ATI LPN
ATI PN Adult Medical Surgical 2019
1. A client with type 1 diabetes mellitus is admitted with hyperglycemia. Which laboratory result requires the most immediate intervention?
- A. Serum glucose of 350 mg/dL.
- B. Serum potassium of 2.8 mEq/L.
- C. Serum sodium of 136 mEq/L.
- D. Serum bicarbonate of 20 mEq/L.
Correct answer: B
Rationale: A serum potassium level of 2.8 mEq/L is critically low and can cause cardiac arrhythmias, requiring immediate intervention. Hypokalemia is a life-threatening condition that needs prompt correction to prevent serious complications. High serum glucose levels (choice A) are a concern in diabetes but do not pose an immediate life-threatening risk compared to severe hypokalemia. Serum sodium (choice C) and serum bicarbonate levels (choice D) are within normal ranges and do not require immediate intervention.
2. A patient with an anxiety disorder is prescribed alprazolam. What is the primary action of this medication?
- A. Increase energy levels
- B. Induce sedation
- C. Elevate mood
- D. Reduce anxiety
Correct answer: D
Rationale: Alprazolam is a benzodiazepine that primarily works by reducing anxiety. It achieves this by enhancing the inhibitory effects of the neurotransmitter GABA in the brain, which leads to a calming effect on the individual. Therefore, the primary action of alprazolam is to decrease anxiety levels rather than increase energy, induce sedation, or elevate mood.
3. The healthcare professional is caring for a client with a chest tube following a thoracotomy. Which assessment finding requires immediate intervention?
- A. Continuous bubbling in the water seal chamber.
- B. Serosanguineous drainage in the collection chamber.
- C. Intermittent bubbling in the suction control chamber.
- D. Chest tube secured to the client's chest wall.
Correct answer: A
Rationale: Continuous bubbling in the water seal chamber indicates an air leak, which requires immediate intervention to prevent complications such as pneumothorax. An air leak can lead to ineffective lung expansion, respiratory distress, and compromised gas exchange. Therefore, prompt action is necessary to maintain the integrity of the closed drainage system and prevent further complications. Choices B, C, and D are incorrect because serosanguineous drainage is an expected finding post-thoracotomy, intermittent bubbling in the suction control chamber is normal, and having the chest tube secured to the client's chest wall is essential for stability and proper functioning.
4. The healthcare provider is assessing a client with chronic obstructive pulmonary disease (COPD). Which finding should the provider expect?
- A. Increased anteroposterior chest diameter.
- B. Decreased respiratory rate.
- C. Dull percussion sounds over the lungs.
- D. Hyperresonance on chest percussion.
Correct answer: A
Rationale: The correct answer is A: Increased anteroposterior chest diameter. The increased anteroposterior chest diameter, often referred to as a barrel chest, is a common finding in clients with COPD due to hyperinflation of the lungs. This occurs because of the loss of lung elasticity and air trapping, leading to a more rounded chest shape. Choices B, C, and D are incorrect. Decreased respiratory rate is not typically associated with COPD; instead, an increased respiratory rate may be seen due to the body's compensatory mechanisms. Dull percussion sounds and hyperresonance on chest percussion are not characteristic findings in COPD. Dull percussion sounds may be indicative of consolidation or pleural effusion, while hyperresonance is more commonly associated with conditions like emphysema.
5. A patient with chronic kidney disease (CKD) is prescribed calcium acetate. What is the primary purpose of this medication?
- A. Treat hyperkalemia
- B. Reduce phosphate levels
- C. Lower blood pressure
- D. Increase hemoglobin levels
Correct answer: B
Rationale: The primary purpose of prescribing calcium acetate to a patient with chronic kidney disease (CKD) is to reduce phosphate levels. Calcium acetate binds to dietary phosphate, preventing its absorption and helping to manage hyperphosphatemia commonly seen in CKD patients.
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