ATI LPN
ATI PN Adult Medical Surgical 2019
1. A client with a history of asthma is prescribed salmeterol (Serevent). Which instruction should the nurse provide?
- A. Use this medication for acute asthma attacks.
- B. Use this medication before using your albuterol inhaler.
- C. Use this medication twice daily for long-term control.
- D. Use this medication as needed for wheezing.
Correct answer: C
Rationale: The correct instruction for a client prescribed salmeterol (Serevent) is to use it twice daily for long-term control. Salmeterol is a long-acting bronchodilator that is not intended for acute asthma attacks or as-needed use for wheezing. Choice A is incorrect because salmeterol is not used for acute asthma attacks. Choice B is incorrect as salmeterol is not meant to replace the albuterol inhaler but rather used for long-term control. Choice D is incorrect because salmeterol should not be used as needed; it is a maintenance medication for asthma.
2. A client with Addison's disease is being treated with fludrocortisone (Florinef). Which electrolyte imbalance should the nurse monitor for?
- A. Hyperkalemia.
- B. Hyponatremia.
- C. Hypernatremia.
- D. Hypocalcemia.
Correct answer: C
Rationale: Fludrocortisone, such as Florinef, is a mineralocorticoid that promotes sodium retention and potassium excretion, which can lead to hypernatremia. Therefore, the nurse should closely monitor for hypernatremia when a client with Addison's disease is being treated with fludrocortisone. Hyperkalemia (Choice A) is incorrect because fludrocortisone promotes potassium excretion, leading to hypokalemia rather than hyperkalemia. Hyponatremia (Choice B) is incorrect as fludrocortisone promotes sodium retention. Hypocalcemia (Choice D) is unrelated to the action of fludrocortisone.
3. Non-pharmacological techniques can help lower blood pressure. Which of the following is not considered one of these types of techniques?
- A. Dietary changes
- B. Multivitamins
- C. Smoking cessation
- D. Limiting caffeine
Correct answer: B
Rationale: Multivitamins are not typically considered a non-pharmacological technique for lowering blood pressure. While dietary changes, smoking cessation, and limiting caffeine intake can positively impact blood pressure levels, multivitamins are generally not specifically recommended as a primary intervention for this purpose. Dietary changes can include reducing salt intake and increasing potassium-rich foods, which are known to help manage blood pressure. Smoking cessation is crucial due to the negative impact of smoking on blood pressure and overall cardiovascular health. Limiting caffeine intake is advised as excessive caffeine consumption can lead to a temporary increase in blood pressure. Therefore, focusing on lifestyle modifications like healthy eating, smoking cessation, and caffeine reduction is more effective in managing blood pressure than relying on multivitamins.
4. A client with a diagnosis of heart failure is prescribed spironolactone (Aldactone). Which laboratory value should the nurse monitor closely?
- A. Serum calcium
- B. Serum potassium
- C. Serum sodium
- D. Serum glucose
Correct answer: B
Rationale: The correct answer is B: Serum potassium. Spironolactone is a potassium-sparing diuretic, which can lead to hyperkalemia. Monitoring serum potassium levels is crucial to prevent potential complications related to high potassium levels, such as cardiac arrhythmias. Therefore, close monitoring of serum potassium is essential for clients taking spironolactone. Choices A, C, and D are incorrect because spironolactone does not directly impact serum calcium, sodium, or glucose levels significantly. While these values may be monitored for other reasons in a client with heart failure, they are not the primary focus of monitoring when spironolactone is prescribed.
5. A 50-year-old man presents with severe epigastric pain radiating to his back, nausea, and vomiting. He has a history of heavy alcohol use. Laboratory tests reveal elevated serum amylase and lipase. What is the most likely diagnosis?
- A. Acute cholecystitis
- B. Peptic ulcer disease
- C. Acute pancreatitis
- D. Gastroesophageal reflux disease
Correct answer: C
Rationale: The patient's history of heavy alcohol use, severe epigastric pain radiating to the back, nausea, vomiting, and elevated serum amylase and lipase levels are classic signs of acute pancreatitis. Alcohol consumption is a common predisposing factor for pancreatitis, leading to inflammation of the pancreas. The clinical presentation, along with the laboratory findings, strongly support the diagnosis of acute pancreatitis in this patient.
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