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MEDSURG PROCTORED EXAMS BUNDLE
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ATI MEDSURG B PRACTICE QUESTIONS AND ANSWERS– LATEST GUIDE 2021/2022
1. A Nurse is contributing to the plan care of a care to promote a restful night’s sleep for a client who has Alzheimer’s disease. Which of the follow... [Show More] ing interventions should the nurse include in the plan? Encourage stimulating activities after dinner Encourage a late afternoon nap Offer a small snack at bedtime Offer hot chocolate at bedtime 2. A nurse if reinforcing teaching with a client who has chronic kidney disease about disease management. Which of the following statements by the client indicates an understanding of the teaching? I will add a banana to my morning cereal I will decrease my intake of carbohydrates I will limit my daily intake of protein I will season my food with a salt substitute 3. A nurse is caring for a client who hasjust returned to the unit following a bronchoscopy. Which of the following findings should the nurse report to the provider? Absent gag reflex Blood tinged mucus Diminished breath sounds Oxygen saturation 95% 4. A nurse is caring for a client who begins to have a seizure while ambulating in the hall. Identify the sequence of actions the nurse should follow. (Move the steps the nurse should take into the box on the right placing them in order of performance. Use all the steps. Lower the client to the floor Place a pad beneath the client’s head Loose the clothing around the client’s neck Time the length of the client’s seizure Reorient and reassure the client 5. A nurse is reinforcing teaching with a client who has a new diagnosis of genital herpers. Which of the following information should the nurse include in the teaching? Use condoms when lesions are present Look for lesions that have a wart-like appearance The virus can be transmitted without lesions present The lesion resolves in 2 weeks and usually do not recur 6. A nurse is planning care for a group of clients after receiving change-of-shift report. Which of the following clients should the nurse plan to see first? A client who had a colectomy 2 days ago and has a nasogastric tube Jackson-Pratt drain and indwelling urinary catheter. A client who is dehydrated has mental confusion and was found getting out of bed several times during the night. A client who had a right lower lobe lobectomy 4 days ago and has a chest tube set to continuous suction. A client who has pneumonia and an oral temperature of 38.7°C (101.7°F) 7. A nurse is caring for a client who is receiving a continuous tube feeding of 60 mL/hr at 1.2 cal/mL. How many calories will the client receive in 12 hrs? (Round the answer to the nearest whole number) Step 1: What is the unit of measurement the nurse should calculate? Calories Step 2: What is the volume the nurse should infuse? 60 mL/hr x 12 hr = 720 mL Step 3: What is the total infusion time? 12 hrs Step 4: Should the nurse convert the units of measurement? No Step 5: Set up an equation and solve for x. 720 mL x 1.2 cal/mL = calories x = 864 cal 8. A nurse is caring for a client who is in Buck's traction for a fractured hip. The client reports increased pain at the site of the fracture. Which of the following actions should the nurse take? Massage the area Remove the weights Loosen the ropes Reposition the client 9. A nurse is reinforcing teaching with a client who istaking levothyroxine. Which of the following statements by the client indicates an understanding of the teaching? I will need to take the medication until my thyroid function returns to normal The medication should be taken before I eat breakfast every morning The medication might lower my blood sugar I will take the medication with an antacid if it gives me heartburn 10. A nurse is delegating the task of repositioning a client who is in skeletal traction to an assistive personnel (AP). Which of the following instructions should the nurse give the AP? Allow the weights to hang freely Release the tension of the ropes Remove the weights when rewrapping bandages Manually lift the weights when moving the client up in bed 11. A nurse is reinforcing teaching about pursed-lip breathing with a client who has a new diagnosis of COPD. The nurse should identify which of the following client statements indicates an understanding of the teaching? Ishould perform pursed-lip breathing exercises before going to be When I’m fatigued, I should inhale slowly through pursed-lips Pursed-lip breathing works best for activitieslike walking up stairs I will exhale through my nose after breathing in through pursed-lips 12. A nurse is admitting a client who is suspected of having active tuberculosis (TB). Which of the following actions should the nurse take first? Administer anti-tuberculosis medication Institute airborne precautions Obtain sputum cultures Auscultate breath sounds 13. A nurse is preparing a client for a cardiac catheterization. Which of the following actions should the nurse take first? Verify the client has given informed consent Administer preoperative medication Make the location of the pedal pulses Have the client void 14. A nurse is assisting in the plan of care for a client who had a recent left hemispheric stroke. Which of the following actions should the nurse include in the plan? Observe for impulsive behavior Approach the client from the right side Use simple verbal cues when directing tasks Place the client in low-fowler’s position during meals 