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Ati lpn Med Surg exam 3
Ati lpn Med Surg exam 3
Total Questions : 50
Showing 10 questions Sign up for moreA nurse is caring for a 45-year-old male client in the emergency department who reports severe abdominal pain.
Based on the information provided, which of the following provider’s prescriptions are anticipated, nonessential, or contraindicated for the client? Select one response per row.
Explanation
• Increase fiber intake: This is nonessential at this time. While a high-fiber diet can help prevent future episodes of diverticulitis, it won’t help in the acute phase, especially when the client is unable to eat or drink without vomiting.
• CT of the abdomen with contrast: This is an anticipated action. A CT scan can help confirm the diagnosis of diverticulitis and assess the severity of the condition.
• Flexible sigmoidoscopy: This is an anticipated action. A flexible sigmoidoscopy can help visualize the diverticula and assess the extent of the inflammation.
• Change IV fluids to 0.9% sodium chloride with KCl: This is an anticipated action. The client is likely dehydrated due to vomiting and unable to take oral fluids, so IV hydration is necessary. The client’s potassium level is at the lower end of the normal range, so adding KCl to the IV fluids can help prevent hypokalemia.
• Type and crossmatch blood: This is an anticipated action. The client has a positive stool occult blood test and a lower than normal hemoglobin and hematocrit, suggesting that he may be experiencing bleeding. It’s important to have blood ready for a transfusion if necessary.
• Administer IV piperacillin-tazobactam: This is contraindicated. Piperacillin-tazobactam is a penicillin-based antibiotic, and the client has a known allergy to penicillin. Another class of antibiotics should be used. Please note that these are potential actions and the healthcare provider should be informed immediately for further evaluation and management. It’s important to continue following the provider’s prescriptions and closely monitor the client’s condition.
A client with hepatitis has contracted the infection from contaminated food. Which type of hepatitis is this client most likely experiencing?
Explanation
Choice A rationale
Hepatitis A is most likely contracted from contaminated food or water. Hepatitis A virus (HAV) is transmitted by the fecal-oral route via contaminated food or infected food handlers. This is different from Hepatitis B, C, and D which are most commonly transmitted via infected blood or body fluids.
Choice B rationale
Hepatitis B is not typically contracted from contaminated food. It is most commonly transmitted via infected blood or body fluids.
Choice C rationale
Hepatitis C is not typically contracted from contaminated food. It is most commonly transmitted via infected blood or body fluids.
Choice D rationale
Hepatitis D is not typically contracted from contaminated food. It is most commonly transmitted via infected blood or body fluids.
A nurse is assisting in the plan of care for a client who had surgery for a bowel obstruction. The client has a nasogastric tube in place.Which of the following actions should the nurse include in the client’s plan of care? (Select all that apply)
Explanation
Choice A rationale
Maintaining bed rest for 48 hours following surgery is a common practice to allow the body to heal and recover.
Choice B rationale
Irrigating the nasogastric tube every 4 to 8 hours is necessary to maintain patency and prevent blockage.
Choice C rationale
Encouraging hourly use of an incentive spirometer while awake can help prevent postoperative complications such as pneumonia and atelectasis.
Choice D rationale
Performing leg exercises every 2 hours is not typically included in the plan of care for a client who had surgery for a bowel obstruction and has a nasogastric tube in place.
The nurse is caring for a client who received a new diet prescription from the physician for nothing by mouth (NPO) except ice chips.
Which actions would the nurse take to alleviate the effects of dehydration? Select all that apply
Explanation
Choice A rationale
Observing mucous membranes for dryness can indicate dehydration.
Choice B rationale
Providing frequent oral care with moist swabs can help alleviate the discomfort of a dry mouth due to NPO status.
Choice C rationale
Offering the client small sips of water is not appropriate as the client is on a diet of nothing by mouth (NPO) except ice chips.
Choice D rationale
Increasing the rate of intravenous (IV) fluids can help prevent dehydration.
A nurse is collecting data from a client who is 12 hr postoperative following a colectomy with colostomy placement. Which of the following findings should the nurse report to the provider?
Explanation
Choice A rationale
No stool noted in the collection bag is not an immediate concern as it can take several days for the bowel to start functioning after surgery.
Choice B rationale
A bluish-purplish colored stoma could indicate inadequate blood supply to the stoma, which is a medical emergency and should be reported to the provider immediately.
