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ATI Adult Medical Surgical
1. A patient with chronic heart failure is prescribed furosemide. What is the primary action of this medication?
- A. Increase cardiac output
- B. Reduce fluid retention
- C. Decrease heart rate
- D. Lower blood pressure
Correct answer: B
Rationale: Furosemide is a loop diuretic that acts by inhibiting sodium and chloride reabsorption in the loop of Henle, leading to increased diuresis. By reducing fluid retention, furosemide helps decrease the workload on the heart in patients with chronic heart failure. This medication does not directly increase cardiac output, decrease heart rate, or lower blood pressure as its primary action.
2. What instruction should the nurse give regarding the administration of alendronate to a patient with osteoporosis?
- A. Take the medication with milk.
- B. Lie down for 30 minutes after taking the medication.
- C. Take the medication with a full glass of water.
- D. Take the medication before bedtime.
Correct answer: C
Rationale: The correct instruction for administering alendronate to a patient with osteoporosis is to take the medication with a full glass of water first thing in the morning. It is important for the patient to remain upright for at least 30 minutes after taking the medication to prevent esophageal irritation. Taking alendronate with milk, lying down after intake, or taking it before bedtime can reduce the medication's effectiveness or increase the risk of side effects.
3. Which of the following statements about Helicobacter pylori (H. pylori) is false?
- A. H. pylori does not invade the gastric or duodenal epithelium
- B. H. pylori stimulates gastric acid secretion
- C. Eradication of H. pylori prevents adenocarcinoma of the stomach
- D. H. pylori produces a urease that splits urea into ammonia and CO2
Correct answer: C
Rationale: H. pylori is known to reside in the mucus layer of the stomach and does not invade the epithelium. It produces urease that splits urea into ammonia and CO2. This action helps in neutralizing the acidic environment and allows H. pylori to survive. Additionally, urease activity can be detected in diagnostic tests for H. pylori. The stimulation of gastric acid secretion and disruption of the protective mucus layer are mechanisms by which H. pylori promotes injury. While eradicating H. pylori infection has been associated with a decreased risk of developing gastric cancer, it does not prevent adenocarcinoma of the stomach entirely.
4. The client with newly diagnosed hypertension is being taught about lifestyle modifications. Which recommendation should be made?
- A. Increase your intake of saturated fats.
- B. Limit your alcohol intake to two drinks per day.
- C. Engage in at least 150 minutes of moderate exercise per week.
- D. Use table salt liberally to season your food.
Correct answer: C
Rationale: Engaging in at least 150 minutes of moderate exercise per week is a key lifestyle modification recommended for individuals with hypertension. Regular exercise helps manage blood pressure, improve cardiovascular health, and overall well-being. It is important for the client to adopt a healthy lifestyle to control hypertension and reduce the risk of complications.
5. An elderly female client comes to the clinic for a regular check-up. The client tells the nurse that she has increased her daily doses of acetaminophen (Tylenol) for the past month to control joint pain. Based on this client's comment, what previous lab values should the nurse compare with today's lab report?
- A. Look at last quarter's hemoglobin and hematocrit to assess for dehydration.
- B. Look for an increase in today's LDH compared to the previous one to assess for possible liver damage.
- C. Expect to find an increase in today's APTT compared to last quarter's due to bleeding.
- D. Determine if there is a decrease in serum potassium due to renal compromise.
Correct answer: B
Rationale: When a client increases their daily doses of acetaminophen for joint pain, it raises concerns about possible liver damage due to acetaminophen overdose. LDH (Lactate Dehydrogenase) levels can indicate liver function, so comparing today's levels with previous ones can help assess for liver damage caused by acetaminophen overuse.
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