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Ati lpn med surg u13 exam
Ati lpn med surg u13 exam
Total Questions : 44
Showing 10 questions Sign up for moreA female patient recently underwent a partial gastrectomy and is now presenting with symptoms of weakness, dizziness, and sweating, particularly after meals. Based on these symptoms, what is the most likely diagnosis?
Explanation
A. Dumping Syndrome: Dumping syndrome is a common complication following gastrectomy, where food moves too quickly from the stomach to the small intestine. Symptoms such as weakness, dizziness, and sweating, particularly after meals, are characteristic of this condition.
B. Peptic Ulcer Disease: While this can occur after gastrectomy, it typically presents with epigastric pain rather than weakness and dizziness after eating.
C. Gastroesophageal Reflux Disease (GERD): GERD typically presents with heartburn and acid regurgitation, not the postprandial weakness and sweating seen in dumping syndrome.
D. Irritable Bowel Syndrome (IBS): IBS symptoms usually include bloating, abdominal discomfort, and altered bowel habits, which are different from the described symptoms.
During the process of collecting a comprehensive medical history from a client who has been admitted with pyelonephritis, which of the following symptoms or historical details would the nurse most likely expect the client to report?
Explanation
A. A history of chronic headaches and migraines: While chronic headaches and migraines can affect overall health, they are not directly related to pyelonephritis.
B. A history of gastrointestinal issues such as irritable bowel syndrome: Gastrointestinal issues like irritable bowel syndrome (IBS) are generally unrelated to kidney function or urinary tract infections.
C. A history of cardiovascular problems such as hypertension: While hypertension can have indirect effects on renal function, it is not a common historical detail specifically associated with pyelonephritis.
D. A history of frequent urinary tract infections: Frequent urinary tract infections (UTIs) are a significant risk factor for developing pyelonephritis, as the infection can ascend from the bladder to the kidneys.
A patient with acute pancreatitis is being discharged from the hospital. Which statement made by the patient indicates a need for further teaching regarding their discharge instructions?
Explanation
A. I should avoid alcohol completely to prevent another episode of pancreatitis: This is correct advice, as alcohol is a common cause of pancreatitis and should be avoided.
B. I can resume my high-fat diet once my symptoms improve. A high-fat diet can trigger another episode of pancreatitis, as fat stimulates pancreatic enzymes that can exacerbate the condition. The patient should follow a low-fat diet.
C. I should take my prescribed medications as directed to manage my symptoms: This statement is appropriate and reflects adherence to the treatment plan.
D. I need to follow up with my healthcare provider regularly to monitor my condition: This is also correct, as regular monitoring is essential to managing pancreatitis.
A nurse is caring for a client who has an admitted diagnosis of renal calculi and medical history of hypertension and gout. The client works 6 days of the week outside in temperatures between 32.2° C to 37.8° C (90° F to 100° F). Which of the following should the nurse tell the client to prevent a reoccurrence of renal calculi?
Explanation
A. Eat a diet high in calcium oxalate-rich foods: This is incorrect. A diet high in oxalate can promote stone formation, so it should be avoided.
B. Drink plenty of fluids during the day. Adequate hydration is the most important strategy to prevent the formation of renal calculi, especially in hot climates where fluid loss through sweat increases the risk.
C. Eat a diet high in purine-rich foods: This is incorrect. Purine-rich foods can increase uric acid levels and contribute to uric acid stone formation, especially in clients with gout.
D. Continue to take your prescribed gout medication: While this is important for managing gout, it does not directly prevent renal calculi, so it is not the most relevant intervention.
A nurse is contributing to the plan of care for a client who has an intestinal obstruction and is receiving continuous gastrointestinal decompression using a nasogastric tube. Which of the following interventions should the nurse include in the plan of care?
Explanation
A. Measure abdominal girth daily. Measuring abdominal girth daily helps assess for changes in distention, which is important in monitoring the effectiveness of the decompression.
B. Moisten the client's lips with lemon-glycerin swabs: This is incorrect because lemon-glycerin swabs can dry the oral mucosa. Using plain water or normal saline swabs would be more appropriate.
C. Maintain the client in Fowler's position: This is appropriate as it helps promote drainage from the nasogastric tube and reduces the risk of aspiration.
D. Use sterile water to irrigate the nasogastric tube: Irrigation is typically done with normal saline to maintain electrolyte balance. Sterile water is not recommended for this purpose.
When caring for older adult clients at a long-term care facility, which of the following assessments should the nurse prioritize when evaluating for the risk and presence of urinary retention? (Select all that apply.)
Explanation
A. Observing for changes in urinary patterns, such as a sudden decrease in urinary output or frequent, small amounts of voiding. This can indicate urinary retention, as frequent, small voids may suggest incomplete emptying of the bladder.