15. A nurse is assisting with an educational program for clients who have been newly diagnosed with diabetes mellitus. Which of the following instructions should the nurse include in the program regarding insulin? Store unopened insulin vials in the freezer for up to 1 month Opened insulin can be stored on a cool countertop away from light Roll discolored insulin gently to mix before use Use refrigerated insulin immediately after removing it from the refrigerator 16. A nurse is caring for a client who reports shortness of breath and has an oxygen saturation of 90%. Which of the following actions should the nurse take? Prepare for intubation of the client Administer opioid medication Administer oxygen via nasal cannula Place the client in low-fowler’s position 17. A nurse is preparing to insert a double-lumen gastric (Salem) sump tube for a client who has peptic ulcer disease and has developed gastrointestinal bleeding. Which of the following images indicates the tube that the nurse should select? 18. A nurse is contributing to the plan of care for a client who has pericarditis. In which of the following positions should the nurse plan to place the client to decrease pain? Semi Fowler’s Supine with lower extremities elevated Upright leaning forward Side-lying with knees bent 19. A nurse is reviewing the medication record of a client who is taking digoxin. Which of the following medications should the nurse identify as increasing the risk for the client to develop digoxin toxicity? Potassium Chloride Famotidine Levothyroxine Furosemide 20. A nurse is reinforcing a teaching to a client about preventing osteoporosis. Which of the following client statements indicates an understanding of the teaching? I will eat more bananas I will walk for 20 minutes 3 days a week I will limit my coffee intake I will take a calcium supplement at bed time 21. A nurse is reinforcing discharge teaching with a client who has Crohn’s disease. Which of he following sttements should the nurse include in the teaching? Increase your intake of dietary fat Maintain a low residue diet Avoid taking antidiarrheal medication Plan to weight yourself weekly 22. A nurse is collecting data from an older adult client who has several concerns. Which of the following concerns should the nurse recognize as a normal change associated with aging? I sweat more than I used to Sometimes I can’t remember my kids names I seem to have more loose stools than I used to My food tastes bland even after I add seasoning 23. A nurse is caring for a client who is suspected of having a myocardial infarction. Which of the following actions should the nurse take to prepare the client for an ECG? Position the client in Sims’ position before electrode placement Ensure that each electrode is dry before application Cleanse the client’s skin prior to electrode placement Place the electrodes on t................................................................................................................CONTINUED [Show Less]
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ATI MEDSURG PRACTICE QUIZ-DETAILED SOLUTIONS FOR MEDSURG TO BEST SCORES GUIDE
ATI MEDSURG PRACTICE QUIZ-DETAILED SOLUTIONS FOR MEDSURG BEST SCORES
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ATI RN MEDSURG PROCTORED EXAM 2020/2021 UPDATED GUIDE LATEST FOR BEST SCORES
1. A nurse is reinforcing teaching with a client who has HIV and is being discharged to home. Which of the following instructions should the nurse include... [Show More] in the teaching? 1) Take temperature once a day. 2) Wash the armpits and genitals with a gentle cleanser daily. 3) Change the litter boxes while wearing gloves. 4) Wash dishes in warm water. 2. A nurse is caring for a client who is postoperative following a tracheostomy, and has copious and tenacious secretions. Which of the following is an acceptable method for the nurse to use to thin this client's secretions? 1) Provide humidified oxygen. 2) Perform chest physiotherapy prior to suctioning. 3) Prelubricate the suction catheter tip with sterile saline when suctioning the airway. 4) Hyperventilate the client with 100% oxygen before suctioning the airway.. 3. Following admission, a client with a vascular occlusion of the right lower extremity calls the nurse and reports difficulty sleeping because of cold feet. Which of the following nursing actions should the nurse take to promote the client's comfort? 1) Rub the client's feet briskly for several minutes. 2) Obtain a pair of slipper socks for the client. 3) Increase the client's oral fluid intake. 4) Place a moist heating pad under the client's feet. 4. A nurse is caring for a client is who is 4 hr postoperative following a transurethral resection of the prostate (TURP). Which of the following is the priority finding for the nurse report to the provider? 1) Emesis of 100 mL 2) Oral temperature of 37.5° C (99.5° F) 3) Thick, red-colored urine 4) Pain level of 4 on a 0 to 10 rating scale 5. A nurse is caring for a client who has a temperature of 39.7° C (103.5° F) and has a prescription for a hypothermia blanket. The nurse should monitor the client for which of the following adverse effects of the hypothermia blanket? 1) Shivering 2) Infection 3) Burns 4) Hypervolemia 6. A nurse is reinforcing teaching about exercise with a client who has type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching? 1) "I will carry a complex carbohydrate snack with me when I exercise." 2) "I should exercise first thing in the morning before eating breakfast." 