Question

A nurse is preparing to administer digoxin 1.5 mg PO to a client. The amount available is digoxin 0.5 mg/tablet. How many tablets should the nurse administer (Round the answer to the nearest whole number.). Use a leading zero if it applies. Do not use a trailing zero.

Answer 1

Correct Answers:

3

Rationale :

✍️To determine the correct dosage,

> Use formula

Ordered dose ÷ Amount available per tablet

> Ordered dose = 1.5 mg

> Amount available per tablet = 0.5 mg

1.5 mg ÷ 0.5 mg/tablet

👉= 3 tablets.

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Answer 2

Correct Answers:

Alcoholism.

Rationale :

🔸A magnesium level of 1.2 mg/dL indicates hypomagnesemia, often caused by chronic alcohol use.

🔸Alcohol increases renal excretion of magnesium and leads to nutritional deficiencies, both of which contribute to low serum levels.

🔸 Magnesium is crucial for neuromuscular and cardiac function, and its deficiency can cause arrhythmias, weakness, and confusion.

🔸 Early identification of alcoholism as the underlying cause is essential for appropriate correction and long-term management.

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Answer 3

Correct Answers:

Right lower quadrant.

Rationale :

✅ A terminal ileostomy involves the surgical removal or bypass of the colon and the creation of a stoma from the distal ileum, which is brought through the right lower quadrant (RLQ) of the abdomen.

✅ The ileum is the last portion of the small intestine, anatomically located in the RLQ, which makes this the standard and practical site for stoma creation.

✅ This location allows for proper alignment of the gastrointestinal tract and effective drainage of liquid stool typically produced by the small bowel.

✅Accurate understanding of the stoma location is essential for preoperative education, post-operative care, and stoma site appliance management, which can greatly influence the patient's adaptation to their new bowel diversion.

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Answer 4

Correct Answers:

Hyperkalemia.

Rationale :

Sodium polystyrene sulfonate (Kayexalate) is administered to treat hyperkalemia, a potentially life-threatening electrolyte imbalance characterized by serum potassium levels above 5.0 mEq/L.
When potassium levels are excessively high, it disrupts cardiac conduction and can lead to dangerous arrhythmias, which may manifest as an irregular pulse and neuromuscular symptoms such as lower extremity weakness.
Kayexalate works by binding potassium in the colon and facilitating its excretion through the feces.
In acute situations, rectal administration provides a more immediate route of action.
Recognizing the association between elevated potassium and cardiac or neuromuscular changes is critical in emergency care settings to prevent cardiac arrest or paralysis.

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Answer 5

Correct Answers:

I will sleep with the head of my bed elevated.
I will consume less caffeine and fewer spicy foods.
I will try not to gain weight.

Rationale :

🔹 I will sleep with the head of my bed elevated.

Elevating the head of the bed helps reduce gastroesophageal reflux, a common symptom of hiatal hernia, by using gravity to keep gastric contents in the stomach.
This position especially helps prevent nocturnal reflux, improving comfort and sleep quality.

🔹I will consume less caffeine and fewer spicy foods.

Both caffeine and spicy foods are known to lower the tone of the lower esophageal sphincter (LES), allowing acidic stomach contents to backflow into the esophagus.
Reducing these in the diet minimizes esophageal irritation and decreases reflux episodes.

🔹 I will try not to gain weight.

Excess weight increases intra-abdominal pressure, which contributes to herniation of the stomach through the diaphragm and worsens reflux.
Weight management is a key component of lifestyle modification for controlling symptoms and preventing worsening of the hernia

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Answer 6

Correct Answers:

Notify the provider of the client's allergy.

Rationale :

🔹When a client reports a shellfish allergy, there is a heightened concern for a possible cross-reactive sensitivity to iodine-based contrast media, which is commonly used in procedures like cardiac catheterization.

🔹Shellfish allergy is due to tropomyosin, not iodine but clients who report a reaction should still be treated as at-risk.

🔹The priority action is to notify the provider immediately so that appropriate premedication (e.g., corticosteroids, antihistamines) can be considered, or alternative contrast agents or imaging methods can be selected.

🔹This action directly protects the client from a potential anaphylactic reaction, which is life-threatening and must be proactively prevented.

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Answer 7

Correct Answers:

Use the inhaler before engaging in physical activity.

