ATI LPN
Adult Medical Surgical ATI
1. The patient described in the preceding question has a positive H. pylori antibody blood test. She is compliant with the medical regimen you prescribe. Although her symptoms initially respond, she returns to see you six months later with the same symptoms. Which of the following statements is correct?
- A. She is at low risk for reinfection with H. pylori
- B. A positive serum IgG indicates that eradication of H. pylori was successful
- C. The urease breath test is an ideal test to document failure of eradication
- D. Dyspepsia typically worsens with H. pylori eradication
Correct answer: C
Rationale: Reinfection with H. pylori is rare, and the persistence of infection usually indicates poor compliance with the medical regimen or antibiotic resistance. The serum IgG may remain positive indefinitely and cannot be used to determine failure of eradication; however, a decrease in quantitative IgG levels has been utilized to indicate treatment success. If available, either the stool antigen or urease breath test is ideal to document treatment failure due to their high sensitivity, specificity, and ease of performance. The relationship between dyspepsia and H. pylori is controversial, but generally, dyspepsia does not typically improve with H. pylori eradication.
2. How does the nurse apply Maslow's hierarchy of needs in care?
- A. Judging the patient's behavior
- B. Improving the skillfulness of care
- C. Understanding the patient's behavior
- D. Improving communication skills
Correct answer: C
Rationale: Maslow's hierarchy of needs is a framework that helps nurses understand the different levels of human needs and prioritize care accordingly. By applying this framework, nurses can better understand the patient's behavior in the context of their unmet needs. This understanding allows nurses to provide holistic and patient-centered care that addresses not just the physical but also the emotional, social, and psychological needs of the patient. Choice A is incorrect because applying Maslow's hierarchy is about understanding, not judging, the patient's behavior. Choice B is incorrect as it does not directly relate to the application of Maslow's hierarchy. Choice D is also incorrect as improving communication skills, although important, is not the primary focus when applying Maslow's hierarchy of needs in care.
3. A nurse is caring for a client in a mental health facility. The client’s daughter is crying and tells the nurse that she feels guilty for leaving her father in the hospital. Which of the following is an appropriate response?
- A. I’d like to know more about what’s bothering you.
- B. Why are you feeling this way?
- C. You did the right thing by bringing him here.
- D. I’m sure your father doesn’t blame you.
Correct answer: A
Rationale: The correct response is A: 'I’d like to know more about what’s bothering you.' Encouraging the daughter to express her feelings allows her to explore her emotions, which can be helpful in addressing her guilt and providing emotional support. Choice B is not as open-ended and may come across as confrontational. Choice C may invalidate the daughter's feelings of guilt by implying she shouldn't feel that way. Choice D assumes the father's emotions and may not address the daughter's feelings of guilt effectively.
4. A patient with social anxiety disorder is learning cognitive-behavioral therapy (CBT) techniques. Which skill is most likely being taught?
- A. Avoiding social situations that cause anxiety
- B. Challenging and changing negative thoughts
- C. Using deep breathing exercises during social interactions
- D. Taking anti-anxiety medication before social events
Correct answer: B
Rationale: The correct answer is B. In cognitive-behavioral therapy (CBT) for social anxiety disorder, the focus is on challenging and changing negative thoughts that contribute to anxiety. This process involves identifying distorted thought patterns and replacing them with more balanced and realistic thoughts, helping individuals develop healthier perspectives on social situations. Choices A, C, and D are incorrect because avoiding social situations, using deep breathing exercises, and taking medication are not the primary skills taught in CBT for social anxiety disorder. CBT aims to address the underlying thought patterns and behaviors that maintain anxiety, rather than avoidance or temporary relief.
5. A nurse is caring for a newborn who is 1 hour old and has a respiratory rate of 50 breaths per minute with periods of apnea lasting up to 10 seconds. Which of the following actions should the nurse take?
- A. Administer oxygen
- B. Stimulate the newborn
- C. Initiate positive pressure ventilation
- D. Continue routine monitoring
Correct answer: D
Rationale: A respiratory rate of 50 breaths per minute with occasional periods of apnea lasting less than 15 seconds is normal for a newborn. The nurse should continue routine monitoring unless the apneic periods become prolonged or the newborn shows signs of respiratory distress. Administering oxygen or initiating positive pressure ventilation is not indicated in this scenario as the newborn's respiratory rate and apneic episodes are within normal limits for their age. Stimulating the newborn is also unnecessary since the described parameters fall within the expected range for a 1-hour-old infant.
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