3) "I should avoid injecting insulin into my thigh if I am going to go running." 4) "I will not exercise if my urine is positive for ketones." 7. A nurse notes a small section of bowel protruding from the abdominal incision of a client who is postoperative. After calling for assistance, which of the following actions should the nurse take first? 1) Cover the client's wound with a moist, sterile dressing. 2) Have the client lie supine with knees flexed. 3) Check the client's vital signs. 4) Inform the client about the need to return to surgery. 8. A nurse is collecting data from a client who has alcohol use disorder and is experiencing metabolic acidosis. Which of the following manifestations should the nurse expect? 1) Cool, clammy skin. 2) Hyperventilation 3) Increased blood pressure 4) Bradycardia 9. A nurse is reinforcing discharge teaching with a client following a cataract extraction. Which of the following should the nurse include in the teaching? 1) Avoid bending at the waist. 2) Remove the eye shield at bedtime. 3) Limit the use of laxatives if constipated. 4) Seeing flashes of light is an expected finding following extraction. 10.A nurse is caring for a client who has heart failure and has been taking digoxin 0.25 mg daily. The client refuses breakfast and reports nausea. Which of the following actions should the nurse take first? 1) Suggest that the client rests before eating the meal. 2) Request a dietary consult. 3) Check the client's vital signs. 4) Request an order for an antiemetic. 11. A nurse is caring for a client who is 3 days postoperative following a cholecystectomy. The nurse suspects the client's wound is infected because the drainage from the dressing is yellow and thick. Which of the following findings should the nurse report as the type of drainage found? 1) Sanguineous 2) Serous 3) Serosanguineous 4) Purulent 12. A nurse is reinforcing discharge teaching to a client following arthroscopic surgery. To prevent postoperative complications which of the following actions should be reinforced during the teaching? 1) Administer an opioid analgesic to the client 30 min prior to initiating CPM exercises. 2) Place the client’s affected leg into the CPM machine with the machine in the flexed position. 3) Place the client into a high Fowler’s position when initiating the CPM exercises. 4) Align the joints of the CPM machine with the knee gatch in the client’s bed. 13.A nurse is collecting data from a client who has emphysema. Which of the following findings should the nurse expect? (Select all that apply.) 1) Dyspnea 2) Barrel chest 3) Clubbing of the fingers 4) Shallow respirations 5) Bradycardia 14. A nurse is caring for a client who sustained a basal skull fracture. When performing morning hygiene care, the nurse notices a thin stream of clear drainage coming from out of the client's right nostril. Which of the following actions should the nurse take first? 1) Take the client's temperature. 2) Place a dressing under the client's nose. 3) Notify the charge nurse. 4) Test the drainage for glucose. 15. A nurse is caring for a client who has a spinal cord injury at T-4. The nurse should recognize that the client is at risk for autonomic dysreflexia. Which of the following interventions should the nurse take to prevent autonomic dysreflexia? 1) Monitor for elevated blood pressure. 2) Provide analgesia for headaches. 3) Prevent bladder distention. 4) Elevate the client's head. 16. A nurse is caring for a client who is being evaluated for endometrial cancer. Which of the following findings should the nurse expect the client to report? 1) Hot flashes 2) Recurrent urinary tract infections 3) Blood in the stool 4) Abnormal vaginal bleeding 17.A nurse is caring for a client following an open reduction and internal fixation of a fractured femur. Which of the following findings is the nurse's priority? 1) Altered level of consciousness 2) Oral temperature of 37.7° C (100° C) 3) Muscle spasms 4) Headache 18.A nurse is assisting in the care of a client who is 2 hours postoperative following a wedge resection of the left lung and has a chest tube to suction. Which of the following is the priority finding the nurse should report to the provider? 1) Abdomen is distended 2) Chest tube drainage of 70 mL in the last hour 3) Subcutaneous emphysema is noted to the left chest wall 4) Pain level of 6 on a 0 to 10 scale 19. A nurse is reinforcing discharge teaching with a client about how to care for a newly created ileal conduit. Which of the following instructions should the nurse include in the teaching? 1) Change the ostomy pouch daily. 2) Empty the ostomy pouch when it is 2/3 full. 3) Trim the opening of the ostomy seal to be 1/2 in. wider than the stoma. 4) Apply lotion to the peristomal skin when changing the ostomy pouch. 20.A nurse is assisting in the plan of care for a client who had a removal of the pituitary gland. Which of the following actions should the nurse include in the plan? 1) Position the client supine while in bed. 2) Change the nasal drip pad as needed. 3) Encourage frequent brushing of teeth. 4) Encourage the client to cough every 2 hr following surgery. 21. A nurse is caring for a client who asks why she is being prescribed aspirin 325 mg daily following a myocardial infarction. The nurse should instruct the client that aspirin is prescribed for clients who have coronary artery disease for which of the following effects? 