ATI LPN
Adult Medical Surgical ATI
1. When assessing a client with a chest tube connected to suction, which observation indicates that the chest tube is functioning properly?
- A. Continuous bubbling in the water seal chamber.
- B. Intermittent bubbling in the suction control chamber.
- C. No fluctuation in the water seal chamber.
- D. Steady bubbling in the suction control chamber.
Correct answer: D
Rationale: Steady bubbling in the suction control chamber is the correct observation that indicates the chest tube is functioning properly. This steady bubbling signifies that the suction is actively maintaining the desired pressure level within the system, ensuring proper drainage and lung re-expansion. Continuous bubbling in the water seal chamber, intermittent bubbling in the suction control chamber, or no fluctuation in the water seal chamber are not indicative of optimal chest tube function and may require further assessment or intervention.
2. A 28-year-old woman presents with abdominal pain, diarrhea, and weight loss. She has a history of recurrent mouth ulcers and a perianal fistula. What is the most likely diagnosis?
- A. Ulcerative colitis
- B. Irritable bowel syndrome
- C. Crohn's disease
- D. Diverticulitis
Correct answer: C
Rationale: The combination of symptoms including recurrent mouth ulcers, perianal fistula, abdominal pain, diarrhea, and weight loss is characteristic of Crohn's disease. These extra-intestinal manifestations, along with the gastrointestinal symptoms, point towards Crohn's disease rather than ulcerative colitis, irritable bowel syndrome, or diverticulitis.
3. The nurse is providing an educational workshop about coronary artery disease (CAD) and its risk factors. The nurse explains to participants that CAD has many risk factors, some that can be controlled and some that cannot. What risk factors should the nurse list that can be controlled or modified?
- A. Gender, obesity, family history, and smoking
- B. Inactivity, stress, gender, and smoking
- C. Cholesterol levels, hypertension, and smoking
- D. Stress, family history, and obesity
Correct answer: C
Rationale: Cholesterol levels, hypertension, and smoking are controllable risk factors for CAD. Managing these factors through lifestyle changes and medical interventions can help reduce the risk of developing coronary artery disease.
4. A client who has just started taking levodopa-carbidopa (Sinemet) for Parkinson's disease reports experiencing nausea. What should the nurse recommend to the client?
- A. Take the medication on an empty stomach.
- B. Consume a low-protein snack with the medication.
- C. Increase your intake of dairy products.
- D. Stop taking the medication and notify your healthcare provider.
Correct answer: B
Rationale: Nausea is a common side effect of levodopa-carbidopa (Sinemet). Consuming a low-protein snack with the medication can help reduce nausea. The protein in food can compete with levodopa for absorption, so taking it with a low-protein snack may improve its effectiveness and reduce gastrointestinal side effects. Option A is incorrect as taking the medication on an empty stomach may exacerbate nausea. Option C is incorrect because increasing intake of dairy products is not recommended to alleviate nausea. Option D is incorrect because abruptly stopping the medication without healthcare provider guidance can lead to adverse effects.
5. A client is admitted with diabetic ketoacidosis (DKA). Which assessment finding requires immediate intervention?
- A. Fruity breath odor.
- B. Blood glucose of 450 mg/dL.
- C. Deep, rapid respirations.
- D. Serum potassium of 5.2 mEq/L.
Correct answer: C
Rationale: The correct answer is C: Deep, rapid respirations (Kussmaul breathing). This is a sign of severe acidosis commonly seen in diabetic ketoacidosis (DKA) and requires immediate intervention. Kussmaul breathing helps to compensate for the metabolic acidosis by blowing off carbon dioxide. Prompt intervention is necessary to prevent further deterioration and potential respiratory failure. Fruity breath odor (Choice A) is a classic sign of DKA but does not require immediate intervention. While a blood glucose level of 450 mg/dL (Choice B) is high, it does not pose an immediate threat to the client's life. Serum potassium of 5.2 mEq/L (Choice D) is slightly elevated but not the most critical finding that requires immediate intervention in this scenario.
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