ATI LPN
ATI PN Adult Medical Surgical 2019
1. A client with a history of hypertension is prescribed hydrochlorothiazide. Which instruction should the nurse include in the client's teaching?
- A. Take this medication in the morning.
- B. Avoid foods high in potassium.
- C. Monitor your blood pressure regularly.
- D. Decrease your intake of high-sodium foods.
Correct answer: C
Rationale: Regular monitoring of blood pressure is crucial for individuals with hypertension to assess the effectiveness of the prescribed medication and to ensure blood pressure is within the target range. This helps in managing hypertension and preventing complications associated with high blood pressure. Choices A, B, and D are incorrect because while taking the medication in the morning may be recommended for some drugs, it is not the key instruction for hydrochlorothiazide. Avoiding foods high in potassium and decreasing high-sodium foods are important dietary considerations for certain conditions, but they are not the immediate focus when starting hydrochlorothiazide.
2. During a change-of-shift assessment, a nurse is evaluating four clients. Which finding should the nurse report to the provider first?
- A. A client with cystic fibrosis who has a productive cough and reports thirst
- B. A client with gastroenteritis who is lethargic and confused
- C. A client with diabetes mellitus whose blood glucose is 185 mg/dL
- D. A client with sickle cell anemia who reports pain 15 minutes after receiving analgesics
Correct answer: B
Rationale: Lethargy and confusion in a client with gastroenteritis are concerning findings that may indicate severe dehydration or electrolyte imbalance, requiring immediate intervention. While the other options are important, they do not pose an immediate life-threatening risk compared to the altered mental status in a client with gastroenteritis.
3. A 35-year-old man presents with difficulty swallowing, weight loss, and regurgitation of undigested food. A barium swallow shows a 'bird beak' appearance of the lower esophagus. What is the most likely diagnosis?
- A. Esophageal cancer
- B. Achalasia
- C. Peptic stricture
- D. Gastroesophageal reflux disease
Correct answer: B
Rationale: The 'bird beak' appearance on a barium swallow is characteristic of achalasia, a condition where the lower esophageal sphincter fails to relax properly. This leads to difficulty swallowing, weight loss, and regurgitation of undigested food, which are hallmark symptoms of achalasia.
4. A client has been prescribed ferrous sulfate. Which instruction should the nurse provide to the client?
- A. Avoid strawberries, citrus fruits, and melon to improve absorption
- B. Take with fluids other than coffee or tea
- C. Take on a full stomach
- D. Double the dose if you miss a dose one day
Correct answer: B
Rationale: The correct instruction the nurse should provide to a client prescribed ferrous sulfate is to take it with fluids other than coffee or tea. Coffee and tea can inhibit iron absorption. Therefore, choices A, C, and D are incorrect. Avoiding strawberries, citrus fruits, and melon is not necessary for improving absorption of ferrous sulfate, taking it on a full stomach is not recommended, and doubling the dose if a dose is missed can lead to an overdose.
5. What is a major source of stress on the current U.S. healthcare system?
- A. Rising cost of providing healthcare to all citizens
- B. Lack of adequate education for healthcare professionals
- C. Inadequate number of hospital beds across the country
- D. Increasing cost of malpractice insurance
Correct answer: A
Rationale: The increasing cost of providing healthcare to all citizens is a major source of stress on the current U.S. healthcare system. This rise in costs impacts various aspects of the system, including accessibility, quality of care, and financial sustainability. It affects healthcare providers, patients, insurance companies, and the government, making it a critical issue that needs to be addressed to ensure a more efficient and effective healthcare system. Choices B, C, and D are incorrect because although lack of education for healthcare professionals, inadequate number of hospital beds, and increasing malpractice insurance costs can be challenges within the healthcare system, they are not the primary source of stress that affects the system as a whole.
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