1) To provide analgesia 2) To reduce inflammation 3) To prevent blood clotting 4) To prevent fever 22.A nurse is collecting data from a client who has open-angle glaucoma. Which of the following findings should the nurse expect? 1) Loss of peripheral vision 2) Headache 3) Halos around lights 4) Discomfort in the eyes 23. A nurse is collecting data from a client who has acute gastroenteritis. Which of the following data collection findings should the nurse identify as the priority? 1) Weight loss of 3% of total body weight. 2) Blood glucose 150 mg/dL. 3) Potassium 2.5 mEq/L 4) Urine specific gravity 1.035 24.A nurse is reinforcing discharge teaching with a client who had a total abdominal hysterectomy and a vaginal repair. Which of the following statements by the client indicates a need for further teaching? 1) "I should increase my intake of protein and vitamin C." 2) "I will no longer have menstrual periods." 3) "Once I am able to resume sexual activity, I can use a water-based lubricant if I experience discomfort." 4) "I will take a tub bath instead of a shower." 25.A nurse is assisting with the care of a client who has a femur fracture and is in skeletal traction. Which of the following actions should the nurse take? 1) Loosen the knots on the ropes if the client is experiencing pain. 2) Ensure the client’s weights are hanging freely from the bed. 3) Check the client’s bony prominences every 12 hr. 4) Cleanse the client’s pin sites with povidone-iodine. 26. A nurse in a provider’s office is reinforcing teaching with a client who has anemia and has been taking ferrous gluconate for several weeks. Which of the following instructions should the nurse include? 1) Take this medication between meals. 2) Limit intake of Vitamin C while taking this medication. 3) Take this medication with milk. 4) Limit intake of whole grains while taking this medication. 27. A nurse in a provider’s office is reinforcing teaching with a client who has anemia and has been taking ferrous gluconate for several weeks. Which of the following instructions should the nurse include? 1) Take this medication between meals. 2) Limit intake of Vitamin C while taking this medication. 3) Take this medication with milk. 4) Limit intake of whole grains while taking this medication. 28.A nurse is reviewing the plan of care for a client who has cellulitis of the leg. Which of the following interventions should the nurse recommend? 1) Apply topical antifungal agents. 2) Apply fresh ice packs every 4 hr. 3) Wash daily with an antibacterial soap. 4) Keep draining lesions uncovered to air dry. 29.A nurse is reinforcing teaching with a client who is postoperative after having an ileostomy established. Which of the following instructions should the nurse include in the teaching? 1) Empty the pouch immediately after meals. 2) Change the entire appliance once a day. 3) Limit fluid intake. 4) Avoid medications in capsule or enteric form. 30. A nurse is caring for a client with severe burns to both lower extremities. The client is scheduled for an escharotomy and wants to know what the procedure involves. Which of the following statements is appropriate for the nurse to make? 1) "An escharotomy surgically removes dead tissue." 2) "A cannula will be inserted into the bone to infuse fluids and antibiotics." 3) "A piece of skin will be removed and grafted over the burned area." 4) "Large incisions will be made in the burned tissue to improve circulation." 31. A nurse is collecting data from a client who has a possible cataract. Which of the following manifestations should the nurse expect the client to report? 1) Decreased color perception 2) Loss of peripheral vision 3) Bright flashes of light 4) Eyestrain 32. A nurse is contributing to the plan of care for a client who has an intestinal obstruction and is receiving continuous gastrointestinal decompression using a nasogastric tube. Which of the following interventions should the nurse include in the plan of care? 1) Measure abdominal girth daily. 2) Use sterile water to irriga..............................................................................CONTINUED [Show Less]
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ATI MEDSURG PROCTORED EXAM REVIEW – LATEST STUDY GUIDE SOLUTIONS FOR BEST SCORES WITH RATIONALES
1.A nurse is assessing a client who is 12hr postoperative following a colon resection. Which of the following findings should the nurse report to the surg... [Show More] eon? 1. Heart rate 90/min 2. Absent bowel sounds → normal findings after major bowel surgery; takes several days to return to normal. 3. Hgb 8.2 g/dl 4. Gastric pH of 3.0 Rationale: Normal Hgb is 13-18M g/dl, 12-16 g/dl. This may indicate a possible hemorrhaging. 2. A nurse is caring for a client who has diabetes insipidus. Which of the following medications should the nurse plan to administer? a. Desmopressin b. Regular insulin c. Furosemide d. Lithium carbonate Rationale: Diabetes Insipidus has decreased ADH. Administer Desmopressin/Vasopressin increase ADH and keeps pt. on urinating 3. A nurse is admitting a client who has arthritic pain and reports taking ibuprofen several times daily for 3 years. Which of the following test should the nurse monitor? a. Fasting blood glucose b. Stool for occult blood c. Urine for white blood cells d. Serum calcium Rationale:ATI Pharm 16. Pg. 485 Ibuprofen (NSAIDs) monitor for GI bleed (bloody, tarry stools, abd pain). 