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ATI Adult Medical Surgical
1. A patient with hyperthyroidism is prescribed propylthiouracil (PTU). What is the primary purpose of this medication?
- A. Increase thyroid hormone production
- B. Suppress thyroid hormone production
- C. Enhance iodine absorption
- D. Stimulate the thyroid gland
Correct answer: B
Rationale: Propylthiouracil (PTU) is a medication used to treat hyperthyroidism by suppressing the production of thyroid hormones. It works by inhibiting the enzyme responsible for the synthesis of thyroid hormones, thereby reducing their levels in the body. This helps to alleviate the symptoms of hyperthyroidism and restore thyroid hormone levels to normal range.
2. The healthcare provider is providing care to a client with a tracheostomy. Which action should the healthcare provider take to prevent tracheostomy complications?
- A. Use sterile technique when performing tracheostomy care.
- B. Suction the tracheostomy tube every hour.
- C. Keep the tracheostomy tube cuff inflated at all times.
- D. Change the tracheostomy ties daily.
Correct answer: A
Rationale: Using sterile technique when performing tracheostomy care is essential to prevent infections and other complications. Proper sterile technique helps reduce the risk of introducing harmful bacteria into the tracheostomy site, which can lead to infections and other serious issues. By maintaining a sterile environment during tracheostomy care, the healthcare provider can promote healing and prevent potential complications.
3. A 55-year-old man presents with jaundice, pruritus, and dark urine. Laboratory tests reveal elevated bilirubin and alkaline phosphatase. Imaging shows dilated intrahepatic bile ducts and a normal common bile duct. What is the most likely diagnosis?
- A. Primary biliary cirrhosis
- B. Primary sclerosing cholangitis
- C. Gallstones
- D. Pancreatic cancer
Correct answer: A
Rationale: The clinical presentation of jaundice, pruritus, dark urine, elevated bilirubin and alkaline phosphatase, along with imaging findings of dilated intrahepatic bile ducts and a normal common bile duct, are characteristic of primary biliary cirrhosis. Primary biliary cirrhosis is an autoimmune liver disease that leads to destruction of intrahepatic bile ducts, causing cholestasis and liver damage. This condition typically presents in middle-aged women but can also affect men, as seen in this case.
4. A client with a diagnosis of rheumatoid arthritis is experiencing severe pain. Which medication is likely to be prescribed?
- A. Acetaminophen (Tylenol)
- B. Ibuprofen (Advil)
- C. Methotrexate (Rheumatrex)
- D. Prednisone (Deltasone)
Correct answer: C
Rationale: Methotrexate is commonly prescribed for rheumatoid arthritis to reduce inflammation and slow disease progression. It is a disease-modifying antirheumatic drug (DMARD) that helps control symptoms and prevent joint damage in individuals with rheumatoid arthritis. While acetaminophen and ibuprofen are used for pain relief, they are not typically prescribed to address the underlying inflammation and disease progression associated with rheumatoid arthritis. Prednisone may be used for short-term symptom relief or during disease flares, but it is not a first-line treatment for rheumatoid arthritis.
5. A client returns to the unit after a neck dissection. The surgeon placed a Jackson-Pratt drain in the wound. When assessing the wound drainage over the first 24 postoperative hours, what finding would prompt the nurse to notify the health care provider immediately?
- A. Presence of small blood clots in the drainage
- B. 60 mL of milky or cloudy drainage
- C. Spots of drainage on the dressings surrounding the drain
- D. 120 mL of serosanguinous drainage
Correct answer: B
Rationale: Milky or cloudy drainage can indicate infection or lymphatic leakage, which requires immediate attention. This finding may suggest a serious complication post neck dissection, warranting prompt notification of the healthcare provider for further evaluation and intervention.
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