Choice C rationale
An edematous stoma is a common finding in the immediate postoperative period.
Choice D rationale
Slight bleeding of the stoma site can be a normal finding after colostomy placement.
A nurse in a provider’s office is reviewing the health histories of four clients.
For which of the following clients should the nurse anticipate scheduling a colonoscopy?
Explanation
Choice A rationale
A 56-year-old who had a colonoscopy 6 years ago does not necessarily need a colonoscopy unless there are other risk factors present.
Choice B rationale
A 45-year-old who has Clostridium difficile does not necessarily need a colonoscopy unless there are other risk factors present.
Choice C rationale
A 32-year-old who has a sister who died of colon cancer is at a higher risk for developing colon cancer and should therefore be scheduled for a colonoscopy.
Choice D rationale
A 34-year-old who reports a new onset of constipation does not necessarily need a colonoscopy unless there are other risk factors present.
The nurse is preparing to perform an abdominal examination. Which step would be taken first?
Explanation
Choice A rationale
Auscultation is an important step in an abdominal examination, but it is not the first step. It is performed after inspection and before percussion and palpation to ensure that the motility of the bowel and bowel sounds are not altered.
Choice B rationale
Inspection is the first step in an abdominal examination. This step involves visually examining the abdomen for any abnormalities, such as distension, discoloration, or visible peristalsis. The
nurse observes the color, shape, and movement of the abdomen, and looks for any visible masses, scars, or skin changes. This step provides valuable information about the patient’s overall health and potential issues that may require further investigation.
Choice C rationale
Percussion is a part of the abdominal examination, but it is not the first step. It is performed after inspection and auscultation. During percussion, the nurse taps on the abdomen to assess the size and position of the abdominal organs, and to detect any fluid or masses.
Choice D rationale
Palpation is the last step in an abdominal examination. It is performed after inspection, auscultation, and percussion. During palpation, the nurse uses their hands to feel the abdomen for any masses, tenderness, or organ enlargement.
A nurse is collecting data from a client who has been taking omeprazole for the past 4 weeks.
The nurse determines that the medication is effective when the client reports relief from which of the following symptoms?
Explanation
Choice A rationale
Omeprazole is a proton pump inhibitor that reduces gastric acid secretion. It is used to treat conditions such as duodenal and gastric ulcers, prolonged dyspepsia, gastroesophageal reflux disease, and erosive esophagitis. Therefore, relief from acid indigestion would indicate that the medication is effective.
Choice B rationale
While headaches can be a side effect of omeprazole, relief from headaches is not a primary indicator of the medication’s effectiveness in treating conditions related to gastric acid secretion.
Choice C rationale
Diarrhea can be a side effect of omeprazole, but relief from diarrhea does not directly indicate the effectiveness of omeprazole in reducing gastric acid secretion.
Choice D rationale
Nausea can be a symptom of the conditions that omeprazole treats, but relief from nausea alone does not directly indicate the effectiveness of omeprazole in reducing gastric acid secretion.
The nurse provides education for a patient about the treatment for acute gastritis. Which patient statement requires correction by the nurse?
Explanation
Choice A rationale
Alcohol can irritate the stomach lining and exacerbate the symptoms of gastritis. Therefore, the patient should avoid alcohol to help manage their condition.
Choice B rationale
Eating six small meals each day can help manage gastritis by preventing the stomach from being empty for too long, which can increase stomach acid and irritate the stomach lining. This statement does not require correction.
Choice C rationale
Antacids can help manage the pain associated with gastritis by neutralizing stomach acid. This statement does not require correction.
Choice D rationale
Spicy foods can irritate the stomach lining and exacerbate the symptoms of gastritis. Avoiding spicy foods can help manage the condition. This statement does not require correction.
A nurse is assisting with the plan of care for a client who had an upper endoscopy 1 hr ago. The nurse should place the priority on monitoring which of the following?
Explanation
Choice A rationale
While a sore throat can be a side effect of an upper endoscopy, it is not the priority for monitoring after the procedure.
Choice B rationale
Abdominal bloating can occur after an upper endoscopy, but it is not the priority for monitoring.
Choice C rationale
Monitoring the return of the gag reflex is a priority after an upper endoscopy. The gag reflex may be impaired due to the use of local anesthetics during the procedure. An impaired gag reflex increases the risk of aspiration.
Choice D rationale
Belching can occur after an upper endoscopy, but it is not the priority for monitoring
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