ATI LPN
Medical Surgical ATI Proctored Exam
1. After a client with ascites due to liver cirrhosis undergoes a paracentesis, what should the nurse do post-procedure?
- A. Encourage the client to drink plenty of fluids
- B. Monitor the client's blood pressure and heart rate
- C. Position the client flat on their back
- D. Administer a dose of furosemide
Correct answer: B
Rationale: Post-paracentesis, monitoring the client's blood pressure and heart rate is crucial as it helps in early detection of potential complications such as hypotension or bleeding. This close observation enables timely intervention and ensures the client's safety.
2. What should be monitored to evaluate the effectiveness of enoxaparin in a patient with deep vein thrombosis (DVT)?
- A. Prothrombin time (PT)
- B. Partial thromboplastin time (PTT)
- C. International normalized ratio (INR)
- D. Platelet count
Correct answer: C
Rationale: The international normalized ratio (INR) is the appropriate parameter to monitor the effectiveness of enoxaparin in preventing clot formation in patients with deep vein thrombosis (DVT). INR reflects the clotting ability of the blood and is commonly used to assess the therapeutic range of anticoagulant medications, such as enoxaparin, which is crucial in managing and preventing thrombotic events like DVT.
3. A client with hypothyroidism is started on levothyroxine (Synthroid). Which statement by the client indicates a need for further teaching?
- A. I will take this medication every morning before breakfast.
- B. I should have my thyroid levels checked regularly.
- C. If I lose weight, I may need an increased dose.
- D. I can stop taking this medication once my symptoms improve.
Correct answer: D
Rationale: The correct answer is D. Levothyroxine is typically a lifelong therapy for hypothyroidism. It should not be discontinued even if symptoms improve because the medication helps replace the deficient thyroid hormone. Stopping the medication prematurely can lead to a recurrence of symptoms and potential complications. Patients must understand the importance of continuous levothyroxine therapy and the necessity of regular follow-up with their healthcare provider to monitor thyroid levels and adjust the dosage as needed.
4. Why is a low-protein diet recommended for a patient with renal failure?
- A. To prevent fluid overload
- B. To reduce nitrogenous waste
- C. To maintain electrolyte balance
- D. To prevent hyperglycemia
Correct answer: B
Rationale: A low-protein diet is crucial for patients with renal failure to reduce the generation of nitrogenous waste products like urea and creatinine, which the compromised kidneys struggle to eliminate effectively. By limiting protein intake, the production of these waste products is decreased, lessening the burden on the kidneys and helping to manage the progression of renal failure. Choices A, C, and D are incorrect because a low-protein diet primarily aims to reduce the workload on the kidneys by decreasing the production of nitrogenous waste, not to prevent fluid overload, maintain electrolyte balance, or prevent hyperglycemia.
5. A client is being treated with an antidepressant for major depressive disorder. Which statement by the client indicates a need for further teaching?
- A. I know it may take several weeks before I start feeling better.
- B. I should avoid drinking alcohol while taking this medication.
- C. I will stop taking the medication as soon as I feel better.
- D. I should take the medication at the same time every day.
Correct answer: C
Rationale: Choice C indicates a need for further teaching because stopping antidepressants abruptly can lead to withdrawal symptoms. It is essential for the client to follow the healthcare provider's instructions and complete the full course of medication even if they start feeling better to prevent potential relapse or withdrawal effects.
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