a client with diabetes mellitus has just undergone a right below the knee amputation following gangrene infection a few days after the amputation the a client with diabetes mellitus has just undergone a right below the knee amputation following gangrene infection a few days after the amputation the
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Nursing Elites

ATI RN

ATI Pathophysiology Exam

1. A client with diabetes mellitus has just undergone a right, below-the-knee amputation following gangrene infection. A few days after the amputation, the client confides in the nurse that he still feels his right foot. Knowing the pathophysiologic principles behind this, the nurse can:

Correct answer: B

Rationale: The correct answer is B. The sensation of feeling the amputated limb is known as phantom limb pain, which is common after amputation. One theory suggests that it occurs because the end of a regenerating nerve becomes trapped in the scar tissue at the amputation site. Administering psychotropic medication (choice A) is not the first-line treatment for phantom limb pain. Requesting a psychological consult (choice C) is premature without first addressing the known pathophysiological basis of phantom limb pain. Educating the client that the sensitivity will go away with time (choice D) is not entirely accurate as phantom limb pain can persist long-term.

2. What condition is characterized by the inflammation of the heart's outer lining, often causing chest pain and other symptoms?

Correct answer: A

Rationale: Pericarditis is the correct answer because it is the inflammation of the pericardium, the outer lining of the heart. This condition commonly presents with symptoms like chest pain. Endocarditis (choice B) is the inflammation of the inner lining of the heart chambers and valves. Myocarditis (choice C) is the inflammation of the heart muscle itself. Valvular heart disease (choice D) refers to various conditions affecting the heart valves, not specifically the outer lining of the heart.

3. A nurse is caring for a client who has a tracheostomy. Which of the following actions should the nurse take when providing tracheostomy care?

Correct answer: C

Rationale: The correct answer is to use a sterile brush to clean the inner cannula. This action is crucial to prevent infection during tracheostomy care. Choice A is incorrect as clean technique is not adequate for tracheostomy care, sterile technique is required. Choice B is incorrect as tracheostomy ties should be replaced when soiled, not routinely every 24 hours. Choice D is incorrect as tracheostomy dressings should be changed more frequently to maintain cleanliness and prevent infection.

4. A client has a prescription for Nitroglycerin. Which of the following instructions should the nurse include?

Correct answer: B

Rationale: The correct administration of Nitroglycerin involves taking one tablet at the onset of chest pain, then another tablet every 5 minutes for up to three doses. This protocol aims to relieve angina symptoms. Choice A is incorrect because waiting 15 minutes between doses may delay symptom relief. Choice C is incorrect as Nitroglycerin is not typically taken at bedtime but rather during angina episodes. Choice D is incorrect because Nitroglycerin is usually taken sublingually, so it doesn't need to be taken on an empty stomach.

5. When taking medroxyprogesterone acetate (Provera) for the treatment of endometriosis, what important instruction should the nurse provide about taking this medication?

Correct answer: A

Rationale: When taking medroxyprogesterone acetate for endometriosis, it is essential to maintain consistent hormone levels by taking the medication at the same time each day. This consistency helps optimize the effectiveness of the treatment. Choice B is incorrect because medroxyprogesterone should be taken without regard to meals, not necessarily with food. Choice C is incorrect because discontinuing the medication without consulting a healthcare provider can be harmful and may not address side effects appropriately. Choice D is incorrect as medroxyprogesterone is typically taken daily to manage endometriosis symptoms, not weekly, to ensure continuous therapy and symptom control.

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