ATI LPN
ATI PN Adult Medical Surgical 2019
1. A client who is receiving heparin therapy has an activated partial thromboplastin time (aPTT) of 90 seconds. What action should the nurse take?
- A. Increase the heparin infusion rate.
- B. Notify the healthcare provider.
- C. Apply pressure to the injection site.
- D. Administer protamine sulfate.
Correct answer: B
Rationale: An activated partial thromboplastin time (aPTT) of 90 seconds is elevated, indicating a risk of bleeding. The appropriate action for the nurse is to notify the healthcare provider. Increasing the heparin infusion rate can further elevate the aPTT, leading to an increased risk of bleeding. Applying pressure to the injection site is not relevant in this situation. Administering protamine sulfate is used to reverse the effects of heparin in cases of overdose or bleeding, but it is not the initial action for an elevated aPTT.
2. A 45-year-old obese man arrives at a clinic reporting daytime sleepiness, difficulty falling asleep at night, and snoring. The nurse should recognize the manifestations of what health problem?
- A. Adenoiditis
- B. Chronic tonsillitis
- C. Obstructive sleep apnea
- D. Laryngeal cancer
Correct answer: C
Rationale: The symptoms described, including daytime sleepiness, difficulty falling asleep at night, and snoring, are classic signs of obstructive sleep apnea. This condition is commonly seen in obese individuals due to the relaxation of throat muscles during sleep, leading to airway obstruction. Adenoiditis and chronic tonsillitis are less likely as they don't typically present with the same symptoms mentioned.
3. What nursing intervention can help alleviate pruritus in a client with cirrhosis?
- A. Administering antihistamines
- B. Providing a high-protein diet
- C. Applying emollients to the skin
- D. Encouraging frequent baths with hot water
Correct answer: C
Rationale: Applying emollients to the skin can help alleviate pruritus in clients with cirrhosis. Emollients help soothe and moisturize the skin, reducing the discomfort associated with itching.
4. Which regimen is most effective for treating H. pylori infection?
- A. Metronidazole, bismuth subsalicylate, amoxicillin for 14 days
- B. Clarithromycin and omeprazole for 14 days
- C. Metronidazole, lansoprazole, and clarithromycin for 14 days
- D. Metronidazole, clarithromycin, and omeprazole for 7 days
Correct answer: C
Rationale: Regimen C, which consists of metronidazole, lansoprazole, and clarithromycin for 14 days, is recommended by the FDA as an effective treatment for H. pylori infection. This regimen has been shown to have a high eradication rate and is a standard recommendation in clinical practice guidelines for the management of H. pylori-related conditions.
5. A client with a history of diabetes mellitus is admitted with a foot ulcer. The nurse should recognize that which intervention is most critical in promoting healing of the foot ulcer?
- A. Strict control of blood glucose levels.
- B. Regular dressing changes with sterile technique.
- C. Application of antibiotic ointment.
- D. Hydrotherapy treatment daily.
Correct answer: A
Rationale: In diabetic clients with foot ulcers, strict control of blood glucose levels is essential for promoting wound healing. High blood glucose levels can impair circulation and compromise the body's ability to fight infection, delaying the healing process. By maintaining optimal blood glucose levels, the client's overall health and wound healing potential are improved.
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