ATI LPN
ATI PN Adult Medical Surgical 2019
1. A client with chronic pain is prescribed a fentanyl (Duragesic) patch. Which instruction should the nurse provide to the client?
- A. Apply the patch to a clean, dry, and hairless area of the skin.
- B. Use a heating pad over the patch to enhance absorption.
- C. Change the patch daily to maintain effectiveness.
- D. Place the patch on the same site with each application.
Correct answer: A
Rationale: The correct instruction for applying a fentanyl (Duragesic) patch is to place it on a clean, dry, and hairless area of the skin. This ensures proper adhesion of the patch and optimal absorption of the medication. Using a heating pad over the patch is contraindicated as it can increase drug absorption and lead to overdose. Changing the patch daily is necessary for some medications, but fentanyl patches are usually changed every 72 hours to maintain a steady blood level of the medication. Placing the patch on the same site with each application can lead to skin irritation, uneven drug absorption, and should be avoided to allow the skin to recover between applications.
2. A 32-year-old female patient is diagnosed with generalized anxiety disorder (GAD). Which behavior would the nurse expect to observe?
- A. Complains of persistent and excessive worry.
- B. Frequently fidgets and has difficulty sitting still.
- C. Exhibits ritualistic behaviors.
- D. Reports periods of derealization.
Correct answer: A
Rationale: In generalized anxiety disorder (GAD), individuals often experience persistent and excessive worry about various aspects of their life. This worry is difficult to control and is disproportionate to the actual source of concern. The other options describe behaviors more commonly associated with other anxiety disorders like social anxiety disorder (frequent fidgeting and difficulty sitting still), obsessive-compulsive disorder (ritualistic behaviors), and depersonalization/derealization disorder (periods of derealization). Therefore, the correct behavior to expect in a patient with GAD is persistent and excessive worry.
3. Which statement best describes direct contact as a mode of pathogen transmission?
- A. Transmission through large aerosols produced by sneezing or coughing
- B. Transfer of an infectious agent by suspended air particles from a reservoir to a host
- C. Transmission of infectious agents carried by dust
- D. Transmission through skin-to-skin contact or body fluids
Correct answer: D
Rationale: Direct contact transmission occurs when pathogens are spread through skin-to-skin contact or body fluids. This mode of transmission includes activities like touching, kissing, or sexual contact where infectious agents can pass directly from one person to another. It does not involve large aerosols, suspended air particles, or dust as carriers of the pathogen.
4. Which of the following health professionals can sign the birth certificate?
- A. Public health nurse
- B. Rural health midwife
- C. Municipal health officer
- D. Any of these health professionals
Correct answer: D
Rationale: According to R.A. 3753, any birth attendant, including public health nurses, rural health midwives, and municipal health officers, may sign the certificate of live birth. This law allows a range of health professionals involved in childbirth to be authorized to sign birth certificates, ensuring accessibility and convenience for parents.
5. When assessing a patient with major depressive disorder, which of the following is a common cognitive symptom?
- A. Hallucinations
- B. Delusions
- C. Lack of appetite
- D. Negative self-talk
Correct answer: D
Rationale: Negative self-talk is a common cognitive symptom of major depressive disorder. It involves a pattern of negative thoughts and beliefs about oneself, which can significantly impact a patient's self-esteem and overall outlook on life. Hallucinations and delusions are more commonly associated with other mental health conditions like schizophrenia, while lack of appetite is typically considered a physical symptom of depression rather than a cognitive one.
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