ATI LPN
Adult Medical Surgical ATI
1. A 48-year-old woman presents with fatigue, pruritus, and jaundice. She has a history of ulcerative colitis. Laboratory tests reveal elevated bilirubin and alkaline phosphatase. What is the most likely diagnosis?
- A. Hepatitis B
- B. Primary biliary cirrhosis
- C. Primary sclerosing cholangitis
- D. Autoimmune hepatitis
Correct answer: C
Rationale: The combination of symptoms (fatigue, pruritus, jaundice) along with a history of ulcerative colitis and elevated bilirubin and alkaline phosphatase levels suggests primary sclerosing cholangitis. Primary sclerosing cholangitis is commonly associated with inflammatory bowel disease, such as ulcerative colitis. It is characterized by inflammation and fibrosis of the bile ducts, leading to cholestasis and elevated alkaline phosphatase and bilirubin levels.
2. A client is being taught about the use of an albuterol inhaler. Which of the following instructions should be included?
- A. Use the inhaler every 4 hours around the clock.
- B. Shake the inhaler well before use.
- C. Rinse your mouth with water after each use.
- D. Use the inhaler while lying down.
Correct answer: B
Rationale: Shaking the inhaler well before use is a crucial step in ensuring proper medication delivery. This action helps disperse the medication evenly within the device, optimizing the effectiveness of each dose. It ensures that the client receives the intended amount of medication. The other options are incorrect: Option A suggests a fixed time interval for inhaler use, which may not be suitable for all clients and can lead to overuse. Option C, rinsing the mouth, is more relevant for corticosteroid inhalers to prevent oral thrush. Option D, using the inhaler while lying down, is not recommended as it may lead to improper drug delivery and is not the correct position for inhaler use.
3. In addition to poor eating habits, a factor that often contributes to marginal nutritional status is:
- A. dependence on caffeine.
- B. acute illness.
- C. low income.
- D. size of the family unit.
Correct answer: C
Rationale: Low income is a significant factor contributing to marginal nutritional status due to limited access to nutritious food. While dependence on caffeine or acute illness can impact health, they are not as directly linked to marginal nutrition as low income. The size of the family unit may affect food distribution within the household but is not as directly related to marginal nutritional status as low income.
4. A patient who is diagnosed with cervical cancer that is classified as Tis, N0, M0 asks the nurse what the letters and numbers mean. Which response by the nurse is most appropriate?
- A. The cancer involves only the cervix.
- B. The cancer cells closely resemble normal cells.
- C. Further testing is necessary to determine the spread of the cancer.
- D. Determining the original site of the cervical cancer is challenging.
Correct answer: A
Rationale: The correct response is A: 'The cancer involves only the cervix.' In staging, 'Tis' indicates cancer in situ, which means it is localized to the cervix and not invasive at this time. The differentiation of cancer cells is not part of clinical staging. Since the cancer is in situ, its origin is the cervix. Further testing is not required as the cancer has not spread beyond the cervix. Choice B is incorrect as the staging information provided does not relate to the resemblance of cancer cells to normal cells. Choice C is incorrect because further testing is not necessary as the cancer is localized. Choice D is incorrect because the staging information provided clearly indicates the site of origin as the cervix.
5. A nurse is caring for a client who has hypokalemia. Which of the following clinical findings should the nurse expect?
- A. Hyperactive reflexes.
- B. Strong, bounding pulse.
- C. Decreased bowel sounds.
- D. Increased deep tendon reflexes.
Correct answer: C
Rationale: The correct answer is C: Decreased bowel sounds. In hypokalemia, decreased bowel sounds are common due to slowed peristalsis. Hyperactive reflexes (choice A) and increased deep tendon reflexes (choice D) are more indicative of hyperkalemia. A strong, bounding pulse (choice B) is not typically associated with hypokalemia.
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