ATI LPN
ATI Medical Surgical Proctored Exam 2019 Quizlet
1. A 62-year-old male client with a history of coronary artery disease complains that his heart is 'racing' and he often feels dizzy. His blood pressure is 110/60, and he uses portable oxygen at 2 liters per nasal cannula. Based on the rhythm shown, which prescription should the nurse administer?
- A. Give magnesium via secondary infusion.
- B. Initiate IV heparin solution as per protocol.
- C. Administer IV adenosine (Adenocard).
- D. Prepare for synchronized cardioversion.
Correct answer: C
Rationale: Administering IV adenosine is the appropriate intervention for a client with symptomatic tachycardia to restore normal sinus rhythm. Adenosine is a medication used to treat supraventricular tachycardia (SVT) by interrupting the reentry pathways through the AV node and restoring normal sinus rhythm. It is a rapid-acting medication given as a rapid IV push followed by a saline flush. The dose is typically administered in a healthcare setting where cardiac monitoring is available due to its potential to cause transient asystole.
2. A nurse is caring for a client who has severe preeclampsia and is receiving magnesium sulfate intravenously. The nurse discontinues the magnesium sulfate after the client displays toxicity. Which of the following actions should the nurse take?
- A. Position the client supine.
- B. Prepare an IV bolus of dextrose 5% in water.
- C. Administer methylergonovine IM.
- D. Administer calcium gluconate IV.
Correct answer: D
Rationale: In cases of magnesium sulfate toxicity, calcium gluconate is the antidote that should be administered promptly. Positioning the client supine (Choice A) is not the priority in this scenario. Administering dextrose 5% in water (Choice B) is not indicated for magnesium sulfate toxicity. Methylergonovine IM (Choice C) is used for postpartum hemorrhage, not for magnesium sulfate toxicity.
3. A client with a seizure disorder has a new prescription for valproic acid. Which of the following laboratory values should the nurse plan to monitor? (Select all that apply)
- A. PTT
- B. Aspartate aminotransferase (AST)
- C. Alanine aminotransferase (ALT)
- D. All of the Above
Correct answer: D
Rationale: The correct answer is D, 'All of the Above.' Valproic acid can impact liver function and coagulation. Monitoring the Prothrombin Time (PTT), Aspartate Aminotransferase (AST), and Alanine Aminotransferase (ALT) is crucial. PTT is monitored to assess coagulation status, while AST and ALT are liver enzymes that indicate liver function. Monitoring these values helps detect any potential adverse effects of valproic acid on the liver and blood clotting. Choices A, B, and C are incorrect because each of these laboratory values plays a critical role in evaluating the client's response to valproic acid therapy and detecting associated complications.
4. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy. Which instruction should the nurse provide?
- A. Use oxygen continuously, even while sleeping.
- B. Adjust the oxygen flow rate to 5 liters per minute if short of breath.
- C. Report any signs of difficulty breathing immediately.
- D. Take off the oxygen while eating or drinking.
Correct answer: A
Rationale: The correct instruction for a client with COPD receiving oxygen therapy is to use oxygen continuously, even while sleeping. This is important to ensure adequate oxygenation and optimal respiratory function for clients with COPD. Continuous oxygen therapy helps maintain oxygen levels during sleep, which is crucial for individuals with COPD who may experience nighttime hypoxemia. Therefore, advising the client to use oxygen continuously, even during sleep, is essential in managing COPD and preventing complications associated with oxygen deprivation.
5. The client is prescribed clozapine (Clozaril), and the nurse plans to educate them about its purpose. Which statement should the nurse provide?
- A. It will help you function better in the community.
- B. The medication will help you think more clearly.
- C. You will be able to cope with your symptoms.
- D. It will improve your grooming and hygiene.
Correct answer: B
Rationale: Clozapine (Clozaril) is an antipsychotic medication that is known to improve cognitive function and thought clarity in individuals with schizophrenia. It primarily helps in managing symptoms related to thought processes rather than focusing on community function, coping with symptoms, or grooming and hygiene.
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