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Adult Medical Surgical ATI
1. A 35-year-old woman presents with abdominal pain, diarrhea, and weight loss. She has a history of recurrent mouth ulcers and a perianal fistula. What is the most likely diagnosis?
- A. Ulcerative colitis
- B. Irritable bowel syndrome
- C. Crohn's disease
- D. Diverticulitis
Correct answer: C
Rationale: The combination of symptoms including recurrent mouth ulcers, perianal fistula, abdominal pain, diarrhea, and weight loss strongly suggests Crohn's disease. These extra-intestinal manifestations are characteristic of Crohn's disease, a chronic inflammatory condition that can affect any part of the gastrointestinal tract. Ulcerative colitis primarily involves the colon, while irritable bowel syndrome is a functional disorder without the inflammatory component seen in Crohn's disease. Diverticulitis typically presents with localized left lower quadrant pain and is less likely to cause mouth ulcers and perianal fistulas.
2. A client has a new prescription for transdermal nitroglycerin patches. Which of the following instructions should be included for proper use?
- A. Apply the patch to the same site each day.
- B. Place the patch on an area of skin away from skin folds and joints.
- C. Keep the patch on 24 hours per day.
- D. Replace the patch every 72 hours.
Correct answer: B
Rationale: Placing the nitroglycerin patch on an area of skin away from skin folds and joints is crucial to ensure optimal absorption and effectiveness of the medication. Placing the patch on skin folds or joints can interfere with absorption, potentially reducing the patch's efficacy. Therefore, it is essential to follow this instruction to maximize the therapeutic benefits of the nitroglycerin patches. The other options are incorrect because applying the patch to the same site each day can lead to skin irritation, keeping the patch on 24 hours per day may not be necessary depending on the specific patch instructions, and replacing the patch every 72 hours is not the standard frequency for nitroglycerin patches.
3. In evaluating a 10-year-old child with meningitis suspected of having diabetes insipidus, which finding is indicative of diabetes insipidus?
- A. Decreased urine specific gravity.
- B. Elevated urine glucose.
- C. Decreased serum potassium.
- D. Increased serum sodium.
Correct answer: A
Rationale: Diabetes insipidus is characterized by the kidneys' inability to concentrate urine, leading to decreased urine specific gravity. This results in the excretion of large volumes of dilute urine, causing a decrease in urine specific gravity. Therefore, when evaluating a suspected case of diabetes insipidus, a finding of decreased urine specific gravity is indicative of this condition.
4. The nutrients involved in metabolic regulation and control include minerals, vitamins, and:
- A. amino acids.
- B. carbohydrates.
- C. fats.
- D. water.
Correct answer: D
Rationale: The correct answer is D, water. Water plays a crucial role in metabolic regulation along with vitamins and minerals. While amino acids, carbohydrates, and fats are essential nutrients for various bodily functions, they are not primarily involved in metabolic regulation and control.
5. What is the most important advantage of an advance directive?
- A. Such a directive indicates how medical decisions are to be made in case a patient is unable to communicate their wishes.
- B. It spares the family the burden of making significant decisions for a patient regarding terminal care.
- C. It ensures that a person's property is distributed according to their wishes after death, avoiding legal complications.
- D. It allows individuals to appoint a guardian for themselves in case of incapacity, without involving the court system.
Correct answer: B
Rationale: An advance directive, or living will, is a legal document that specifies an individual's preferences for medical treatment if they are unable to communicate their wishes. The most important advantage of an advance directive is that it spares the family from having to make challenging decisions about terminal care on behalf of the patient. Choice A is incorrect because advance directives pertain to healthcare decisions, not property matters. Choice C is incorrect as it refers to a will for property distribution, which is a different legal document. Choice D is incorrect as advance directives are not related to appointing guardians but rather focus on healthcare decision-making.
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