Review ATI LPN Med surg exam 7

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ATI LPN Med surg exam 7

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Total Questions : 52

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Question 1:

A nurse is reviewing data for a client who has disseminated intravascular coagulation (DIC). Which of the following findings should the nurse expect?

A. Excessive thrombosis and bleeding. B. Progressive increase in platelet production. C. Immediate sodium and fluid retention. D. Increased clotting factors.

Answer and Explanation

Choice A:

Disseminated intravascular coagulation (DIC) is a condition characterized by both excessive clotting and excessive bleeding. The clotting cascade is inappropriately activated throughout the body, leading to the formation of numerous small blood clots in the blood vessels. These clots consume clotting factors and platelets, which can then lead to excessive bleeding. This paradoxical combination of thrombosis and bleeding is a hallmark of DIC.

Choice B:

In DIC, platelet consumption exceeds production. The formation of numerous clots uses up platelets faster than they can be produced, which can result in thrombocytopenia and bleeding. Therefore, a progressive increase in platelet production is not an expected finding in DIC.

Choice C:

Immediate sodium and fluid retention is not a feature of DIC. This condition primarily involves the clotting and bleeding mechanisms, not fluid balance or sodium levels.

Choice D:

In DIC, clotting factors are consumed in the formation of numerous clots. This leads to a deficiency of clotting factors, contributing to the bleeding tendency seen in this condition. Increased clotting factors would not be expected in a patient with DIC.

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Question 2:

A nurse is assisting with triaging clients after a mass casualty event. Which of the following clients should the nurse attend to first?

A. A client who has a splinted open fracture of the left medial malleolus. B. A client who has a penetrating head injury and is experiencing seizures. C. A client who has severe respiratory stridor and a deviated trachea. D. A client who has a small circular partial-thickness burn of the left calf.

Answer and Explanation

Choice A:

An open fracture, while needing medical attention, is not immediately life-threatening. The client's condition is stable enough to wait while more critical cases are attended to.

Choice B:

A penetrating head injury with seizures is a critical condition. However, ensuring a patent airway takes precedence in emergency situations. This client's seizures indicate serious brain injury, but the immediate threat to life, such as airway obstruction, must be prioritized.

Choice C:

Severe respiratory stridor and a deviated trachea indicate a life-threatening airway obstruction. This client needs immediate attention to secure the airway and prevent respiratory failure. This is the highest priority because without a clear airway, the client will not survive long enough to benefit from other interventions.

Choice D:

A partial-thickness burn, although painful and requiring treatment, is not immediately life-threatening. This client can safely wait while those with more critical needs are attended to.

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Question 3:

A nurse is reinforcing teaching about Russell's traction with a newly licensed nurse. Which of the following statements should the nurse make?

A. "Russell's traction uses a sling under the knee to treat a fracture of the femur." B. "Russell's traction uses a cervical halter to decrease cervical muscle spasms." C. "Russell's traction uses a pelvic girdle belt to decrease lower back pain." D. "Russell's traction uses skeletal pins to stabilize the fracture."

Answer and Explanation

Choice A:

Russell's traction involves the use of a sling under the knee to apply a pulling force on the femur. This helps in aligning and stabilizing the fractured femur, allowing for proper healing. The sling supports the leg, while weights provide the necessary traction force.

Choice B:

A cervical halter is used in cervical traction to relieve muscle spasms and align the cervical spine, not in Russell's traction. This type of traction is not related to treating femur fractures.

Choice C:

A pelvic girdle belt is used in pelvic traction to relieve lower back pain and stabilize pelvic fractures, not in Russell's traction. Russell's traction specifically pertains to femur fractures.

Choice D:

Skeletal pins are used in skeletal traction, where pins are inserted into the bone to apply direct traction. Russell's traction, however, does not use skeletal pins; it uses a sling and weights to apply traction.

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Question 4:

A nurse is caring for a client who is suspected to have active laryngeal tuberculosis (TB). Which of the following actions should the nurse plan to take to safely care for this client?

