ATI LPN
Medical Surgical ATI Proctored Exam
1. A 55-year-old woman presents with fatigue, pruritus, and jaundice. Laboratory tests reveal elevated bilirubin and alkaline phosphatase levels. Imaging shows dilated intrahepatic bile ducts and a normal common bile duct. What is the most likely diagnosis?
- A. Primary biliary cirrhosis
- B. Primary sclerosing cholangitis
- C. Gallstones
- D. Pancreatic cancer
Correct answer: A
Rationale: The presentation of fatigue, pruritus, and jaundice in a 55-year-old woman, along with elevated bilirubin and alkaline phosphatase levels, and imaging findings of dilated intrahepatic bile ducts and a normal common bile duct, are characteristic of primary biliary cirrhosis. Primary biliary cirrhosis is an autoimmune liver disease that typically affects middle-aged women, leading to progressive destruction of the intrahepatic bile ducts.
2. When treating Baby John, who has been diagnosed with a lower respiratory infection, the selection of drugs of choice for the treatment depends primarily on:
- A. Preference of the physician
- B. Selectivity of the organism
- C. Sensitivity of the organism
- D. Tolerance of the client
Correct answer: C
Rationale: The primary factor in selecting drugs for the treatment of a lower respiratory infection in Baby John is the sensitivity of the organism causing the infection. The choice of antibiotics should be guided by the susceptibility of the specific pathogen to ensure effective treatment and prevent resistance.
3. A nurse is preparing to perform closed intermittent bladder irrigation for a client following a transurethral resection of the prostate (TURP). Which of the following actions is appropriate by the nurse?
- A. Aspirate the irrigation solution from the bladder
- B. Insert the tip of the irrigation syringe into the catheter opening
- C. Apply sterile gloves
- D. Open the flow clamp to the irrigating fluid infusion tubing
Correct answer: C
Rationale: The correct action for the nurse to take before performing a closed intermittent bladder irrigation is to apply sterile gloves. Sterile gloves help maintain asepsis, reduce the risk of infection, and ensure patient safety during the procedure. Aspirating the irrigation solution from the bladder (Choice A) is not a standard step in closed intermittent bladder irrigation. Inserting the tip of the irrigation syringe into the catheter opening (Choice B) can introduce contaminants into the system. Opening the flow clamp to the irrigating fluid infusion tubing (Choice D) should only be done after ensuring all equipment is ready and the nurse is gloved to maintain sterility.
4. A client with hypertension is being taught about the DASH diet. Which of the following statements by the client indicates an understanding of the teaching?
- A. I should increase my intake of sodium-rich foods.
- B. I should decrease my intake of potassium-rich foods.
- C. I should increase my intake of fruits and vegetables.
- D. I should decrease my intake of whole grains.
Correct answer: C
Rationale: The correct answer is C. The Dietary Approaches to Stop Hypertension (DASH) diet is recommended for managing hypertension. Increasing the intake of fruits and vegetables is a key component of the DASH diet as these foods are rich in nutrients that can help lower blood pressure levels. Choices A, B, and D are incorrect because they go against the principles of the DASH diet, which focuses on reducing sodium intake, increasing potassium-rich foods, and consuming whole grains.
5. A patient is receiving education about dietary restrictions while taking a monoamine oxidase inhibitor (MAOI). Which food should the patient avoid?
- A. Aged cheese
- B. Fresh vegetables
- C. Grilled chicken
- D. Fruit juices
Correct answer: A
Rationale: Patients taking MAOIs should avoid aged cheese as it contains high levels of tyramine, which can lead to a hypertensive crisis. Monoamine oxidase inhibitors can inhibit the breakdown of tyramine, leading to an excess accumulation in the body and potentially dangerous increases in blood pressure.
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