a client with amyotrophic lateral sclerosis als is admitted to the hospital which intervention should the nurse include in the plan of care
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Nursing Elites

ATI RN

ATI Pathophysiology Exam

1. A client with amyotrophic lateral sclerosis (ALS) is admitted to the hospital. Which intervention should the nurse include in the plan of care?

Correct answer: C

Rationale: The correct intervention for a client with ALS is to provide nutritional support to prevent aspiration. ALS causes muscle weakness, including the muscles used for swallowing, increasing the risk of aspiration. Providing proper nutrition and support can help prevent this complication. Administering muscle relaxants (Choice A) may not be suitable for ALS as it can further weaken muscles. While assisting with ADLs (Choice B) and encouraging physical therapy (Choice D) are important aspects of care, the priority for a client with ALS is to prevent complications related to swallowing and nutrition.

2. A 65-year-old man is admitted to the intensive care unit from the operating room after a triple coronary artery bypass graft. He is intubated and on a ventilator. Lactic acid levels were normal postoperatively, but now they are rising. The increased level could be an indication of:

Correct answer: B

Rationale: In this scenario, the rising lactic acid levels in a 65-year-old man after a coronary artery bypass graft could indicate bowel ischemia. Bowel ischemia can lead to anaerobic metabolism, causing an increase in lactic acid levels. Excessive sedation may cause respiratory depression but would not directly lead to rising lactic acid levels. Excessive volume infusion in the operating room might cause fluid overload but would not typically result in rising lactic acid levels. Mild hypothermia postoperatively could lead to shivering and increased oxygen consumption, but it is less likely to be the primary cause of rising lactic acid levels in this context.

3. Which of the following is a characteristic of osteosarcoma?

Correct answer: C

Rationale: Osteosarcoma is an aggressive bone tumor that most commonly arises in the bone marrow of long bones, such as the femur or tibia. Choice A is incorrect as osteosarcoma is not a slow-growing tumor but rather a fast-growing one. Choice B is incorrect as osteosarcoma is not typically solitary but can involve multiple lesions. Choice D is incorrect as osteosarcoma primarily affects the medullary (marrow) cavity of bones, rather than infiltrating the trabeculae in spongy bone and surrounding tissue.

4. In osteoporosis, what is the expected therapeutic action of raloxifene (Evista)?

Correct answer: A

Rationale: The correct answer is A. Raloxifene works by decreasing bone resorption and increasing bone density. This helps in strengthening bones, reducing the risk of fractures, and improving bone health in patients with osteoporosis. Choice B is incorrect because raloxifene does not directly stimulate the formation of new bone but rather prevents bone loss. Choice C is incorrect as raloxifene does not primarily affect calcium absorption in the intestines. Choice D is also incorrect as raloxifene does not primarily decrease the excretion of calcium through the kidneys.

5. A woman is complaining that she feels like the room is spinning even though she is not moving. Which of the following is characteristic of benign positional vertigo?

Correct answer: C

Rationale: The correct answer is C: 'It is usually triggered when the patient bends forward.' Benign positional vertigo is often triggered by changes in head position, such as bending forward. Choices A, B, and D are incorrect. A is incorrect because benign positional vertigo is not typically associated with headaches. B is incorrect because pupillary changes are not a common feature of benign positional vertigo. D is incorrect because nystagmus in benign positional vertigo usually stops when the eyes fixate on an object.

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