ATI LPN
Medical Surgical ATI Proctored Exam
1. A 30-year-old woman presents with fatigue, polyuria, and polydipsia. Laboratory tests reveal hyperglycemia and ketonuria. What is the most likely diagnosis?
- A. Type 1 diabetes mellitus
- B. Type 2 diabetes mellitus
- C. Diabetes insipidus
- D. Hyperthyroidism
Correct answer: A
Rationale: The clinical presentation of a 30-year-old woman with fatigue, polyuria, polydipsia, hyperglycemia, and ketonuria is highly suggestive of type 1 diabetes mellitus. Type 1 diabetes mellitus is characterized by autoimmune destruction of pancreatic beta cells, leading to insulin deficiency and subsequent hyperglycemia. The presence of ketonuria indicates the breakdown of fats for energy due to the lack of insulin. In contrast, type 2 diabetes mellitus typically presents with gradual onset and is often associated with insulin resistance rather than absolute insulin deficiency. Diabetes insipidus is characterized by polyuria and polydipsia but is not associated with hyperglycemia or ketonuria. Hyperthyroidism may present with symptoms like fatigue but does not typically cause hyperglycemia or ketonuria.
2. A client with type 2 diabetes mellitus is prescribed metformin (Glucophage). Which instruction should the nurse provide?
- A. Take the medication on an empty stomach.
- B. Limit your fluid intake while on this medication.
- C. Monitor your blood glucose levels regularly.
- D. Avoid eating foods high in potassium.
Correct answer: C
Rationale: Monitoring blood glucose levels regularly is crucial for clients with type 2 diabetes who are taking metformin. This helps assess the effectiveness of the medication in managing blood sugar levels and allows for timely adjustments in the treatment plan if needed. By monitoring blood glucose levels, the client and healthcare team can work together to achieve optimal diabetes control and prevent complications associated with uncontrolled blood sugar levels.
3. In acute pancreatitis, a client experiencing severe abdominal pain should have which enzyme level closely monitored?
- A. Serum amylase.
- B. Serum sodium.
- C. Serum calcium.
- D. Serum potassium.
Correct answer: A
Rationale: In acute pancreatitis, serum amylase levels should be closely monitored. Elevated serum amylase levels are a key diagnostic marker for acute pancreatitis, aiding in the assessment and management of the patient's condition. Monitoring serum sodium, calcium, or potassium levels is not typically associated with acute pancreatitis and would not provide relevant information for this specific condition.
4. When a client reports being allergic to penicillin, which question should the nurse ask to gather more information?
- A. Are you allergic to any other medications?
- B. How often have you taken penicillin in the past?
- C. Is anyone else in your family allergic to penicillin?
- D. What happens to you when you take penicillin?
Correct answer: D
Rationale: Questioning the client about the specific allergic reaction to penicillin is crucial for assessing the severity and type of allergic response, aiding in determining appropriate treatment and avoiding potential adverse reactions.
5. A client who has Type 1 diabetes and is at 10-weeks gestation comes to the prenatal clinic complaining of a headache, nausea, sweating, feeling shaky, and being tired all the time. What action should the nurse take first?
- A. Check the blood glucose level.
- B. Draw blood for a Hemoglobin A1C.
- C. Assess urine for ketone levels.
- D. Provide the client with a protein snack.
Correct answer: A
Rationale: The correct action for the nurse to take first is to check the client's blood glucose level. This is crucial to determine if the symptoms are a result of hypoglycemia or hyperglycemia, which requires immediate attention to maintain the client's health and the health of the developing fetus.
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