4. A nurse in the emergency department is assessing a client. Which of the following actions should the nurse take first (Click on the “Exhibit” button for additional information about the client. There are three tabs that contain separate categories of data.) a. Obtain a sputum sample for culture b. Prepare the client for a chest x-ray c. Initiate airborne precautions d. Administer ondansertron. Rationale: No idea what the Exhibit is all about; wont be able to answer it. 5. A nurse is contacting the provider for a client who has cancer and is experiencing breakthrough pain. Which of the following prescriptions should the nurse anticipate? a. Transmucosal fentanyl b. Intramuscular meperidine c. Oral acetaminophen d. Intravenous dexamethasone Rationale:ATI pg. 27 6. A nurse is admitting a client who reports chest pain and has been placed on a telemetry monitor. Which of the following should the nurse analyze to determine whether the client is experiencing a myocardial infarction? a. PR interval b. QRS duration c. T wave d. ST segment Rationale: ST elevation indicates MI. ST depression indicates ischemia 7. A nurse is teaching a client who has ovarian cancer about skin care following radiation treatment. Which of the following instructions should the nurse include? a. Pat the skin on the radiation site to dry it b. Apply OTC moisturizer to the radiation site c. Cover the radiation site loosely with a gauze wrap before dressing d. Use a soft washcloth to clean the area around the radiation site Rationale: pg. 584. Dry the area thoroughly using patting motions. 8. A nurse is caring for a client who is receiving a blood transfusion. The nurse observes that the client has bounding peripheral pulses, hypertension, and distended jugular veins. The nurse should anticipate administering which of the following prescribed medications? a. Diphenhydramine b. Acetaminophen c. Pantoprazole d. Furosemide Rationale: S/S may indicate fluid retention or heart failure. It is important to administer diuretics to prevent cardiovascular/respiratory distress. 9. A nurse is assessing a client who is receiving magnesium sulfate IV for the treatment of hypomagnesemia. Which of the following findings indicates effectiveness of the medication? a. Lungs clear b. Apical pulse 82/min c. Hyperactive bowel sounds d. Blood pressure 90/50 mm Hg Rationale: ATI p. 494: s/s of hypomagnesemia consist of hypoactive bowel sounds, constipation, paralytic ileus. So effectiveness would indicate opposite of this 10. A nurse is reviewing a client’s ABG results pH 7.42, PaC02 30 mm Hg, and HCO3 21 mEq/L. The nurse should recognize these findings as indication of which of the following conditions? a. Metabolic acidosis b. Metabolic alkalosis c. Compensated respiratory alkalosis d. Uncompensated respiratory acidosis Rationale: because the HCO3 21 trying to compensate for respiratory alkalosis 11. A nurse is caring for a client who has a deep partial thickness burns over 15% of her body which of the following labs should the nurse expect during the first 24 hours A. Decreased BUN ELEVATED DT fluid loss B. Hypoglycemia (High due to stress) C. Hypoalbuminemia (Low due to fluid loss) D. Decreased Hematocrit (Elevated due to 3rd spacing during resuscitation phase) (Page 481 ch 75 med surge ati pdf 10.0) 12. A nurse is caring for a client who has dumping syndrome following a gastrectomy, which of the following actions should the nurse take ? a. Offer the client high carbohydrate meal options (High fat, high protein, low fiber, low to moderate carbs page 317, chapter 49 Peptic ulcer disease med surge ati pdf 10.0) b. Provide the client with four full meals a day (Small frequent meals) c. Encourage the client to to drink at least 360 ml of fluids with meals (Eliminate liquids with meals for 1 hr prior and following a meal) d. Have the client lie down for 30 minutes after meals (Lying down after a meal slows the movement of food within the intestines) 13. A nurse is teaching a group of young adult clients about risk factors for hearing loss. Which of the following factors should the nurse include in the teaching? SATA. (p.70 chapter 13) Born with a high weight Chronic infections of the middle ear Use a loop diuretic Perforation of the ear drum Frequent exposure to low volume noise 14. A nurse is preparing to administer fresh frozen plasma to a client . Which of the following actions should the nurse take? (Chapter 92 page 606 med surge ati pdf 10.0) Administer the plasma immediately after thawing (Blood must be warm, you also have a 30 minute window to give it so bacteria doesn’t grow. So it doesn’t necessarily have to be right away.) Transfuse the plasma over 4 hour (Can be in 2 to 4 hours) Hold the transfusion if the client is actively bleeding (YOU HAVE TO GIVE IT. That’s the whole point! The patient is losing blood so you have to replace it. We give fresh frozen plasma because he or she may have clotting deficiencies) Administer the transfusion through a 24 gauge saline lock (Has to be a 18 or 20 gauge) 15. A nurse is assessing a clients who reports numbness and tingling of his toes and exhibits a positive TROUSSEAU. Which of the following electrolyte imbalance should the nurse suspect? (ch 44 page 277 MS ATI PDF 10.0) Hypoatremia Hyperchloremia Hypermagnesemia Hypocalcemia (low calcium = low ca causes increased firing = spasms. Learned this is LVN school.) 