ATI LPN
ATI Medical Surgical Proctored Exam 2019 Quizlet
1. A client from a nursing home is admitted with urinary sepsis and has a single-lumen, peripherally-inserted central catheter (PICC). Four medications are prescribed for 9:00 a.m. and the nurse is running behind schedule. Which medication should the nurse administer first?
- A. Piperacillin/tazobactam (Zosyn) in 100 ml D5W, IV over 30 minutes q8 hours.
- B. Vancomycin (Vancocin) 1 gm in 250 ml D5W, IV over 90 minutes q12 hours.
- C. Pantoprazole (Protonix) 40 mg PO daily.
- D. Enoxaparin (Lovenox) 40 mg subq q24 hours.
Correct answer: A
Rationale: In a patient with urinary sepsis, administering Piperacillin/tazobactam first is crucial as it is an antibiotic that directly targets the infection. Addressing the infection promptly is essential to prevent its progression and complications. Vancomycin, Pantoprazole, and Enoxaparin are important medications for the patient's overall treatment plan, but in this scenario, the antibiotic should take precedence due to the urgency of managing the sepsis.
2. Following a CVA, the nurse assesses that a client developed dysphagia, hypoactive bowel sounds, and a firm, distended abdomen. Which prescription for the client should the nurse question?
- A. Continuous tube feeding at 65 ml/hr via gastrostomy.
- B. Total parenteral nutrition to be infused at 125 ml/hour.
- C. Nasogastric tube connected to low intermittent suction.
- D. Metoclopramide (Reglan) intermittent piggyback.
Correct answer: A
Rationale: In a client with dysphagia, hypoactive bowel sounds, and a firm, distended abdomen post-CVA, continuous tube feeding at 65 ml/hr via gastrostomy may exacerbate abdominal distension and hypoactive bowel sounds. This situation requires immediate assessment and reevaluation before continuing with the prescription.
3. What guides behavior and decision making based on values and beliefs?
- A. Morals
- B. Beliefs
- C. Ethics
- D. Autonomy
Correct answer: A
Rationale: Morals are the values and beliefs that guide behavior and decision-making. While beliefs are part of the equation, morals specifically dictate how individuals act and make choices. Ethics, on the other hand, refer to a system of moral principles governing conduct. Autonomy, although important, is not directly related to the values and beliefs that guide behavior and decision making.
4. The healthcare professional is caring for a client with heart failure who is receiving digoxin (Lanoxin). Which assessment finding requires immediate intervention?
- A. Heart rate of 58 beats per minute.
- B. Nausea and vomiting.
- C. Blood pressure of 130/80 mm Hg.
- D. Shortness of breath.
Correct answer: B
Rationale: The correct answer is B. Nausea and vomiting are common signs of digoxin toxicity, which can lead to serious complications like dysrhythmias. Prompt intervention is crucial to prevent further harm to the client. Choice A, a heart rate of 58 beats per minute, although slightly lower than normal, may be appropriate for a client on digoxin. Choice C, a blood pressure of 130/80 mm Hg, is within normal limits and does not indicate an immediate need for intervention. Choice D, shortness of breath, is a common symptom in heart failure and requires monitoring but is not as indicative of digoxin toxicity as nausea and vomiting.
5. A client with left-leg weakness is learning to use a cane. Which teaching point is most appropriate?
- A. Use the cane on the weaker side of the body
- B. Maintain two points of support on the ground at all times
- C. Advance the cane 30 to 45 cm with each step
- D. Advance the cane and the strong leg simultaneously
Correct answer: B
Rationale: The correct teaching point is to maintain two points of support on the ground at all times when using a cane. This ensures stability and helps distribute weight evenly. Choice A is incorrect because the cane should be used on the stronger side of the body to provide support to the weaker leg. Choice C is incorrect as advancing the cane too far with each step can lead to imbalance. Choice D is incorrect as advancing the cane and the strong leg simultaneously may not provide adequate support for the weaker leg.
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