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ATI Adult Medical Surgical
1. A patient with chronic pain is prescribed gabapentin. What is the primary purpose of this medication?
- A. Relieve neuropathic pain
- B. Reduce inflammation
- C. Enhance opioid analgesia
- D. Suppress cough
Correct answer: A
Rationale: Gabapentin is primarily prescribed to relieve neuropathic pain. It works by stabilizing electrical activity in the nerves, making it effective in managing conditions such as diabetic neuropathy, postherpetic neuralgia, and other forms of chronic pain originating from nerve damage.
2. A client with severe anemia is being treated with a blood transfusion. Which assessment finding indicates a transfusion reaction?
- A. Elevated blood pressure.
- B. Fever and chills.
- C. Increased urine output.
- D. Bradycardia.
Correct answer: B
Rationale: Fever and chills are classic signs of a transfusion reaction. These symptoms indicate that the body is having a response to the transfused blood, possibly due to incompatibility or an immune reaction. Elevated blood pressure (choice A) is not a typical sign of a transfusion reaction. Increased urine output (choice C) and bradycardia (choice D) are also not characteristic signs of a transfusion reaction. It is crucial to recognize symptoms of a transfusion reaction promptly to prevent further complications and ensure appropriate management.
3. A client with severe rheumatoid arthritis is experiencing joint pain and stiffness. Which intervention should the nurse implement to help relieve the client's symptoms?
- A. Apply cold packs to the affected joints.
- B. Encourage passive range-of-motion exercises.
- C. Administer a muscle relaxant.
- D. Provide a high-calorie diet.
Correct answer: B
Rationale: Encouraging passive range-of-motion exercises is the most appropriate intervention to help relieve symptoms of joint pain and stiffness in clients with severe rheumatoid arthritis. These exercises help maintain joint mobility, prevent muscle contractures, and reduce stiffness in the affected joints. Passive range-of-motion exercises can also improve circulation to the joints, promoting healing and reducing pain. Applying cold packs may help with inflammation and pain temporarily, but it does not address the long-term joint mobility issues associated with rheumatoid arthritis. Muscle relaxants are not typically indicated for managing joint pain and stiffness in rheumatoid arthritis. While nutrition is important for overall health, providing a high-calorie diet is not a direct intervention for relieving joint pain and stiffness in this context.
4. A patient with severe pain is prescribed morphine sulfate. What is the most important side effect for the nurse to monitor?
- A. Diarrhea
- B. Hypertension
- C. Respiratory depression
- D. Increased urine output
Correct answer: C
Rationale: When a patient is prescribed morphine sulfate, the most critical side effect for the nurse to monitor is respiratory depression. Morphine can suppress the respiratory drive, leading to inadequate ventilation and potentially life-threatening consequences. Monitoring the patient's respiratory status closely is essential to promptly identify and manage any signs of respiratory depression.
5. A client with deep vein thrombosis (DVT) is receiving heparin therapy. Which laboratory test should the nurse monitor to assess the effectiveness of the therapy?
- A. Prothrombin time (PT)
- B. Platelet count
- C. Activated partial thromboplastin time (aPTT)
- D. International normalized ratio (INR)
Correct answer: C
Rationale: Activated partial thromboplastin time (aPTT) is the appropriate laboratory test to monitor the effectiveness of heparin therapy. Heparin works by prolonging the clotting time, which is reflected in the aPTT results. Monitoring aPTT helps ensure the patient is within the therapeutic range and not at risk of bleeding or clotting complications. Prothrombin time (PT) (Choice A) primarily measures the extrinsic pathway of coagulation and is used to monitor warfarin therapy, not heparin. Platelet count (Choice B) assesses the number of platelets present in the blood and is not specific to monitoring heparin therapy. International normalized ratio (INR) (Choice D) is used to monitor warfarin therapy, not heparin.
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