve conduction, and its deficiency is common in individuals with alcohol use disorder. Cyanocobalamin (Vitamin B12) deficiency can also present with neurological symptoms, but in this case, the patient's history of chronic alcohol use points more towards thiamine deficiency. Folic acid deficiency typically presents with symptoms like fatigue and megaloblastic anemia. Vitamin D deficiency is associated with bone health issues rather than neurological symptoms.
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