16. A home health nurse is teaching a clients how to care for a peripherally central catheter in his right arm. Which of the following statements should the nurse include in the teaching? (Chapter 27 cardiovascular diagnostics and therapeutic procedures p. 165 MS ATI PDF 10.0) Change the transparent dressing over the insertion site every 48 hours - transparent dressing can be up to 7 days Clean the insertion site with mild soap and water - when showering, must insertion site must be covered !!!!! No water can be in it . Measure your right arm circumference once weekly- does not say in the chapter Use a 10 milliliter syringe when flushing the catheter - flush with 10 ml NS b4 and after med administration 17. A nurse is caring for a client who has a central venous access device. Which of the following assessment findings should the nurse report to the provider? (P.166 MS ATI PDF 10.0) RBC count of 4.7 million/mm 3 BUN 22 mg/ dl - not dramatically high enough to pay attention to. WBC count of 16,000/ mm 3 - phlebitis is a complication , infection is a complication that can happen 7 days after insertion , also temp increase if 1 degree can happen. Blood glucose of 120 mg/dl 18. A nurse is providing dietary teaching to a client who has chronic kidney disease and a decreased glomerular filtration rate. Which of the following statements by the client indicates an understanding of the teaching? (p.382 chapter 59) I will spread my protein allowances over the entire day - the doctor issue the patient an allowed amount of protein so its ok. I should increase my intake of canned salmon to three times per week (NO SODIUM) I will season my food with lemon pepper rather than salt (We do not want to give the dietary sodium, potassium, phosphorus , and magnesium. I don’t know what lemon pepper has, but we want to RESTRICT sodium, potassium, phosphorus and magnesium.) I should limit my intake of hard cheese to 3 ounces each day (NO SODIUM at all) 19. A nurse is caring for a client who has a peripherally inserted central catheter. The client is receiving an antibiotic via intermittent IV bolus. Which of the following actions should the nurse take? (PAGE 166 ch 27 MS ATI PDF 10.0) Administer 20 ml of 0.9 sodium chloride after each dose of medication (you only flush with 10 ml of NS, not 20. 20 is for flushing blood) Flush the catheter using a 5 ml syringe - you use a 10mL syringe to flush Verify the placement with an x ray prior to the initial dose Change the transparent membranes dressing daily (dressing can last for up to 7 days) 20. A nurse is teaching a client using a metered dose rescue inhaler. Which of the following statements should the nurse include in the teaching? Do not shake your inhaler before use (suppose to shake it) Exhale fully before bringing the inhaler to your lips Depress the canister after you inhale (depress the canister before inhaling, and 5 seconds later you inhale) Use peroxide to clean the mouthpiece if your inhaler (warm water) Textbook pg 573. 21. A nurse is assessing the pain status of a group of clients. Which of the following findings indicate a client is experiencing referred pain? (page 30) A client who has angina reports substernal chest pain A client who has pancreatitis reports pain in the left shoulder - referred pain is pain that is felt in ANOTHER PLACE THAT IS NOT IN THE SAME AREAAS WHERE THE PAIN SHOULD BE FELT. THE PAIN IS FELT SOMEWHERE ELSE A client who is postoperative reports incisional pain A client who has peritonitis reports generalized abdominal pain 22. A nurse is caring for a client who has just returned from surgery with an external fixator to the left tibia. Which of the following assessments findings requires immediate intervention by the nurse? (p .456 MS ATI PDF 10.0 chapter 71) The client reports a pain level of 7 on a scale from 0 -10 at the operative site. (This foo just came from surgery so pain is normal for post op patients for first couple of hours.) The clients capillary refill in the left toe is 6 seconds sxs of compartment syndrome. ABCs are compromised. (Cap refill should be below 3 seconds. This is sxs for compartment syndrome. Untreated can lead to necrosis.) The client has an oral temperature of 38.3 (100.9 F) (I wouldn’t pick this because i always see temp 101 as a priority from previous rationales with other atis.) The client has 100 ml of blood in the closed suction drained. (I believe this is normal for post-op patients.) 23. A nurse is assessing a client who has acute pancreatitis and has been receiving total parenteral nutrition for the past 72 hours. Which of the following findings requires the nurse to intervene? (chapter 47 page 299 MS ATI PDF 10.0) Right upper quadrant pain (Dude has acute pancreatitis, so it’s normal) Capillary blood glucose level of 164 mg/dl - glucose not significantly high WBC count 13,000/mm3 (Infection is one complication of TPN administration but WBC is in normal range.) Crackle in bilateral lower lobes (ABC’s compromised, also one of the complications of TPN is fluid imbalance aka fluid volume excess.) 17. A nurse is caring for a client who has hypotension, cool and clammy skin, tachycardia, and tachypnea. In which of the following positions should the nurse place the client? (THIS IS CARDIOGENIC SHOCK!!!!!! P 195. Chapter 31 MS ATI PDF 10.0) Reverse Trendelenburg (page 232 says for hypotension patients must be flat with legs elevated to increase venous return.) Side Lying High Fowlers Feet elevated 20) A nurse is caring for a cli..........................................................................................................CONTINUED......................................................................DOWNLOAD FOR BEST SCORES [Show Less]
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ATI MEDSURG PROCTORED EXAM STUDY GUIDE-LATEST RELIABLE GUIDE-MEDSURG TESTBANK.
