ATI Adult Medical Surgical

ATI Adult Medical Surgical Related

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The nurse is administering sevelamer (RenaGel) during lunch to a client with end-stage renal disease (ESRD). The client asks the nurse to bring the medication later. The nurse should describe which action of RenaGel as an explanation for taking it with meals?

  • A. Prevents indigestion associated with the ingestion of spicy foods.
  • B. Binds with phosphorus in foods and prevents absorption.
  • C. Promotes stomach emptying and prevents gastric reflux.
  • D. Buffers hydrochloric acid and prevents gastric erosion.
Correct Answer: B

Rationale: The correct answer is B. Sevelamer (RenaGel) is a phosphate binder used in ESRD to bind with phosphorus in foods, preventing its absorption in the gastrointestinal tract. This is important as ESRD patients often have high levels of phosphorus in their blood, which can lead to complications like cardiovascular disease. Taking RenaGel with meals ensures that it binds with phosphorus in the food, reducing its absorption.

Choice A is incorrect as RenaGel does not prevent indigestion associated with spicy foods. Choice C is incorrect as RenaGel does not promote stomach emptying or prevent gastric reflux. Choice D is incorrect as RenaGel does not buffer hydrochloric acid or prevent gastric erosion.

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Which signs or symptoms are characteristic of an adult client diagnosed with Cushing's syndrome?

  • A. Husky voice and complaints of hoarseness.
  • B. Warm, soft, moist, salmon-colored skin.
  • C. Visible swelling of the neck, with no pain.
  • D. Central-type obesity, with thin extremities.
Correct Answer: D

Rationale: The correct answer is D because central-type obesity with thin extremities is a classic characteristic of Cushing's syndrome due to excess cortisol. This pattern of weight distribution is caused by cortisol's impact on fat metabolism and distribution. A is incorrect because a husky voice and hoarseness are not typical symptoms of Cushing's syndrome. B is incorrect as warm, soft, moist, salmon-colored skin is not a common finding in Cushing's syndrome. C is incorrect because visible swelling of the neck without pain is not a typical sign of Cushing's syndrome.

Following a CVA, the nurse assesses that a client has developed dysphagia, hypoactive bowel sounds, and a firm, distended abdomen. Which prescription for the client should the nurse question?

  • A. Continuous tube feeding at 65 ml/hr via gastrostomy.
  • B. Total parenteral nutrition to be infused at 125 ml/hour.
  • C. Nasogastric tube connected to low intermittent suction.
  • D. Metoclopramide (Reglan) intermittent piggyback.
Correct Answer: A

Rationale: The correct answer is A: Continuous tube feeding at 65 ml/hr via gastrostomy. After a CVA, dysphagia, hypoactive bowel sounds, and a firm, distended abdomen indicate a risk for aspiration and bowel obstruction. Continuous tube feeding may worsen these issues. Option B provides nutrition intravenously, bypassing the gastrointestinal tract. Option C helps decompress the stomach. Option D is a medication to help with GI motility. Therefore, the nurse should question option A due to the risk of complications post-CVA.

For a patient with asthma, what is the primary purpose of prescribing salmeterol?

  • A. Relieve acute bronchospasm
  • B. Prevent asthma attacks
  • C. Suppress cough
  • D. Thin respiratory secretions
Correct Answer: B

Rationale: The primary purpose of prescribing salmeterol is to prevent asthma attacks. Salmeterol is a long-acting beta agonist that helps to relax the muscles of the airways over an extended period, reducing the likelihood of bronchospasms and asthma exacerbations. It is not used for relieving acute bronchospasm (choice A), suppressing cough (choice C), or thinning respiratory secretions (choice D) as these are not the main therapeutic effects of salmeterol in asthma management.

For a patient with asthma, what is the primary purpose of prescribing montelukast?

  • A. Relieve acute bronchospasm
  • B. Prevent asthma attacks
  • C. Thin respiratory secretions
  • D. Suppress cough
Correct Answer: B

Rationale: The primary purpose of prescribing montelukast for a patient with asthma is to prevent asthma attacks. Montelukast is a leukotriene receptor antagonist that helps to reduce inflammation in the airways, thereby preventing asthma symptoms and attacks. It is not used to relieve acute bronchospasm (Choice A), as it is not a fast-acting rescue medication like a bronchodilator. Montelukast also does not thin respiratory secretions (Choice C) or suppress cough (Choice D) as its main mechanism of action is to prevent and control asthma symptoms by inhibiting leukotrienes.

A patient with chronic kidney disease (CKD) is prescribed erythropoietin. What is the primary action of this medication?

  • A. Stimulate white blood cell production
  • B. Increase platelet count
  • C. Promote red blood cell production
  • D. Enhance clotting factor production
Correct Answer: C

Rationale: The correct answer is C: Promote red blood cell production. Erythropoietin is a hormone that stimulates the production of red blood cells in the bone marrow. This is crucial for patients with CKD who often develop anemia due to decreased erythropoietin production.

A: Stimulating white blood cell production is the function of other medications, such as colony-stimulating factors, not erythropoietin.
B: Erythropoietin does not have an effect on platelet count.
D: Enhancing clotting factor production is not the primary action of erythropoietin.

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