B. Assessing for reports of urinary hesitancy, dribbling of urine, straining, or a sensation of incomplete bladder emptying during urination. These symptoms are common in urinary retention, indicating that the client is having difficulty fully emptying the bladder.
C. Encouraging the client to drink large amounts of fluid in a short period to stimulate bladder emptying: This is incorrect, as overhydration can worsen urinary retention, especially in clients with an impaired ability to empty their bladder.
D. Applying pressure over the lower abdomen to force urine out of the bladder: This is incorrect and can cause harm, as it may increase the risk of bladder injury.
E. Evaluating for palpable bladder distention after voiding to assess incomplete bladder emptying.
A distended bladder after voiding suggests incomplete emptying and potential urinary retention.
A 55-year-old male patient presents to the emergency department with complaints of acute gastrointestinal (GI) bleeding. The patient reports passing black, tarry stools and experiencing dizziness and weakness. On physical examination, he is pale and diaphoretic.
Which of the following are the most appropriate initial nursing interventions for this patient? (Select all that apply)
Explanation
A. Administer IV fluids: The patient is hypotensive (blood pressure 88/54 mmHg) and tachycardic (heart rate 115 bpm), indicating possible hypovolemic shock due to blood loss. Administering IV fluids will help to stabilize blood pressure.
B. Prepare for possible blood transfusion: The patient's hemoglobin level is critically low (6.5 g/dL), indicating significant blood loss and severe anemia. Preparing for a blood transfusion is crucial to correct the anemia.
C. Monitor hemoglobin and hematocrit levels: Continuous monitoring of hemoglobin and hematocrit levels is vital to assess the severity of the patient's anemia and response to treatment, guiding further interventions.
D. Administer a proton pump inhibitor (PPI): PPIs can help reduce gastric acid secretion, which may help control bleeding from peptic ulcers, a common cause of upper GI bleeding.
E. Administer oral iron supplements to address anemia: Oral iron supplements are typically used for long-term management of iron deficiency anemia but are not effective for immediate correction of severe anemia, particularly in an acute setting with ongoing blood loss.
A patient with a history of ulcerative colitis presents to the emergency department with severe abdominal pain, frequent bloody diarrhea, and signs of dehydration. Which medication should the nurse anticipate administering during this exacerbation of ulcerative colitis?
Explanation
A. Prednisone: Prednisone, a corticosteroid, is often used to reduce inflammation and suppress the immune response during exacerbations of ulcerative colitis. It helps manage the symptoms and prevent further complications.
B. Metronidazole: While used in some gastrointestinal conditions, it is more commonly prescribed for infections related to Crohn’s disease or infections caused by anaerobic bacteria, not for ulcerative colitis exacerbations.
C. Omeprazole: Omeprazole is a proton pump inhibitor used to reduce stomach acid and is typically indicated for gastroesophageal reflux disease (GERD) or peptic ulcers, not ulcerative colitis.
D. Loperamide: This antidiarrheal medication should be used with caution in ulcerative colitis, as it can increase the risk of toxic megacolon.
A patient with a nasogastric (NG) tube in place is experiencing respiratory distress. What is the most appropriate initial nursing intervention?
Explanation
A. Elevate the head of the bed to 90 degrees: While elevating the head of the bed may help ease breathing, it does not address the potential issue of NG tube misplacement.
B. Administer a bronchodilator as prescribed: This would only be appropriate if the patient’s respiratory distress were related to bronchospasm or asthma, not NG tube displacement.
C. Check the placement of the NG tube to ensure it has not dislodged into the lungs. When a patient with an NG tube experiences respiratory distress, the tube may have dislodged and entered the respiratory tract, which could obstruct breathing. Verifying the placement of the NG tube is critical to preventing aspiration or further complications.
D. Increase the flow rate of the patient’s oxygen therapy: This may provide temporary relief but does not resolve the underlying cause of the distress if the NG tube has entered the respiratory tract.
A nurse is assessing an older adult client who has a urinary tract infection (UTI). Which of the following findings should the nurse identify as unique for this age group?
Explanation
A. Low back pain: While this can be a symptom of a UTI, it is not unique to older adults and can be seen in various age groups.
B. Confusion: In older adults, UTIs often present with atypical symptoms, such as confusion or delirium, rather than the classic symptoms like dysuria or frequency. This can be a sign of infection in this population.
C. Urinary retention: This is not specific to UTIs in older adults and can occur for other reasons, such as benign prostatic hyperplasia (BPH).
D. Incontinence: Although older adults may experience incontinence, it is not a unique sign of UTI and could be related to other conditions like weakened pelvic muscles.
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