Rationale :

Inhaled bronchodilators, particularly short-acting beta-agonists (SABAs), are prescribed to relax bronchial smooth muscle, reducing airway resistance and improving ventilation in patients with chronic obstructive pulmonary disease (COPD).
Using the inhaler before physical exertion helps to prevent activity-induced dyspnea and bronchospasm, which are common in COPD due to the narrowed airways.
This anticipatory use of medication enhances exercise tolerance and quality of life.
Teaching clients the prophylactic use of bronchodilators empowers them to remain physically active while minimizing respiratory distress.

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Answer 8

Correct Answers:

To provide essential nutrients while allowing the bowel to rest and heal.

Rationale :

✅ Total parenteral nutrition (TPN) is a form of intravenous nutritional support used when the gastrointestinal tract cannot be safely or effectively used for digestion and absorption, such as in clients with severe inflammatory bowel disease (IBD).

✅ In cases of ulcerative colitis or Crohn’s disease flares, bowel rest is a key therapeutic goal, and TPN allows for complete bowel rest while still supplying essential calories, electrolytes, and vitamins.

✅ This support prevents malnutrition, supports tissue healing, and promotes clinical recovery.

✅ The decision to use TPN must balance nutritional needs and risk of infection, but it plays a critical role in managing severe or refractory IBD.

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Answer 9

Correct Answers:

Helicobacter pylori infection.

Rationale :

Helicobacter pylori (H. pylori) is a spiral-shaped bacterium that colonizes the gastric and duodenal mucosa, leading to inflammation and ulceration, especially in the duodenum.
It disrupts the mucosal barrier and stimulates acid hypersecretion, making the mucosa vulnerable to peptic injury.
This organism is the most common cause of duodenal ulcers, surpassing other factors such as NSAID use or alcohol.
Diagnostic tests for H. pylori include urea breath tests, stool antigen tests, or biopsy via endoscopy
Treatment typically involves triple therapy with antibiotics and proton pump inhibitors, aiming for eradication and mucosal healing.

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Answer 10

Correct Answers:

Notify the health care provider.

Rationale :

> A client who reports severe, unrelieved pain after opioid administration, accompanied by coolness and diminished pulses, is exhibiting classic signs of compartment syndrome, a limb-threatening surgical emergency.

> In this condition, pressure builds within a confined muscle compartment, leading to impaired perfusion and potential tissue necrosis.

> Immediate notification of the health care provider is critical to prevent permanent damage, as surgical fasciotomy may be required to relieve the pressure.

> Delaying intervention can result in loss of limb function or amputation, making this the nurse’s top priority action.

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RN ATI Medsurg Final Exam

No.

1 : A nurse is preparing to administer digoxin 1.5 mg PO to a client. The amount available is digoxin 0.5 mg/tablet. How many tablets should the nurse administer (Round the answer to the nearest whole number.). Use a leading zero if it applies. Do not use a trailing zero.

2 : A client is admitted to the emergency department with a magnesium level of 1.2 mg/dL. The nurse is aware that a likely cause of the value is which of the following:

3 : A client diagnosed with ulcerative colitis is scheduled for a terminal ileostomy. The nurse is aware the stoma will be in what area of the client's abdomen?

4 : The nurse is preparing to administer sodium polystyrene sulfonate (Kayexalate) rectally to a patient with an irregular pulse and weakness of the lower extremities. What laboratory finding does the nurse determine is the reason for this treatment?

5 : A nurse is teaching a client who has a hiatal hernia about dietary recommendations. Which of the following client statements indicate an understanding of the teaching? (Select all that apply.)

6 : The nurse asks a client who is about to have a cardiac catheterization about any allergies. The client states, "I always get a rash when I eat shellfish." Which of the following is the priority nursing action?

7 : A patient with chronic obstructive pulmonary disease (COPD) is being discharged home with a new prescription for an inhaled bronchodilator. Which instruction should the nurse include in the discharge teaching?

8 : Which of the following is a rationale for prescribing total parenteral nutrition (TPN) for a patient with inflammatory bowel disease (IBD)?

9 : A 36-year-old patient with suspected gastrointestinal (GI) bleeding undergoes a diagnostic endoscopy, which determines the site of bleeding is a duodenal ulcer. What is the most likely cause of a duodenal ulcer?

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