1. A nurse is reinforcing teaching with a client who has HIV and is being discharged to home. Which of the following instructions should the nurse include... [Show More] in the teaching? 1) Take temperature once a day. Answer Rationale: The nurse should reinforce to the client to take his temperature once a daily to identify if a temperature is present due to the client’s altered immune system. INCORRECT 2) Wash the armpits and genitals with a gentle cleanser daily. Answer Rationale: The nurse should instruct the client to use an antimicrobial cleanser to wash his armpits and genitals twice daily. INCORRECT 3) Change the litter boxes while wearing gloves. Answer Rationale: The client should avoid changing litter boxes. Litter boxes carry toxoplasmosis which can be life threatening to a client who has HIV. INCORRECT 4) Wash dishes in warm water. Answer Rationale: The nurse should instruct the client to wash dishes in hot soapy water to destroy the bacteria. 2. A nurse is caring for a client who is postoperative following a tracheostomy, and has copious and tenacious secretions. Which of the following is an acceptable method for the nurse to use to thin this client's secretions? 1) Provide humidified oxygen. Answer Rationale: Increasing fluid intake as tolerated and providing adequate humidification can help thin secretions safely. INCORRECT 2) Perform chest physiotherapy prior to suctioning. Answer Rationale: Performing chest physiotherapy mobilizes secretions but does not thin them. INCORRECT 3) Prelubricate the suction catheter tip with sterile saline when suctioning the airway. Answer Rationale: Prelubricating the suction catheter tip with sterile saline helps to ease the insertion of the catheter, producing less trauma. However, it has no effect on the tenacity of the client's secretions. INCORRECT 4) Hyperventilate the client with 100% oxygen before suctioning the airway. Answer Rationale: Hyperventilating the client prior to suctioning prevents hypoxia. However, it has no effect on the tenacity of the client's secretions. 3. Following admission, a client with a vascular occlusion of the right lower extremity calls the nurse and reports difficulty sleeping because of cold feet. Which of the following nursing actions should the nurse take to promote the client's comfort? INCORRECT 1) Rub the client's feet briskly for several minutes. Answer Rationale: Massaging the legs or feet could mobilize a clot. Impaired arterial or venous circulation of the lower extremities is a contraindication for leg massage. 2) Obtain a pair of slipper socks for the client. Answer Rationale: Slipper socks with nonskid soles will help provide warmth and increase the client's level of comfort. INCORRECT 3) Increase the client's oral fluid intake. Answer Rationale: Increasing the client's fluid intake will not increase circulation to an area an occlusion impairs. INCORRECT 4) Place a moist heating pad under the client's feet. Answer Rationale: Impaired arterial or venous circulation to a lower extremity is a contraindication for applying a heating pad. 4. A nurse is caring for a client is who is 4 hr postoperative following a transurethral resection of the prostate (TURP). Which of the following is the priority finding for the nurse report to the provider? INCORRECT 1) Emesis of 100 mL Answer Rationale: The nurse should recognize postoperative nausea is a complication related to the administration of anesthesia and should treat the nausea with anti-emetics and provide supportive measures; however, it is not the priority finding. INCORRECT 2) Oral temperature of 37.5° C (99.5° F) Answer Rationale: The nurse should monitor a client who develops a fever and encourage deep breathing, coughing, and fluid intake (if permitted); however, it is not the priority finding to report. The increase in temperature is likely due to decreased respiratory effort related to the use of anesthesia and should clear with pulmonary hygiene. 3) Thick, red-colored urine Answer Rationale: The nurse should recognize viscous drainage that is red in color may indicate hemorrhage and should be reported to the provider immediately. INCORRECT 4) Pain level of 4 on a 0 to 10 rating scale Answer Rationale: The nurse should assess for and treat postoperative pain which is an expected finding in the postoperative client; however it is not the priority finding to report. Specific pain, such as bladder spasms, may indicate complications however and should be reported to the provider. 5. A nurse is caring for a client who has a temperature of 39.7° C (103.5° F) and has a prescription for a hypothermia blanket. The nurse should monitor the client for which of the following adverse effects of the hypothermia blanket? 1) Shivering Answer Rationale: The hypothermia blanket can cause shivering if the client is cooled too quickly. Shivering can cause the client’s temperature to increase. INCORRECT 2) Infection Answer Rationale: Infection is not a complication of the hypothermia blanket therapy. A manifestation of infection is hyperthermia. INCORRECT 3) Burns Answer Rationale: Burns are associated with the improper use of heating pads, not hypothermia blankets. INCORRECT 4) Hypervolemia Answer Rationale: Hypervolemia is not a complication of the hypothermia blanket therapy. Dehydration is a risk associated with hyperthermia due to fluid loss. 6. A nurse is reinforcing teaching about exercise with a client who has type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching? INCORRECT 1) "I will carry a complex carbohydrate snack with me when I exercise." Answer Rationale: The nurse should reinforce that the client should carry a simple carbohydrate such as hard candy or glucose tablets for use during exercise if the client becomes hypoglycemic. INCORRECT 2) "I should exercise first thing in the morning before eating breakfast." Answer Rationale: The nurse should reinforce that exercise should follow a meal. Exercising first thing in the morning on an empty stomach places the client at risk for hypoglycemia. INCORRECT 3) "I should avoid injecting insulin into my thigh if I am going to go running." Answer Rationale: The nurse should reinforce that the client should avoid injecting insulin into an area that will soon be exercised to avoid increasing the absorption rate of the insulin. 