an older adult has a diagnosis of alzheimer disease and has recently been experiencing fecal incontinence however the nurse has observed no recent cha
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Nursing Elites

ATI LPN

Medical Surgical ATI Proctored Exam

1. An older adult with a diagnosis of Alzheimer's disease has been experiencing fecal incontinence, with no recent change in stool character noted by the nurse. What is the nurse's most appropriate intervention?

Correct answer: C

Rationale: The most appropriate intervention for an older adult with Alzheimer's disease experiencing fecal incontinence and no change in stool character is to toilet the client on a frequent, scheduled basis. Scheduled toileting can help manage incontinence by establishing a routine for bowel movements, which may aid in reducing episodes of fecal incontinence.

2. A client with a diagnosis of rheumatoid arthritis is experiencing severe pain. Which medication is likely to be prescribed?

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.

3. A patient with a diagnosis of peptic ulcer disease is prescribed omeprazole. When should the patient take this medication for optimal effectiveness?

Correct answer: C

Rationale: Omeprazole is best taken before meals for optimal effectiveness in reducing stomach acid production and promoting ulcer healing. Taking it before meals allows the medication to act on the proton pumps before food intake triggers acid production, thereby maximizing its therapeutic benefits. Choices A, B, and D are incorrect because taking omeprazole with meals, at bedtime, or after meals may not align with its mechanism of action, potentially reducing its effectiveness in managing peptic ulcer disease.

4. What is the best therapy for a 65-year-old man with symptoms of regurgitation, chest pain, dysphagia, weight loss, dilated esophagus, and an absent gastric air bubble on CXR?

Correct answer: B

Rationale: The patient's presentation and radiologic findings are consistent with achalasia. The absence of a mass on upper endoscopy and CT scan helps rule out secondary causes. Achalasia is best managed with endoscopic balloon dilatation or myotomy. Proton-pump inhibitors are not effective for achalasia. Sucralfate is not a primary treatment for achalasia. Esophageal resection is only considered if malignancy develops. Patients with achalasia may experience chest pain and weight loss due to food accumulation in the dilated esophagus. Endoscopic balloon dilatation is a safe and effective treatment option for improving symptoms in achalasia patients.

5. A client diagnosed with major depressive disorder refuses to get out of bed, eat, or participate in group therapy. Which intervention is most important for the nurse to implement?

Correct answer: C

Rationale: In cases of major depressive disorder where the client is non-participatory and withdrawn, sitting with the client and providing support without pressuring them to engage in activities like eating or therapy is crucial. This approach respects the client's current state, builds trust, and creates a supportive environment that can eventually lead to the client opening up and accepting help.

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