ATI PN Adult Medical Surgical 2019

ATI PN Adult Medical Surgical 2019 Related

Review ATI PN Adult Medical Surgical 2019 related questions and content

A client with left-sided heart failure is experiencing dyspnea and orthopnea. Which position should the nurse place the client in to relieve these symptoms?

  • A. High Fowler's position.
  • B. Supine position.
  • C. Trendelenburg position.
  • D. Sims' position.
Correct Answer: A

Rationale: The correct answer is A: High Fowler's position. Placing the client in a High Fowler's position helps reduce dyspnea and orthopnea by facilitating lung expansion and improving ventilation. In this position, the client's head and chest are elevated at a 90-degree angle, allowing for maximal chest expansion and improved oxygenation. This position also helps reduce the workload on the heart by decreasing venous return, which can help alleviate symptoms of left-sided heart failure.

Summary:
- A: High Fowler's position is correct as it facilitates lung expansion and improves ventilation.
- B: Supine position would not be ideal as it can exacerbate symptoms by increasing pressure on the lungs and heart.
- C: Trendelenburg position would worsen symptoms by increasing venous return and fluid overload.
- D: Sims' position is used for procedures or to facilitate drainage, not for relieving dyspnea and orthopnea.

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A client with a history of myocardial infarction (MI) is prescribed atorvastatin (Lipitor). Which outcome indicates that the medication is effective?

  • A. Increased blood pressure.
  • B. Lowered cholesterol levels.
  • C. Decreased heart rate.
  • D. Improved liver function.
Correct Answer: B

Rationale: The correct answer is B: Lowered cholesterol levels. Atorvastatin is a statin medication used to lower cholesterol levels, reducing the risk of further cardiovascular events in patients with a history of MI. Lowering cholesterol helps prevent plaque buildup in arteries, reducing the likelihood of another MI. Increased blood pressure (A) and decreased heart rate (C) are not direct indicators of atorvastatin's effectiveness. Improved liver function (D) may be a consideration due to potential side effects, but the primary goal of atorvastatin is to lower cholesterol levels to prevent cardiovascular events.

A client with a history of chronic heart failure is experiencing severe shortness of breath and has pink, frothy sputum. Which action should the nurse take first?

  • A. Administer morphine sulfate.
  • B. Place the client in a high Fowler's position.
  • C. Initiate continuous ECG monitoring.
  • D. Prepare the client for intubation.
Correct Answer: B

Rationale: The correct action for the nurse to take first is to place the client in a high Fowler's position (Choice B). This position helps improve lung expansion and oxygenation by reducing pressure on the diaphragm and improving ventilation. With severe shortness of breath and pink, frothy sputum, the priority is to optimize respiratory function. Administering morphine sulfate (Choice A) may be indicated later for pain and anxiety but is not the immediate priority. Initiating continuous ECG monitoring (Choice C) is important but not as urgent as addressing the respiratory distress. Preparing the client for intubation (Choice D) should be considered if respiratory distress worsens, but initial interventions should focus on improving oxygenation through positioning.

A client with heart failure is prescribed digoxin (Lanoxin). Which sign of digoxin toxicity should the nurse teach the client to report?

  • A. Increased appetite.
  • B. Yellow or blurred vision.
  • C. Weight gain.
  • D. Nasal congestion.
Correct Answer: B

Rationale: The correct answer is B: Yellow or blurred vision. Digoxin toxicity can lead to visual disturbances, such as yellow or blurred vision, due to its effects on the optic nerve. The nurse should teach the client to report this symptom immediately as it indicates a serious adverse effect. Increased appetite (A), weight gain (C), and nasal congestion (D) are not specific signs of digoxin toxicity and are more commonly associated with other health conditions or side effects of medications. It is crucial for the nurse to emphasize the importance of monitoring and reporting any visual changes to prevent serious complications from digoxin toxicity.

A client with severe rheumatoid arthritis is experiencing joint pain and stiffness. Which intervention should the nurse implement to help relieve the client's symptoms?

  • A. Apply cold packs to the affected joints.
  • B. Encourage passive range-of-motion exercises.
  • C. Administer a muscle relaxant.
  • D. Provide a high-calorie diet.
Correct Answer: B

Rationale: The correct answer is B: Encourage passive range-of-motion exercises. This intervention helps improve joint mobility, reduce stiffness, and alleviate pain in clients with rheumatoid arthritis. Passive range-of-motion exercises can prevent joint contractures and maintain joint function. Applying cold packs (A) may help reduce inflammation but does not address joint stiffness. Administering a muscle relaxant (C) is not typically indicated for rheumatoid arthritis. Providing a high-calorie diet (D) is important for overall health but does not directly address joint pain and stiffness in this case.

A client with a history of gout is experiencing an acute attack. Which medication should the nurse expect the healthcare provider to prescribe?

  • A. Aspirin.
  • B. Allopurinol (Zyloprim).
  • C. Colchicine.
  • D. Probenecid (Benemid).
Correct Answer: C

Rationale: The correct answer is C: Colchicine. Colchicine is used to treat acute gout attacks by reducing inflammation and pain. It works by decreasing the inflammatory response to urate crystals in the joints. Aspirin (choice A) is not recommended for gout treatment as it can worsen symptoms. Allopurinol (choice B) and Probenecid (choice D) are used for long-term management of gout by reducing uric acid levels and preventing future attacks, not for acute attacks. Colchicine is the appropriate choice for treating the client's acute gout symptoms.

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