a nurse is caring for a client after bariatric surgery and is assessing for hemorrhage what is a sign of hemorrhage
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Nursing Elites

ATI LPN

Medical Surgical ATI Proctored Exam

1. A patient is being cared for after bariatric surgery, and the healthcare provider is assessing for hemorrhage. What is a sign of hemorrhage?

Correct answer: B

Rationale: Frank red bleeding from the surgical site is a significant sign of hemorrhage that warrants immediate attention. It indicates active bleeding that needs to be addressed promptly to prevent further complications.

2. A 50-year-old man presents with progressive jaundice, dark urine, and pruritus. Imaging reveals a mass in the head of the pancreas. What is the most likely diagnosis?

Correct answer: A

Rationale: The presentation of progressive jaundice, dark urine, and pruritus along with a pancreatic mass, particularly in the head of the pancreas, strongly suggests pancreatic cancer as the most likely diagnosis. These symptoms are classic for obstructive jaundice caused by a mass in the head of the pancreas, making pancreatic cancer the most fitting choice.

3. The healthcare provider is assessing a client with Raynaud's phenomenon. Which finding should the healthcare provider expect?

Correct answer: C

Rationale: Raynaud's phenomenon is characterized by vasospasm, leading to episodes of cyanosis (bluish discoloration) and pallor (pale color) in the fingers or toes, often triggered by cold temperatures or stress. This occurs due to the reduced blood flow during vasospastic episodes, causing the discoloration. Choices A, B, and D are incorrect findings associated with other conditions and are not typical of Raynaud's phenomenon.

4. A client with a cold is taking the antitussive benzonatate (Tessalon). Which assessment data indicates to the nurse that the medication is effective?

Correct answer: B

Rationale: The correct answer is B. Denying having coughing spells indicates the effectiveness of benzonatate, an antitussive that suppresses coughing. The goal of antitussive medications like benzonatate is to reduce or eliminate coughing, so the absence of coughing spells signifies the drug's efficacy. The other options do not directly reflect the medication's intended effect and are not specific indicators of benzonatate's effectiveness.

5. A client with newly diagnosed hypertension is prescribed enalapril (Vasotec). Which instruction should the nurse provide to the client?

Correct answer: B

Rationale: The correct instruction for the nurse to provide the client taking enalapril (Vasotec) is to report any persistent cough to their healthcare provider. Enalapril can cause a side effect of a persistent cough, and it is essential for the healthcare provider to be notified if this occurs to evaluate the need for a medication adjustment or change. Choices A, C, and D are incorrect. Increasing potassium-rich foods is not specifically related to enalapril use; there is no requirement to take enalapril with a full meal, and avoiding grapefruit juice is more relevant for medications metabolized by the CYP3A4 enzyme, not typically for enalapril.

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