ATI LPN
ATI Learning System PN Medical Surgical Final Quizlet
1. In acute pancreatitis, a client experiencing severe abdominal pain should have which enzyme level closely monitored?
- A. Serum amylase.
- B. Serum sodium.
- C. Serum calcium.
- D. Serum potassium.
Correct answer: A
Rationale: In acute pancreatitis, serum amylase levels should be closely monitored. Elevated serum amylase levels are a key diagnostic marker for acute pancreatitis, aiding in the assessment and management of the patient's condition. Monitoring serum sodium, calcium, or potassium levels is not typically associated with acute pancreatitis and would not provide relevant information for this specific condition.
2. A client who participates in a health maintenance organization (HMO) needs a bone marrow transplant for the treatment of breast cancer. The client tells the nurse that she is concerned that her HMO may deny her claim. What action by the nurse best addresses the client's need at this time?
- A. Have the client's healthcare provider write a letter to the HMO explaining the need for the transplant.
- B. Help the client place a call to the HMO to seek information about limitations of coverage.
- C. Encourage the client to contact a lawyer to file a lawsuit against the HMO if necessary.
- D. Have the social worker contact the state board of insurance to register a complaint against the HMO.
Correct answer: B
Rationale: The best action for the nurse to take in this situation is to help the client directly contact the HMO to seek information about limitations of coverage. This approach addresses the client's immediate concerns and clarifies the situation, enabling the client to understand the coverage and potential outcomes regarding the bone marrow transplant. Choice A is not the best option as having the healthcare provider write a letter may not provide immediate clarification on coverage. Choice C is inappropriate as legal action should be considered as a last resort, and choice D involving the state board of insurance is not necessary at this initial stage of addressing the client's concern.
3. A nurse in a long-term care facility is auscultating the lung sounds of a client who reports shortness of breath and increased fatigue. The nurse should report which of the following to the provider after hearing this sound?
- A. Fine crackles
- B. Rhonchi
- C. Wheezing
- D. Stridor
Correct answer: A
Rationale: The correct answer is A: Fine crackles. Fine crackles suggest fluid in the lungs, which could indicate a serious respiratory issue like pulmonary edema. This sound should be reported to the provider for further evaluation and possible intervention. Rhonchi (choice B) are low-pitched wheezing sounds often caused by secretions in the larger airways, wheezing (choice C) is a high-pitched whistling sound usually caused by narrowed airways, and stridor (choice D) is a high-pitched sound heard on inspiration that indicates upper airway obstruction. While these sounds also require attention, fine crackles are more indicative of fluid accumulation in the lungs, making them the priority for reporting in this scenario.
4. A nurse is teaching a client with mild persistent asthma who has been prescribed montelukast. Which statement by the nurse is appropriate?
- A. This medication can be used during an acute asthma attack.
- B. This medication should be taken before exercise.
- C. You can take this medication for 10 days, then discontinue.
- D. This medication helps decrease swelling and mucus production.
Correct answer: D
Rationale: The correct answer is D: 'This medication helps decrease swelling and mucus production.' Montelukast is used for long-term asthma management as it helps reduce inflammation and mucus production in the airways. It is not appropriate for acute asthma attacks. Choice A is incorrect because montelukast is not a rescue medication for acute attacks. Choice B is incorrect because montelukast is not specifically taken before exercise. Choice C is incorrect because montelukast is usually taken regularly, not just for a short duration.
5. A client is experiencing difficulty voiding following the removal of an indwelling catheter. What action should the nurse take to assist the client?
- A. Assess for bladder distention after 4 hours
- B. Pour warm water over the perineum
- C. Restrict the client's oral fluid intake
- D. Restrict movement for at least 12 hours
Correct answer: B
Rationale: The correct action for the nurse to assist the client who is experiencing difficulty voiding after the removal of an indwelling catheter is to pour warm water over the perineum. This technique can help stimulate urination by promoting relaxation of the perineal muscles and improving blood flow to the area. Assessing for bladder distention after 4 hours (Choice A) is important but not the immediate intervention needed to assist the client in voiding. Restricting the client's oral fluid intake (Choice C) can exacerbate the issue by reducing urine production. Restricting movement for at least 12 hours (Choice D) is unnecessary and may lead to discomfort and other complications.
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