LPN LPN
ATI PN Adult Medical Surgical 2019
1. A client with a history of asthma is prescribed salmeterol (Serevent). Which instruction should the nurse provide?
- A. Use this medication for acute asthma attacks.
- B. Use this medication before using your albuterol inhaler.
- C. Use this medication twice daily for long-term control.
- D. Use this medication as needed for wheezing.
Correct answer: C
Rationale: The correct instruction for a client prescribed salmeterol (Serevent) is to use it twice daily for long-term control. Salmeterol is a long-acting bronchodilator that is not intended for acute asthma attacks or as-needed use for wheezing. Choice A is incorrect because salmeterol is not used for acute asthma attacks. Choice B is incorrect as salmeterol is not meant to replace the albuterol inhaler but rather used for long-term control. Choice D is incorrect because salmeterol should not be used as needed; it is a maintenance medication for asthma.
2. A client with coronary artery disease (CAD) is prescribed atorvastatin (Lipitor). Which laboratory value requires immediate intervention?
- A. Total cholesterol of 180 mg/dL.
- B. Low-density lipoprotein (LDL) of 200 mg/dL.
- C. Triglycerides of 150 mg/dL.
- D. High-density lipoprotein (HDL) of 40 mg/dL.
Correct answer: B
Rationale: An LDL level of 200 mg/dL is significantly elevated and requires immediate intervention to reduce the risk of cardiovascular events in a client with coronary artery disease (CAD). High LDL levels contribute to the development and progression of atherosclerosis, which can lead to complications like heart attacks and strokes. Lowering LDL levels is a key goal in managing CAD and preventing further cardiovascular damage. Total cholesterol of 180 mg/dL, triglycerides of 150 mg/dL, and HDL of 40 mg/dL are within acceptable ranges and do not pose an immediate risk that necessitates urgent intervention.
3. The mental health nurse observes that a female client with delusional disorder carries some of her belongings with her because she believes that others are trying to steal them. Which nursing action will promote trust?
- A. Explain that distrust is related to feeling anxious.
- B. Initiate short, frequent contacts with the client.
- C. Explain that these beliefs are related to her illness.
- D. Offer to keep the belongings at the nurse's desk.
Correct answer: B
Rationale: Initiating short, frequent contacts with the client is the most appropriate action to promote trust. This approach helps build trust and rapport, addressing the client's need for security. By maintaining regular contact, the nurse can provide reassurance and support, which can help alleviate the client's anxiety related to her delusional beliefs. Choice A does not directly address the client's need for trust and security. Choice C focuses on the client's illness but does not actively address building trust. Choice D, offering to keep the belongings at the nurse's desk, may not be well-received by the client and could potentially worsen her anxiety and distrust.
4. 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.
5. The nurse is caring for a client who is receiving chemotherapy. Which laboratory result indicates that the client is at risk for infection?
- A. Hemoglobin level of 12 g/dL.
- B. Platelet count of 150,000/mm3.
- C. White blood cell count of 2,000/mm3.
- D. Serum creatinine level of 1.0 mg/dL.
Correct answer: C
Rationale: A white blood cell count of 2,000/mm3 is low and indicates leukopenia, which increases the client's risk for infection. Hemoglobin level and platelet count are not directly indicative of infection risk. Serum creatinine level is related to kidney function, not infection risk.
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