ATI LPN
Adult Medical Surgical ATI
1. A 70-year-old man presents with sudden onset of severe abdominal pain. He has a history of atrial fibrillation. Physical examination reveals a soft abdomen with minimal tenderness. What is the most likely diagnosis?
- A. Acute pancreatitis
- B. Mesenteric ischemia
- C. Peptic ulcer disease
- D. Diverticulitis
Correct answer: B
Rationale: The sudden onset of severe abdominal pain in a patient with atrial fibrillation, along with a soft abdomen and minimal tenderness on examination, suggest mesenteric ischemia due to embolic occlusion of the mesenteric arteries. This condition is characterized by a sudden and severe decrease in blood flow to the intestines, leading to abdominal pain and tenderness. Acute pancreatitis typically presents with epigastric pain that may radiate to the back, accompanied by elevated serum amylase and lipase levels. Peptic ulcer disease and diverticulitis usually do not manifest with the sudden onset of severe abdominal pain as described in the case.
2. A healthcare professional is assessing a late preterm newborn. Which of the following clinical manifestations is an indication of hypoglycemia?
- A. Hypertonia
- B. Increased feeding
- C. Hyperthermia
- D. Respiratory distress
Correct answer: D
Rationale: The correct answer is D, respiratory distress, as it is a clinical manifestation of hypoglycemia in newborns. Other signs of hypoglycemia include an abnormal cry, jitteriness, lethargy, poor feeding, apnea, and seizures. Hypertonia, increased feeding, and hyperthermia are not typically associated with hypoglycemia in newborns. Hypertonia is more indicative of neurological issues, increased feeding is not a common sign of hypoglycemia, and hyperthermia is not a typical symptom of low blood sugar.
3. A charge nurse is evaluating the time management skills of a newly licensed nurse. The charge nurse should intervene when the newly licensed nurse does which of the following?
- A. Re-evaluates priorities halfway through the shift
- B. Delegates changing a sterile dressing to a licensed practical nurse
- C. Groups activities for the same client
- D. Works on several tasks simultaneously
Correct answer: D
Rationale: The correct answer is D. Working on several tasks simultaneously may lead to errors due to divided attention and lack of focus. It is important for nurses to prioritize tasks and complete them one at a time to ensure thoroughness and accuracy. Choices A, B, and C are appropriate time management strategies. Re-evaluating priorities, delegating tasks appropriately, and grouping activities for the same client can help improve efficiency and quality of care.
4. The nurse is performing triage on a group of clients in the emergency department. Which of the following clients should the nurse see first?
- A. A 12-year-old oozing blood from a laceration on the left thumb due to a cut from a rusty metal can
- B. A 19-year-old with a fever of 103.8°F who is able to identify her sister but not the place and time
- C. A 49-year-old with a compound fracture of the right leg who is complaining of severe pain
- D. A 65-year-old with a flushed face, dry mucous membranes, and a blood sugar of 470 mg/dL
Correct answer: B
Rationale: The correct answer is B. A 19-year-old with a fever of 103.8°F who is confused and unable to orient to place and time likely has a severe infection or a serious medical condition affecting the central nervous system. This client needs immediate attention as altered mental status combined with a high fever can indicate a life-threatening situation. Choices A, C, and D present important conditions that require medical care, but they are not as urgent as the 19-year-old with a high fever and confusion. The 12-year-old with a laceration may require treatment for bleeding and a tetanus shot, the 49-year-old with a compound fracture needs urgent orthopedic intervention, and the 65-year-old with a high blood sugar is concerning for hyperglycemia but can wait momentarily compared to the client with a fever and altered mental status.
5. A healthcare professional is reviewing the results of an ABG performed on a client with chronic emphysema. Which of the following results suggests the need for further treatment?
- A. PaO2 level of 89 mm Hg
- B. PaCO2 level of 55 mm Hg
- C. HCO3 level of 25 mEq/L
- D. pH level of 7.37
Correct answer: B
Rationale: A PaCO2 level of 55 mm Hg indicates hypercapnia, which is common in clients with emphysema but may require further treatment if it leads to respiratory acidosis or distress. Elevated PaCO2 levels can indicate inadequate ventilation and impaired gas exchange, potentially leading to respiratory acidosis. The other results fall within normal ranges or compensated values for a client with chronic emphysema and do not necessarily indicate the need for immediate intervention.
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