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ATI Adult Medical Surgical
1. What is the primary advantage of prescribing rivaroxaban over warfarin for a patient with a history of deep vein thrombosis (DVT)?
- A. No need for regular INR monitoring
- B. Lower risk of bleeding
- C. Fewer dietary restrictions
- D. Longer half-life
Correct answer: A
Rationale: The primary advantage of prescribing rivaroxaban over warfarin for a patient with a history of deep vein thrombosis (DVT) is that rivaroxaban does not require regular INR monitoring. This eliminates the need for frequent blood tests to adjust the dosage, making it more convenient for patients to manage their anticoagulant therapy.
2. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy. Which instruction should the nurse provide?
- A. Use oxygen continuously, even while sleeping.
- B. Adjust the oxygen flow rate to 5 liters per minute if short of breath.
- C. Report any signs of difficulty breathing immediately.
- D. Take off the oxygen while eating or drinking.
Correct answer: A
Rationale: The correct instruction for a client with COPD receiving oxygen therapy is to use oxygen continuously, even while sleeping. This is important to ensure adequate oxygenation and optimal respiratory function for clients with COPD. Continuous oxygen therapy helps maintain oxygen levels during sleep, which is crucial for individuals with COPD who may experience nighttime hypoxemia. Therefore, advising the client to use oxygen continuously, even during sleep, is essential in managing COPD and preventing complications associated with oxygen deprivation.
3. A client with type 2 diabetes mellitus presents to the clinic with a foot ulcer. Which instruction should the nurse provide to the client to promote healing of the ulcer?
- A. Apply a heating pad to the ulcer twice daily.
- B. Wear tight-fitting shoes to protect the ulcer.
- C. Keep the ulcer clean and dry.
- D. Limit walking to reduce pressure on the ulcer.
Correct answer: C
Rationale: The correct answer is C: "Keep the ulcer clean and dry." For clients with diabetes mellitus, it is crucial to maintain foot ulcers clean and dry to prevent infection and promote healing. Moist environments can lead to bacterial growth and delay healing. Applying a heating pad (Choice A) can increase the risk of burns and further damage the ulcer. Wearing tight-fitting shoes (Choice B) can cause friction and pressure on the ulcer, hindering the healing process. Limiting walking (Choice D) excessively can affect circulation and delay healing. Therefore, the nurse should instruct the client to keep the ulcer clean and dry for optimal wound care management.
4. For a patient with asthma, what is the primary purpose of prescribing salmeterol?
- A. Relieve acute bronchospasm
- B. Prevent asthma attacks
- C. Suppress cough
- D. Thin respiratory secretions
Correct answer: B
Rationale: Salmeterol is classified as a long-acting beta2-agonist, which is used to prevent asthma attacks by providing extended bronchodilation. It is not typically used for immediate relief of acute bronchospasm or for suppressing cough. Additionally, salmeterol does not have the primary purpose of thinning respiratory secretions.
5. A patient is admitted with a diagnosis of myasthenia gravis. What symptom should the nurse expect to find during the assessment?
- A. Joint pain
- B. Muscle weakness
- C. Loss of sensation
- D. Severe headache
Correct answer: B
Rationale: Myasthenia gravis is a neuromuscular disorder characterized by muscle weakness and fatigue, especially in the voluntary muscles. Patients with myasthenia gravis commonly experience weakness in muscles that control eye movements, facial expressions, chewing, swallowing, and speaking. This weakness typically worsens with activity and improves with rest. Joint pain, loss of sensation, and severe headaches are not typical symptoms of myasthenia gravis. Therefore, the correct answer is muscle weakness (choice B) as it aligns with the characteristic symptom of myasthenia gravis.
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