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Adult Medical Surgical ATI
1. In a 45-year-old woman with a history of arthritis experiencing severe heartburn and indigestion refractory to antacids, which findings on an esophageal manometry study are consistent with her diagnosis?
- A. Vigorous peristalsis and elevated lower esophageal sphincter (LES) pressure
- B. Absent peristalsis and elevated LES pressure
- C. Absent peristalsis and decreased LES pressure
- D. Vigorous peristalsis and decreased LES pressure
Correct answer: C
Rationale: The correct answer is C: Absent peristalsis and decreased lower esophageal sphincter (LES) pressure. The patient in this scenario has scleroderma esophagus, characterized by atrophy of esophageal smooth muscle, leading to the loss of peristalsis and LES tone. These changes contribute to severe symptoms of gastroesophageal reflux disease (GERD) and esophagitis. Absent peristalsis and decreased LES pressure are typical findings in scleroderma esophagus, contributing to the refractory nature of the patient's symptoms despite antacid use.
2. Which of the following interventions is most effective in managing a patient with obsessive-compulsive disorder (OCD)?
- A. Encouraging the patient to engage in repetitive behaviors.
- B. Helping the patient to understand that their thoughts are irrational.
- C. Providing the patient with a structured daily routine.
- D. Allowing the patient to avoid situations that trigger their obsessions.
Correct answer: B
Rationale: The most effective intervention in managing a patient with obsessive-compulsive disorder (OCD) is helping the patient to understand that their thoughts are irrational. This cognitive-behavioral approach can assist in reducing the frequency and intensity of obsessive thoughts and compulsive behaviors by challenging and reframing maladaptive beliefs and thought patterns associated with OCD. Encouraging the patient to engage in repetitive behaviors (choice A) reinforces the compulsive behavior rather than addressing the underlying issue. Providing a structured daily routine (choice C) may help in some cases but does not directly target the irrational thoughts and beliefs. Allowing the patient to avoid trigger situations (choice D) can provide temporary relief but does not address the core problem of irrational thoughts and behaviors.
3. What is the purpose of the Expanded Program on Immunization (EPI)?
- A. To provide emergency medical services
- B. To ensure all children receive routine immunizations
- C. To offer specialized treatments for rare diseases
- D. To manage chronic health conditions
Correct answer: B
Rationale: The Expanded Program on Immunization (EPI) is designed to ensure that all children receive routine immunizations to prevent common infectious diseases. It focuses on providing vaccinations to children to build immunity against various preventable diseases, thus contributing to public health by reducing the spread of infectious illnesses.
4. A nurse is teaching a client who has Parkinson's disease about dietary modifications. Which of the following instructions should the nurse include?
- A. Eat high-protein, high-calorie meals
- B. Drink milk with every meal
- C. Avoid foods high in carbohydrates
- D. Drink carbonated beverages with meals
Correct answer: A
Rationale: The correct answer is A: 'Eat high-protein, high-calorie meals.' Individuals with Parkinson's disease benefit from consuming high-protein, high-calorie meals to help maintain muscle mass and energy levels. This dietary modification is important in managing the symptoms of Parkinson's disease. Choice B is incorrect because there is no specific requirement for drinking milk with every meal for individuals with Parkinson's disease. Choice C is incorrect as carbohydrates are also essential for a balanced diet and should not be completely avoided. Choice D is incorrect as carbonated beverages may interfere with the absorption of nutrients from food and are not recommended for individuals with Parkinson's disease.
5. A client with asthma and a new prescription for an ipratropium inhaler is being taught by a nurse. Which statement by the client indicates an understanding of the teaching?
- A. I will rinse my mouth after each use
- B. I should wait 5 minutes before taking a second puff
- C. I should take this medication when I wake up
- D. I should wait 1 minute before taking a second puff
Correct answer: D
Rationale: The correct answer is D because waiting 1 minute between puffs ensures proper absorption of the medication. Choice A is incorrect as rinsing the mouth is not a specific instruction related to using the inhaler. Choice B is incorrect as waiting 5 minutes between puffs is longer than necessary. Choice C is incorrect as the timing of medication administration is not specified in the question.
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