ATI LPN
ATI PN Adult Medical Surgical 2019
1. A client is scheduled for a colonoscopy. Which instruction should the nurse provide?
- A. Eat a light breakfast on the day of the procedure.
- B. You will need to drink a bowel preparation solution before the procedure.
- C. Avoid all liquids for 24 hours before the procedure.
- D. You can continue taking your blood thinners until the day of the procedure.
Correct answer: B
Rationale: The correct instruction for a client scheduled for a colonoscopy is to drink a bowel preparation solution before the procedure. This solution helps cleanse the colon, ensuring clear visualization during the colonoscopy procedure. Choice A is incorrect because a light breakfast is usually recommended the day before the procedure, not on the day of the colonoscopy. Choice C is incorrect as it is important to stay hydrated and follow specific instructions regarding liquid intake. Choice D is incorrect as blood thinners may need to be adjusted or stopped before the colonoscopy to reduce the risk of bleeding during the procedure.
2. A client with newly diagnosed diabetes mellitus is receiving teaching on foot care. Which instruction should the nurse include?
- A. Walk barefoot whenever possible to toughen your feet.
- B. Soak your feet in hot water daily to improve circulation.
- C. Trim your toenails straight across to prevent ingrown toenails.
- D. Use a heating pad to keep your feet warm.
Correct answer: C
Rationale: Correctly trimming toenails straight across is crucial in preventing ingrown toenails and potential infections in individuals with diabetes. Ingrown toenails can lead to complications, so it is essential for diabetic clients to practice proper nail care to avoid these issues. Choices A, B, and D are incorrect. Walking barefoot can increase the risk of foot injuries, soaking feet in hot water can cause burns or skin damage, and using a heating pad can lead to burns or injuries due to decreased sensation in the feet, which is common in diabetes.
3. While assessing a 70-year-old female client with Alzheimer's disease, the nurse notes deep inflamed cracks at the corners of her mouth. What intervention should the nurse include in this client's plan of care?
- A. Apply a moisturizing cream to the affected areas.
- B. Encourage the client to consume foods rich in vitamin B.
- C. Notify the healthcare provider for further evaluation.
- D. Ensure that the client gets adequate B vitamins in foods or supplements.
Correct answer: D
Rationale: Cracks at the corners of the mouth, known as angular cheilitis, can be a sign of vitamin B deficiency, specifically B2 (riboflavin) or B3 (niacin). The nurse should ensure that the client receives adequate B vitamins through foods rich in these nutrients or supplements to address the deficiency, which can help improve the condition of the client's mouth.
4. A 45-year-old woman with occasional indigestion has had episodes of chest pain and dysphagia to both solids and liquids. An upper GI series and EGD fail to disclose any structural abnormalities. What is the most appropriate initial therapy?
- A. Sucralfate
- B. Proton pump inhibitor
- C. Prokinetic agent
- D. Benzodiazepine
Correct answer: B
Rationale: The patient's symptoms of chest pain and dysphagia suggest esophageal spasm, often related to underlying gastroesophageal reflux. The initial therapy should focus on acid suppression. Proton pump inhibitors are the preferred choice to reduce acid production and alleviate symptoms. If proton pump inhibitors are ineffective, other options like smooth muscle relaxants or antidepressants may be considered. A Heller myotomy is not indicated in this case as the patient does not have achalasia.
5. A client has been diagnosed with an esophageal diverticulum after undergoing diagnostic imaging. When taking the health history, the nurse should expect the client to describe what sign or symptom?
- A. Burning pain on swallowing
- B. Regurgitation of undigested food
- C. Symptoms mimicking a myocardial infarction
- D. Chronic parotid abscesses
Correct answer: B
Rationale: Regurgitation of undigested food is a typical symptom of esophageal diverticulum. This condition forms a pouch in the esophagus that can trap food, leading to regurgitation of undigested food. The other options are not typically associated with esophageal diverticulum.
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