a client has developed hepatic encephalopathy secondary to cirrhosis and is receiving care on the medical unit the clients current medication regimen a client has developed hepatic encephalopathy secondary to cirrhosis and is receiving care on the medical unit the clients current medication regimen
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Nursing Elites

ATI LPN

Medical Surgical ATI Proctored Exam

1. A client has developed hepatic encephalopathy secondary to cirrhosis and is receiving care on the medical unit. The client's current medication regimen includes lactulose four times daily. What desired outcome should the nurse relate to this pharmacologic intervention?

Correct answer: A

Rationale: Lactulose is used in hepatic encephalopathy to reduce blood ammonia levels by promoting bowel movements. The desired outcome of lactulose therapy is typically two to three soft bowel movements daily, which helps in eliminating excess ammonia from the body, thus improving the client's condition.

2. A nurse is caring for a client who is postoperative following a thyroidectomy. The nurse should monitor for which of the following findings as a sign of hypocalcemia?

Correct answer: B

Rationale: Tingling in the fingers is a classic sign of hypocalcemia. Following a thyroidectomy, hypocalcemia can occur due to damage to the parathyroid glands, which regulate calcium levels in the body. Nausea, numbness in the toes, and sweating are not specific signs of hypocalcemia. Numbness and tingling usually start in the hands and feet due to their increased nerve sensitivity to low calcium levels.

3. How should a healthcare professional assess a patient with dehydration?

Correct answer: A

Rationale: Correct Answer: When assessing a patient for dehydration, healthcare professionals should monitor skin turgor, as it indicates the degree of dehydration, and check urine output, as decreased urine output can be a sign of dehydration. Choices B, C, and D are incorrect because they do not directly assess for dehydration. Assessing for jugular venous distention (B) is more relevant for heart failure, auscultating lung sounds and monitoring for fever (C) are more relevant for respiratory infections, and monitoring for cyanosis and increased respiratory rate (D) are more indicative of respiratory distress rather than dehydration.

4. A charge nurse on a med-surg unit is preparing to delegate tasks to a licensed practical nurse (LPN). What task should the charge nurse delegate to the LPN?

Correct answer: C

Rationale: The correct task that the charge nurse should delegate to the LPN is to administer an oral antibiotic to a patient. LPNs are trained and permitted to administer medications orally under the supervision of a registered nurse. Initiating a care plan (Choice A) and completing an initial assessment (Choice D) are tasks that typically require higher-level nursing education and critical thinking skills, which are more suitable for registered nurses. Performing a complex wound dressing change (Choice B) involves specialized skills and assessment that are often within the scope of practice of registered nurses or wound care specialists.

5. What is a major function of glucose?

Correct answer: A

Rationale: Glucose serves as a primary source of energy for the body, especially for the brain and muscles. Choice B is incorrect because glucose itself is not responsible for transporting oxygen to cells. Choice C is incorrect as glucose is converted to glycogen, not the other way around. Choice D is incorrect as glucose itself does not play a direct role in maintaining body weight.

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