ATI LPN
ATI Medical Surgical Proctored Exam 2019 Quizlet
1. 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.
2. A client has a new prescription for nitroglycerin. Which of the following instructions should the nurse include?
- A. Store the medication in a cool, dry place.
- B. Take the medication as directed by the healthcare provider.
- C. Take the medication 30 minutes before meals.
- D. Take the medication at the first sign of chest pain.
Correct answer: D
Rationale: Instructing the client to take nitroglycerin at the first sign of chest pain is crucial for immediate relief of angina symptoms. Nitroglycerin is a fast-acting medication that helps dilate blood vessels, improving blood flow to the heart muscle. Therefore, prompt administration at the onset of chest pain is essential to alleviate anginal episodes effectively. Choices A, B, and C are incorrect because storing the medication properly, taking it as directed, or before meals are not specific instructions for managing acute anginal episodes, which require immediate action for symptom relief.
3. The client with a history of left-sided heart failure is exhibiting increasing shortness of breath and frothy sputum. What is the priority nursing action?
- A. Administer oxygen
- B. Encourage coughing and deep breathing
- C. Place the client in a supine position
- D. Notify the healthcare provider immediately
Correct answer: A
Rationale: Shortness of breath and frothy sputum are indicative of pulmonary edema, a serious condition that requires immediate intervention to improve oxygenation. Administering oxygen is the priority action to support the client's respiratory function and prevent further deterioration. Oxygen therapy helps increase the oxygen levels in the blood, alleviate respiratory distress, and support vital organ function. Prompt intervention with oxygen can help stabilize the client while further assessments and treatments are initiated. Encouraging coughing and deep breathing may worsen the client's condition by increasing respiratory effort. Placing the client in a supine position can further compromise breathing in a client with pulmonary edema. Notifying the healthcare provider is important but not the priority when the client's respiratory status is deteriorating.
4. How should a healthcare provider assess and manage a patient with hyperthyroidism?
- A. Administer beta-blockers and monitor for signs of thyroid storm
- B. Encourage a high-protein, low-iodine diet
- C. Monitor for signs of bradycardia
- D. Provide iodine supplements and check for arrhythmias
Correct answer: A
Rationale: Administering beta-blockers is the initial management for hyperthyroidism to control symptoms such as tachycardia and tremors. Monitoring for signs of thyroid storm is crucial as it is a life-threatening complication of hyperthyroidism. Encouraging a high-protein, low-iodine diet (choice B) is not the primary intervention for managing hyperthyroidism. Monitoring for signs of bradycardia (choice C) is not typically seen in hyperthyroidism, as it often presents with tachycardia. Providing iodine supplements and checking for arrhythmias (choice D) are contraindicated in hyperthyroidism as they can worsen the condition.
5. Which lifestyle modification should be emphasized for a client with hypertension?
- A. Increase sodium intake
- B. Reduce caffeine and alcohol intake
- C. Eat carbohydrate-rich meals
- D. Increase protein intake
Correct answer: B
Rationale: The correct answer is to reduce caffeine and alcohol intake for a client with hypertension. Caffeine and alcohol can increase blood pressure, so reducing their intake can help manage hypertension. Increasing sodium intake (Choice A) is not recommended for hypertension as it can lead to fluid retention and increased blood pressure. Eating carbohydrate-rich meals (Choice C) is also not ideal as excessive carbohydrates can contribute to weight gain, which can worsen hypertension. Similarly, increasing protein intake (Choice D) is not a primary focus for managing hypertension unless a specific protein deficiency is present.
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