ATI LPN
Medical Surgical ATI Proctored Exam
1. A client with liver failure is at an increased risk of bleeding due to the inability to synthesize prothrombin in the liver. What factor most likely contributes to this loss of function?
- A. Alterations in glucose metabolism
- B. Retention of bile salts
- C. Inadequate production of albumin by hepatocytes
- D. Inability of the liver to use vitamin K
Correct answer: D
Rationale: The correct answer is D. The liver's inability to use vitamin K is the most likely factor contributing to the loss of prothrombin synthesis in liver failure. Vitamin K is essential for the synthesis of prothrombin, a crucial clotting factor. In liver failure, impaired utilization of vitamin K leads to decreased production of prothrombin, increasing the risk of bleeding in affected individuals.
2. A nurse is providing education on the use of corticosteroids. Which of the following should be included?
- A. Monitor for signs of hyperglycemia
- B. Avoid abrupt discontinuation
- C. Long-term use may have risks
- D. Monitor for signs of dehydration
Correct answer: A
Rationale: The correct answer is to monitor for signs of hyperglycemia when educating on corticosteroids. Corticosteroids can increase blood glucose levels, making it essential to watch for hyperglycemia, especially in diabetic patients. Choice B is incorrect because corticosteroids should not be abruptly stopped due to the risk of adrenal insufficiency. Choice C is incorrect as corticosteroids are associated with various adverse effects, making long-term use risky. Choice D is incorrect as dehydration is not typically a primary concern directly related to corticosteroid use.
3. A client with chronic heart failure has been prescribed furosemide (Lasix). Which instruction should the nurse reinforce to the client regarding this medication?
- A. Take the medication with food.
- B. Limit foods high in potassium while taking this medication.
- C. Report any muscle cramps or weakness to your healthcare provider.
- D. Expect to urinate more frequently while on this medication.
Correct answer: C
Rationale: The correct instruction for the nurse to reinforce to the client regarding furosemide (Lasix) is to report any muscle cramps or weakness to the healthcare provider. Muscle cramps or weakness may indicate hypokalemia, a potential side effect of furosemide. Monitoring and reporting these symptoms promptly can help in preventing complications related to electrolyte imbalances. Choice A is incorrect because furosemide should be taken on an empty stomach. Choice B is not directly related to furosemide use; in fact, foods high in potassium may be beneficial for clients taking furosemide to prevent hypokalemia. Choice D is a common expected side effect of furosemide due to its diuretic action but is not as crucial to report as potential signs of electrolyte imbalances.
4. When inserting an oropharyngeal airway in a small child, what is the preferred method?
- A. Insert the airway with the curvature towards the roof of the mouth and then rotate it 180 degrees.
- B. Insert the airway as you would in an adult, but use an airway that is one size smaller than usual.
- C. Depress the tongue with a tongue blade and insert the airway with the downward curve facing the tongue.
- D. Open the airway with the tongue-jaw lift maneuver and insert the airway until slight resistance is met.
Correct answer: C
Rationale: When inserting an oropharyngeal airway in a small child, it is crucial to depress the tongue with a tongue blade and insert the airway with the downward curve facing the tongue. This technique helps in maintaining an open airway and preventing obstruction by the tongue. Placing the airway with the curve facing the roof of the mouth or using a smaller size is not recommended for small children, as it may not effectively keep the airway patent. The tongue-jaw lift maneuver is not the preferred method for inserting an oropharyngeal airway in small children.
5. In the pediatric ward at Nyamebekyere teaching hospital, when should oxygen be applied to children?
- A. Central cyanosis
- B. Respiratory rate >70 breaths per minute
- C. Grunting noted on assessment
- D. All of the above
Correct answer: D
Rationale: All the listed conditions, central cyanosis, respiratory rate >70 breaths per minute, and grunting on assessment, are indicative of the need for oxygen therapy. Central cyanosis suggests severe hypoxemia, a respiratory rate >70 breaths per minute can indicate respiratory distress, and grunting is a sign of increased work of breathing. Administering oxygen in these situations can help improve oxygenation and support the child's respiratory function, making option D the correct choice.
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