ATI LPN
ATI Medical Surgical Proctored Exam 2019 Quizlet
1. A client receiving total parenteral nutrition (TPN) through a central line suddenly develops dyspnea, chest pain, and a drop in blood pressure. What should the nurse do first?
- A. Stop the TPN infusion.
- B. Notify the healthcare provider.
- C. Place the client in Trendelenburg position.
- D. Administer oxygen at 2 liters/minute.
Correct answer: C
Rationale: Placing the client in Trendelenburg position should be the initial action as it can help manage a suspected air embolism, a potential complication of TPN administration. This position helps trap air in the apex of the atrium, reducing the risk of air reaching the pulmonary circulation and causing further harm. Once the client is in a safe position, further actions such as stopping the TPN infusion, notifying the healthcare provider, and administering oxygen can be taken as appropriate.
2. The healthcare provider is assessing a newborn who is 2 hours old. Which finding requires immediate intervention?
- A. Acrocyanosis
- B. Respiratory rate of 60 breaths per minute
- C. Grunting with nasal flaring
- D. Heart rate of 140 beats per minute
Correct answer: C
Rationale: Grunting with nasal flaring is a concerning sign of respiratory distress in a newborn that can indicate inadequate oxygenation. This finding requires immediate intervention to ensure the newborn's respiratory status is stabilized and to prevent further complications. Prompt assessment and appropriate intervention are crucial in such cases to prevent respiratory compromise and potential deterioration. Acrocyanosis, which is bluish discoloration of the extremities, is a common finding in newborns and usually resolves on its own. A respiratory rate of 60 breaths per minute and a heart rate of 140 beats per minute are within normal ranges for a newborn and do not indicate immediate intervention is needed.
3. Which of the following is an example of a mood stabilizer used to treat bipolar disorder?
- A. Fluoxetine
- B. Lithium
- C. Haloperidol
- D. Lorazepam
Correct answer: B
Rationale: Lithium is a widely recognized mood stabilizer used in the treatment of bipolar disorder. It helps to control mood swings, prevent manic episodes, and reduce the risk of suicidal behavior in individuals with bipolar disorder. Fluoxetine is an antidepressant, Haloperidol is an antipsychotic, and Lorazepam is a benzodiazepine used for anxiety and insomnia, none of which are primary mood stabilizers for bipolar disorder.
4. A nurse is planning care for a school-age child who is 4 hr postoperative following perforated appendicitis. Which of the following actions should the nurse include in the plan of care?
- A. Offer small amounts of clear liquids 6 hr following surgery.
- B. Give cromolyn nebulizer solution every 6 hr.
- C. Apply a warm compress to the operative site every 4 hr.
- D. Administer analgesics on a scheduled basis for the first 24 hr.
Correct answer: D
Rationale: Administering analgesics on a scheduled basis for the first 24 hours is crucial to ensure adequate pain control in the immediate postoperative period. Choice A is incorrect because clear liquids are typically initiated gradually and advanced as tolerated but not specifically at 6 hours post-surgery. Choice B is incorrect as cromolyn nebulizer solution is not indicated for postoperative pain management in this scenario. Choice C is incorrect as applying a warm compress may not be appropriate for the operative site after appendicitis surgery and can potentially increase the risk of infection.
5. Which of the following vaccines is recommended to be given at birth?
- A. BCG
- B. Hepatitis B
- C. OPV
- D. Measles
Correct answer: A
Rationale: The BCG vaccine is recommended to be given at birth to protect against tuberculosis. It is often administered soon after birth to provide early protection against the disease, especially in areas where tuberculosis is prevalent.
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