A. Have staff and visitors wear gowns while in the client’s room. B. Place the client in a private room with a special ventilation system. C. Move the client to a semi-private room with a client who requires droplet precautions. D. Remove personal protective equipment in the hallway outside of the client’s room.

Answer and Explanation

Choice A:

While gowns may be part of the precautions, they are not sufficient alone for preventing the spread of TB, which is transmitted via airborne particles.

Choice B:

Placing the client in a private room with a special ventilation system is crucial for preventing the spread of TB. The special ventilation system, typically a negative pressure room, ensures that airborne particles do not escape into other areas, thereby protecting staff and other patients.

Choice C:

A semi-private room with another patient requiring droplet precautions is inappropriate for a TB patient, as TB requires strict airborne precautions to prevent transmission.

Choice D:

Removing personal protective equipment in the hallway increases the risk of contaminating the hallway and spreading TB. PPE should be removed inside the room or anteroom to contain potential contaminants.

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Question 5:

A nurse is caring for a client who has Ménière’s disease. When asked by the client if he is allowed to ambulate independently, which of the following responses should the nurse make?

A. "You are free to move around your room as you wish, but you should avoid the hallways." B. "You are on strict bed rest and must not be up." C. "Please call for assistance when you wish to get out of bed." D. "Why would we not allow you to walk if you wanted?"

Answer and Explanation

Choice A:

Allowing the client to move around the room unsupervised can lead to falls, as Ménière’s disease can cause sudden episodes of vertigo and imbalance.

Choice B:

Strict bed rest is usually not required for clients with Ménière’s disease. Encouraging mobility with assistance is typically more appropriate.

Choice C:

Asking the client to call for assistance helps prevent falls and ensures the client's safety. Ménière’s disease often causes vertigo, and assistance is necessary to prevent injuries.

Choice D:

This response does not address the client's safety concerns and may lead to misunderstanding the risks associated with ambulation in Ménière’s disease.

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Question 6:

A nurse is reinforcing teaching with a client who has neutropenia. Which of the following instructions should the nurse include in the teaching?

A. Eat plenty of fresh fruits and vegetables. B. Avoid crowded places. C. Participate in gardening for mild exercise. D. Take temperature weekly.

Answer and Explanation

Choice A:

Fresh fruits and vegetables can harbor bacteria and other pathogens that pose a significant infection risk to neutropenic clients. It's advisable to avoid these foods unless they are cooked or properly washed and peeled.

Choice B:

Avoiding crowded places is essential for neutropenic clients because their immune system is weakened, making them more susceptible to infections. Crowded places increase the risk of exposure to infectious agents.

Choice C:

Participating in gardening is not recommended as it exposes neutropenic clients to soil bacteria and fungi, which can cause infections. Activities should be chosen carefully to minimize infection risk.

Choice D:

Taking temperature weekly is not adequate for neutropenic clients. Daily temperature monitoring is important for early detection of infections, which can progress rapidly in immunocompromised individuals.

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Question 7:

A nurse is assisting in the plan of care for a client who has immunosuppression following chemotherapy. Which of the following interventions should the nurse include in the plan of care?

A. Insert an indwelling catheter to monitor for sediment in the urine. B. Take the client's temperature once per shift. C. Provide the client with fresh fruit to avoid constipation. D. Limit the number of health care workers entering the room.

Answer and Explanation

Choice A:

Inserting an indwelling catheter can increase the risk of urinary tract infections, which is particularly dangerous for immunosuppressed clients. Monitoring for sediment can be done through less invasive methods.

Choice B:

Taking the client's temperature once per shift may not be frequent enough. More frequent monitoring is recommended to detect early signs of infection.

Choice C:

Providing fresh fruit, while beneficial for preventing constipation, can pose an infection risk due to potential contamination. Alternatives like canned or cooked fruits should be considered.

