ATI Learning System PN Medical Surgical Final Quizlet

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A 75-year-old patient is admitted for pancreatitis. Which tool would be the most appropriate for the nurse to use during the admission assessment?

  • A. Drug Abuse Screening Test (DAST-10)
  • B. Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar)
  • C. Screening Test-Geriatric Version (SMAST-G)
  • D. Mini-Mental State Examination
Correct Answer: C

Rationale: The most appropriate tool for the nurse to use during the admission assessment of a 75-year-old patient admitted for pancreatitis is the Screening Test-Geriatric Version (SMAST-G). This tool is specifically designed to assess for alcohol abuse in older adults, which is relevant in this case as alcohol consumption can be a risk factor for pancreatitis. The SMAST-G helps identify potential alcohol-related issues in the elderly population, allowing for appropriate interventions and care planning.

Rationale:
A: The Drug Abuse Screening Test (DAST-10) is not the most appropriate tool in this scenario as it focuses on broader drug abuse rather than specifically alcohol abuse.
B: The Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar) is used to assess for alcohol withdrawal symptoms, not alcohol abuse itself.
D: The Mini-Mental State Examination is used to assess cognitive function, which is not directly relevant to the admission assessment for pancreatitis in this case.

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A patient with hyperlipidemia is prescribed atorvastatin. What lab test should be monitored periodically to assess for adverse effects?

  • A. Liver function tests
  • B. Complete blood count
  • C. Blood glucose levels
  • D. Serum potassium
Correct Answer: A

Rationale: Step-by-step rationale:
1. Atorvastatin is a statin medication commonly known to potentially cause liver damage.
2. Monitoring liver function tests periodically helps assess for any liver abnormalities.
3. Elevated liver enzymes may indicate liver injury from atorvastatin.
4. Monitoring liver function tests allows for early detection and management of adverse effects.

Summary:
A: Monitoring liver function tests is crucial due to atorvastatin's potential hepatotoxicity.
B: Complete blood count is not typically affected by atorvastatin.
C: Blood glucose levels are not directly related to atorvastatin use.
D: Serum potassium is not specifically monitored for atorvastatin-related adverse effects.

The healthcare professional is caring for a client with heart failure who is receiving digoxin (Lanoxin). Which assessment finding requires immediate intervention?

  • A. Heart rate of 58 beats per minute.
  • B. Nausea and vomiting.
  • C. Blood pressure of 130/80 mm Hg.
  • D. Shortness of breath.
Correct Answer: B

Rationale: The correct answer is B: Nausea and vomiting. This finding requires immediate intervention because digoxin toxicity can present with gastrointestinal symptoms like nausea and vomiting. This can indicate an overdose of digoxin, which can be life-threatening. Prompt action is necessary to prevent further complications.

A: Heart rate of 58 beats per minute is within the therapeutic range for digoxin and does not require immediate intervention.
C: Blood pressure of 130/80 mm Hg is also within normal limits and does not indicate an urgent issue.
D: Shortness of breath can be a symptom of heart failure but is not a direct indication of digoxin toxicity requiring immediate intervention.

What instruction should a patient with a history of hypertension be provided when being discharged with a prescription for a thiazide diuretic?

  • A. Avoid foods high in potassium.
  • B. Take the medication at bedtime.
  • C. Monitor weight daily.
  • D. Limit fluid intake to 1 liter per day.
Correct Answer: C

Rationale: Rationale:
C is correct because thiazide diuretics can cause fluid retention, leading to weight gain, which may indicate worsening heart failure or hypertension. Daily weight monitoring helps detect fluid retention early, enabling timely intervention.
Summary:
A: Incorrect. Thiazide diuretics can cause potassium loss, so avoiding potassium-rich foods is not necessary.
B: Incorrect. Taking the medication in the morning is preferred to prevent nocturia and sleep disturbances.
D: Incorrect. Fluid intake should not be limited unless advised by a healthcare provider to prevent dehydration.

Which problem in a client requires the most immediate intervention by the nurse?

  • A. Finger paresthesias related to carpal tunnel syndrome.
  • B. Increasing sharp pain related to compartment syndrome.
  • C. Increasing burning pain related to a Morton's neuroma.
  • D. Increasing sharp pain related to plantar fasciitis.
Correct Answer: B

Rationale: The correct answer is B. Compartment syndrome is a medical emergency that can lead to tissue damage and loss of limb function. Immediate intervention is crucial to prevent further complications. Finger paresthesias related to carpal tunnel syndrome (A) are not life-threatening and can be managed conservatively. Morton's neuroma (C) and plantar fasciitis (D) are painful conditions, but they do not pose an immediate threat to the client's health or limb function.

What instruction should the nurse include in the discharge teaching for a patient with hypothyroidism prescribed levothyroxine?

  • A. Take the medication with meals.
  • B. Take the medication in the morning on an empty stomach.
  • C. Discontinue the medication if you feel better.
  • D. Double the dose if a dose is missed.
Correct Answer: B

Rationale: The correct answer is B: Take the medication in the morning on an empty stomach. Levothyroxine should be taken on an empty stomach, preferably 30 minutes to 1 hour before breakfast, to ensure optimal absorption. Food can interfere with absorption, so taking it with meals (choice A) is not recommended. Discontinuing the medication if feeling better (choice C) is dangerous as it can lead to a relapse of hypothyroidism. Doubling the dose if a dose is missed (choice D) can result in overdose and adverse effects. Therefore, choice B is the best option for optimal effectiveness of levothyroxine therapy.

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