ATI LPN
Medical Surgical ATI Proctored Exam
1. A 70-year-old man presents with weight loss, jaundice, and a palpable mass in the right upper quadrant. Laboratory tests reveal elevated bilirubin and alkaline phosphatase levels. What is the most likely diagnosis?
- A. Gallstones
- B. Hepatitis
- C. Pancreatic cancer
- D. Primary biliary cirrhosis
Correct answer: C
Rationale: The presentation of a 70-year-old man with weight loss, jaundice, a palpable mass in the right upper quadrant, and elevated bilirubin and alkaline phosphatase levels is highly suggestive of pancreatic cancer. This clinical scenario, known as Courvoisier's sign, points towards a pancreatic malignancy due to biliary obstruction. Gallstones could cause similar symptoms but would typically not present with a palpable mass. Hepatitis usually does not present with a palpable mass and would have different laboratory findings. Primary biliary cirrhosis typically presents differently with chronic cholestasis without the presence of a palpable mass or a pancreatic lesion.
2. A nurse is planning to administer diltiazem via IV bolus to a client who has atrial fibrillation. Which of the following findings is a contraindication to the administration of diltiazem?
- A. Hypotension
- B. Tachycardia
- C. Decreased level of consciousness
- D. History of diuretic use
Correct answer: A
Rationale: The correct answer is A: Hypotension. Diltiazem, a calcium channel blocker, can cause hypotension. Administering diltiazem to a client with hypotension can further lower their blood pressure, leading to adverse effects like dizziness and syncope. Tachycardia (Choice B) is actually a common indication for diltiazem use, as it helps slow down the heart rate in conditions like atrial fibrillation. Decreased level of consciousness (Choice C) may require evaluation but is not a direct contraindication to diltiazem administration. History of diuretic use (Choice D) is not a contraindication to diltiazem, as the two medications can often be safely used together.
3. A client with hypothyroidism is prescribed levothyroxine (Synthroid). Which instruction should the nurse provide?
- A. Take the medication with a meal.
- B. Take the medication at bedtime.
- C. Take the medication on an empty stomach.
- D. Take the medication with an antacid.
Correct answer: C
Rationale: The correct instruction for a client prescribed levothyroxine (Synthroid) is to take the medication on an empty stomach. This ensures optimal absorption of levothyroxine. Taking it with a meal can interfere with absorption due to food interactions. Taking it at bedtime may lead to inconsistent absorption as it should be taken at the same time every day in the morning. Taking it with an antacid can reduce the absorption of levothyroxine, making it less effective.
4. A nurse is reviewing the plan of care for a client who is taking digoxin. Which of the following findings should the nurse monitor as an adverse effect of this medication?
- A. Hypokalemia
- B. Hypernatremia
- C. Hypertension
- D. Tachycardia
Correct answer: A
Rationale: The correct answer is A: Hypokalemia. Hypokalemia is an adverse effect of digoxin. Digoxin can cause hypokalemia, which increases the risk of toxicity. Monitoring potassium levels is crucial when a client is taking digoxin. Choices B, C, and D are incorrect as hypernatremia, hypertension, and tachycardia are not directly associated with digoxin use.
5. Which type of carbohydrate helps maintain normal blood glucose levels during fasting periods?
- A. Glucose
- B. Galactose
- C. Dextrins
- D. Glycogen
Correct answer: D
Rationale: The correct answer is glycogen. Glycogen is a type of carbohydrate stored in the body that is broken down into glucose to help maintain blood glucose levels during fasting periods. Glucose (choice A) is the simplest form of sugar and is a product of carbohydrate digestion, not the stored form like glycogen. Galactose (choice B) is a monosaccharide found in dairy products. Dextrins (choice C) are intermediate products of starch digestion and not directly involved in maintaining blood glucose levels during fasting.
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