Choice D:

Limiting the number of health care workers entering the room reduces the risk of introducing infections to the immunosuppressed client. This is a key measure to protect clients with weakened immune systems.

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Question 8:

A nurse is preparing to review discharge instructions with a client who has pulmonary tuberculosis. Which of the following information should the nurse include?

A. Place tissue soiled with respiratory secretions in a paper bag for later disposal. B. Provide samples for sputum cultures every 6 weeks. C. Consume alcohol in moderation while taking antituberculosis medications. D. Wear a mask while out or around crowds of people.

Answer and Explanation

Choice A:

Placing tissue soiled with respiratory secretions in a paper bag for later disposal is not an appropriate infection control measure. Used tissues should be disposed of immediately in a proper waste receptacle to prevent the spread of tuberculosis bacteria.

Choice B:

Sputum cultures should be provided more frequently than every 6 weeks to monitor the effectiveness of the treatment and to confirm when the client is no longer infectious. Monthly cultures are typically recommended until the patient shows no signs of active infection.

Choice C:

Consuming alcohol in moderation while taking antituberculosis medications is not advised. Alcohol can interfere with the effectiveness of the medications and may also exacerbate potential side effects, such as liver toxicity, especially with medications like isoniazid and rifampin.

Choice D:

The correct answer is d because wearing a mask while out or around crowds of people helps prevent the spread of tuberculosis. TB is an airborne disease, and wearing a mask reduces the risk of transmitting the infection to others.

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Question 9:

A nurse at an outpatient surgery center is reinforcing discharge teaching with a client’s partner following surgical removal of a cataract. Which of the following information should the nurse include in the teaching?

A. Feed the client soft foods for several days. B. Position the client on the affected side to rest. C. The client should remain in bed for 3 days. D. The client should wear dark glasses while outdoors.

Answer and Explanation

Choice A:

Feeding the client soft foods is not necessary after cataract surgery. Cataract surgery does not affect the client's ability to eat regular foods, and a normal diet can be resumed unless otherwise instructed by the healthcare provider.

Choice B:

Positioning the client on the affected side is contraindicated after cataract surgery because it can increase pressure on the eye and disrupt the healing process. Clients are usually advised to avoid sleeping on the side of the operated eye to prevent complications.

Choice C:

It is not necessary for the client to remain in bed for 3 days following cataract surgery. Clients are encouraged to resume normal activities as tolerated, but they should avoid strenuous activities and heavy lifting to prevent increased intraocular pressure.

Choice D:

The correct answer is d because wearing dark glasses while outdoors helps protect the eyes from bright light and UV rays, which can cause discomfort and harm the healing eye after cataract surgery.

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Question 10:

A nurse in a health clinic is assisting in the planning of an educational program on skin cancer. Which of the following statements should be included in the presentation?

A. Squamous cell carcinoma occurs most often on the face and trunk. B. Radiation therapy is the treatment of choice for metastatic skin cancer. C. Sun exposure as a child is a significant risk factor for skin cancer. D. Basal cell carcinoma is an aggressive cancer with a high rate of metastasis.

Answer and Explanation

Choice A:

Squamous cell carcinoma commonly occurs on sun-exposed areas such as the face, ears, neck, and hands, but not necessarily the trunk. It is important to emphasize the role of sun exposure in the development of this type of skin cancer.

Choice B:

Radiation therapy is used in the treatment of certain types of skin cancer, but it is not typically the first choice for metastatic skin cancer. Other treatments, such as surgery, immunotherapy, or targeted therapy, are often preferred depending on the type and stage of skin cancer.

Choice C:

The correct answer is c because sun exposure, especially during childhood, significantly increases the risk of developing skin cancer later in life. This highlights the importance of sun protection measures from an early age to prevent skin cancer.

Choice D:

Basal cell carcinoma is the most common and least aggressive type of skin cancer. It rarely metastasizes and is usually slow-growing, making early detection and treatment highly effective.

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Total Questions : 52

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ATI LPN Med surg exam 7

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