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 nurse is teaching a client who has multiple sclerosis (MS) about strategies to reduce fatigue. Which of the following instructions should the nurse include?
- A. Exercise to the point of exhaustion
- B. Rest as needed throughout the day
- C. Avoid physical activity
- D. Exercise only once per week
Correct answer: B
Rationale: The correct instruction the nurse should include is to 'Rest as needed throughout the day.' Fatigue is a common symptom of multiple sclerosis (MS), and adequate rest is essential to manage it effectively. Resting as needed helps conserve energy and prevent fatigue from worsening. Choices A, C, and D are incorrect. 'Exercise to the point of exhaustion' is not recommended as it can lead to increased fatigue. 'Avoiding physical activity' entirely is not advisable as appropriate exercise can help maintain strength and energy levels. 'Exercising only once per week' may not be sufficient to combat fatigue and maintain overall well-being in clients with MS.
3. What is the proper technique for administering an intramuscular (IM) injection?
- A. Locate the injection site and insert at 90 degrees
- B. Insert needle at a 45-degree angle
- C. Massage the site after injection
- D. Insert needle at a 15-degree angle
Correct answer: A
Rationale: The correct technique for administering an intramuscular (IM) injection is to locate the injection site and insert the needle at a 90-degree angle. This angle ensures that the medication is delivered into the muscle for proper absorption. Choice B is incorrect because a 45-degree angle is typically used for subcutaneous injections, not intramuscular. Choice C is incorrect as massaging the site after an injection can cause the medication to disperse unevenly. Choice D is incorrect as a 15-degree angle would not reach the muscle layer effectively for an IM injection.
4. What are the nursing interventions for a patient receiving anticoagulant therapy?
- A. Monitor INR levels and check for bleeding
- B. Administer antiplatelet therapy
- C. Check for signs of DVT and provide anticoagulation
- D. Administer aspirin and monitor for bleeding
Correct answer: A
Rationale: The correct nursing intervention for a patient receiving anticoagulant therapy is to monitor INR levels and check for signs of bleeding. Monitoring the INR levels helps assess the effectiveness and safety of anticoagulant therapy, while checking for bleeding is essential due to the increased risk associated with anticoagulants. Choice B is incorrect as antiplatelet therapy is not the standard treatment for patients on anticoagulant therapy. Choice C is incorrect as providing additional anticoagulation is not a direct nursing intervention in this scenario. Choice D is incorrect because administering aspirin, an antiplatelet medication, along with anticoagulants can increase the risk of bleeding and is generally avoided.
5. What is one useful outcome of keeping a record of everything you eat and drink for a day?
- A. Precise estimates of portion sizes.
- B. Determination of appropriate energy intake.
- C. Estimation of supplement needs.
- D. Increased awareness of personal food patterns.
Correct answer: D
Rationale: The correct answer is D: Increased awareness of personal food patterns. Keeping a food record is beneficial as it helps individuals become more mindful of their eating habits and food choices. This awareness can lead to identifying patterns, triggers, and areas for improvement in one's diet. Choices A, B, and C are incorrect because the primary benefit of keeping a food record is not about precise estimates of portion sizes, determining energy intake, or estimating supplement needs, but rather about developing a deeper understanding of personal food patterns.
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