ATI LPN
ATI Medical Surgical Proctored Exam 2019 Quizlet
1. A primipara at 38-weeks gestation is admitted to labor and delivery for a biophysical profile (BPP). The nurse should prepare the client for what procedures?
- A. Chorionic villus sampling under ultrasound.
- B. Amniocentesis and fetal monitoring.
- C. Ultrasonography and nonstress test.
- D. Oxytocin challenge test and fetal heart rate monitoring.
Correct answer: C
Rationale: A biophysical profile (BPP) is a prenatal test that assesses the well-being of the fetus. It typically includes ultrasonography to evaluate fetal movements, muscle tone, breathing movements, and amniotic fluid volume. Additionally, a nonstress test is performed to monitor the fetal heart rate in response to its movements. These tests help in determining the overall health and viability of the fetus, making them essential components of prenatal care for assessing fetal well-being.
2. A client with chronic kidney disease (CKD) is experiencing hyperkalemia. Which intervention should the nurse implement to address this condition?
- A. Administer calcium gluconate.
- B. Encourage a diet high in potassium.
- C. Provide potassium supplements.
- D. Restrict sodium intake.
Correct answer: A
Rationale: Administering calcium gluconate is the appropriate intervention for a client with hyperkalemia. Calcium gluconate helps stabilize the heart by counteracting the effects of high potassium levels and reducing the risk of cardiac complications in individuals with hyperkalemia. Choices B, C, and D are incorrect. Encouraging a diet high in potassium or providing potassium supplements would exacerbate hyperkalemia. Restricting sodium intake is not directly related to addressing hyperkalemia.
3. When teaching a client postoperative breathing techniques with an incentive spirometer (IS), what should the nurse encourage the client to do to maintain sustained maximal inspiration?
- A. Exhale forcefully into the tubing for 3 to 5 seconds.
- B. Inspire deeply and slowly over 3 to 5 seconds.
- C. Breathe into the spirometer using normal breath volumes.
- D. Perform IS breathing exercises every 6 hours.
Correct answer: B
Rationale: To maintain sustained maximal inspiration when using an incentive spirometer, the client should be encouraged to inspire deeply and slowly over 3 to 5 seconds. This technique aids in achieving the goal of sustained maximal inspiration, which is essential for postoperative respiratory recovery.
4. When a client reports being allergic to penicillin, which question should the nurse ask to gather more information?
- A. Are you allergic to any other medications?
- B. How often have you taken penicillin in the past?
- C. Is anyone else in your family allergic to penicillin?
- D. What happens to you when you take penicillin?
Correct answer: D
Rationale: Questioning the client about the specific allergic reaction to penicillin is crucial for assessing the severity and type of allergic response, aiding in determining appropriate treatment and avoiding potential adverse reactions.
5. A client with acute pancreatitis is admitted to the hospital. What is the priority nursing intervention for this client?
- A. Administering oral pancreatic enzymes
- B. Encouraging a high-protein diet
- C. Maintaining NPO status and administering IV fluids
- D. Providing a low-fat diet
Correct answer: C
Rationale: The priority nursing intervention for a client with acute pancreatitis is to maintain NPO (nothing by mouth) status and administer IV fluids. This approach helps rest the pancreas, decrease pancreatic stimulation, and prevent further exacerbation of the condition. By withholding oral intake and providing IV fluids, the pancreas is given the opportunity to recover and inflammation can be reduced. This intervention is crucial in the acute phase of pancreatitis to support the healing process and prevent complications.
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