ATI LPN
ATI PN Adult Medical Surgical 2019
1. A client with osteoporosis is being discharged home. Which instruction should the nurse include in the discharge teaching?
- A. Avoid weight-bearing exercises.
- B. Take calcium supplements with meals.
- C. Limit vitamin D intake.
- D. Increase intake of caffeine-containing beverages.
Correct answer: B
Rationale: Taking calcium supplements with meals is a crucial instruction for a client with osteoporosis. Calcium absorption is enhanced when taken with food, and proper calcium intake is essential for managing osteoporosis effectively by promoting bone health and density. Avoiding weight-bearing exercises (Choice A) is incorrect because these exercises help improve bone strength. Limiting vitamin D intake (Choice C) is also incorrect as vitamin D is necessary for calcium absorption. Increasing caffeine intake (Choice D) is not recommended as caffeine can interfere with calcium absorption.
2. A client with liver cirrhosis and ascites is being treated with spironolactone. What is a key nursing consideration for this medication?
- A. Monitoring for signs of hyperkalemia
- B. Checking for signs of hypoglycemia
- C. Assessing for signs of dehydration
- D. Observing for symptoms of hyponatremia
Correct answer: A
Rationale: Spironolactone is a potassium-sparing diuretic, which can lead to hyperkalemia as it helps retain potassium in the body. Therefore, monitoring for signs of hyperkalemia such as muscle weakness, arrhythmias, or ECG changes is crucial to prevent potential complications.
3. What instruction should the nurse include in the discharge teaching for a patient with hypothyroidism prescribed levothyroxine?
- A. Take the medication with meals.
- B. Take the medication in the morning on an empty stomach.
- C. Discontinue the medication if you feel better.
- D. Double the dose if a dose is missed.
Correct answer: B
Rationale: The correct instruction for a patient with hypothyroidism prescribed levothyroxine is to take the medication in the morning on an empty stomach to enhance absorption. Taking it with meals can interfere with absorption. Patients should not discontinue the medication without consulting their healthcare provider as it can lead to adverse effects. Doubling the dose if a dose is missed can increase the risk of side effects and overdosage. It is crucial for patients to follow the prescribed dosing schedule and consult their healthcare provider for any concerns or missed doses.
4. A healthcare professional is assessing a client with severe dehydration. Which finding indicates a need for immediate intervention?
- A. Heart rate of 110 beats per minute.
- B. Blood pressure of 90/60 mm Hg.
- C. Urine output of 20 ml/hour.
- D. Dry mucous membranes.
Correct answer: C
Rationale: A urine output of 20 ml/hour indicates severe dehydration and impaired renal function. This finding suggests a critical state where the kidneys are conserving water, leading to reduced urine output. Immediate intervention is required to restore fluid balance and prevent further complications associated with severe dehydration. Choice A, a heart rate of 110 beats per minute, may indicate dehydration but is not as severe as the critically low urine output. Choice B, a blood pressure of 90/60 mm Hg, can be seen in dehydration but is not as concerning as the extremely low urine output. Choice D, dry mucous membranes, is a common sign of dehydration but does not require immediate intervention compared to the severely reduced urine output.
5. The client with bacterial pneumonia is receiving intravenous antibiotics. Which assessment finding indicates that the treatment is effective?
- A. Increased respiratory rate.
- B. Decreased oxygen saturation.
- C. Clear lung sounds.
- D. Elevated white blood cell count.
Correct answer: C
Rationale: Clear lung sounds indicate that the antibiotics are effectively treating the bacterial pneumonia by resolving the infection and reducing the inflammation in the lungs, leading to improved air exchange and ventilation. Increased respiratory rate (Choice A) and decreased oxygen saturation (Choice B) are indicative of ongoing respiratory distress and ineffective treatment. Elevated white blood cell count (Choice D) suggests a persistent infection rather than effective treatment.
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