4) "I will not exercise if my urine is positive for ketones." Answer Rationale: The nurse should reinforce that exercise should be avoided if ketones are present in the urine as this indicates an elevated blood glucose level or ketoacidosis. 7. A nurse notes a small section of bowel protruding from the abdominal incision of a client who is postoperative. After calling for assistance, which of the following actions should the nurse take first? 1) Cover the client's wound with a moist, sterile dressing. Answer Rationale: According to evidence-based practice, the nurse's first action should be to cover the wound with a moist, sterile dressing to prevent entry of bacteria into the wound and to keep the tissue moist. INCORRECT 2) Have the client lie supine with knees flexed. Answer Rationale: The nurse should have the client lie supine with knees flexed to promote adequate circulation to the vital organs. However, evidence-based practice indicates that this is not the first action the nurse should take. INCORRECT 3) Check the client's vital signs. Answer Rationale: The nurse should check the client’s vital signs because the client is at risk for shock following wound evisceration. However, evidence-based practice indicates that this is not the first action the nurse should take. INCORRECT 4) Inform the client about the need to return to surgery. Answer Rationale: The nurse should inform the client about the need to return to emergency surgery to preserve the bowel and prevent complications. However, evidence-based practice indicates that this is not the first action the nurse should take. 8. A nurse is collecting data from a client who has alcohol use disorder and is experiencing metabolic acidosis. Which of the following manifestations should the nurse expect? INCORRECT 1) Cool, clammy skin Answer Rationale: The nurse should expect to find warm, flushed skin in a client who is experiencing metabolic acidosis. 2) Hyperventilation Answer Rationale: The nurse should expect to find hyperventilation in a client who is experiencing metabolic acidosis. The system attempts to compensate or return the pH to normal by increasing the rate and depth of respirations. INCORRECT 3) Increased blood pressure Answer Rationale: The nurse should expect to find hypotension in a client who is experiencing metabolic acidosis. INCORRECT 4) Bradycardia Answer Rationale: The nurse should expect to find tachycardia in a client who is experiencing metabolic acidosis. 9. A nurse is reinforcing discharge teaching with a client following a cataract extraction. Which of the following should the nurse include in the teaching? 1) Avoid bending at the waist. Answer Rationale: The nurse should reinforce that the client should avoid bending at the waist as this increases intraocular pressure; the client should be instructed to flex the knees and crouch instead. INCORRECT 2) Remove the eye shield at bedtime. Answer Rationale: The client should be instructed to use an eye shield when retiring for the night to protect the eye from accidental injury, such as rubbing that may occur when the client is asleep. INCORRECT 3) Limit the use of laxatives if constipated. Answer Rationale: The client should be encouraged to use laxatives in the event of constipation to avoid straining while attempting to have a bowel movement. Straining increases intraocular pressure and can cause damage to the surgical site. INCORRECT 4) Seeing flashes of light is an expected finding following extraction. Answer Rationale: The nurse should instruct the client that flashes of light indicates a complication of cataract extraction, and should be reported to the provider. 10.A nurse is caring for a client who has heart failure and has been taking digoxin 0.25 mg daily. The client refuses breakfast and reports nausea. Which of the following actions should the nurse take first? INCORRECT 1) Suggest that the client rests before eating the meal. Answer Rationale: The nurse should encourage frequent rest periods for the client who has heart failure, as dyspnea and fluid overload increases the workload to consume adequate nutrition; however, another action is the priority. INCORRECT 2) Request a dietary consult. Answer Rationale: The nurse should consider obtaining a dietary consult for the client who has heart failure to provide nutritional evaluation and counseling; however, another action is the priority. 3) Check the client's vital signs. Answer Rationale: When using the airway, breathing, circulation approach to client care, the nurse should place the priority on obtaining vital signs. Nausea is a manifestation of digoxin toxicity, along with other manifestations such as muscle weakness, confusion, abdominal cramping, and changes in vision. INCORRECT 4) Request an order for an antiemetic. Answer Rationale: The nurse should request antiemetics for the client who is experiencing nausea in order to maintain client comfort and nutritional intake; however, another action is the priority. 11. A nurse is caring for a client who is 3 days postoperative following a cholecystectomy. The nurse suspects the client's wound is infected because the drainage from the dressing is yellow and thick. Which of the following findings should the nurse report as the type of drainage found? INCORRECT 1) Sanguineous Answer Rationale: Sanguineous indicates fresh bleeding. INCORRECT 2) Serous Answer Rationale: Serous describes clear, watery plasma. INCORRECT 3) Serosanguineous Answer Rationale: Serosanguineous describes watery drainage that has some blood in it. 4) Purulent Answer Rationale: Purulent describes drainage that is thick yellow, green, or brown in color. 12. A nurse is reinforcing discharge teaching to a client following arthroscopic surgery. To prevent postoperative complications which of the following actions should be reinforced during the teaching? 1) Administer an opioid analgesic to the client 30 min prior to initiating CPM exercises. Answer Rationale: The nurse should administer analgesics prior to initiating any exercise program for the client who has had joint arthroplasty. It is important that analgesics are administered in time for the medication to work before the start of the exercise program to ensure discomfort is minimized. INCORRECT 2) Place the client’s affected leg into the CPM machine with the machine in the flexed position. Answer Rationale: The nurse should place the client’s leg in the CPM machine while the machine is in the extended position to allow for proper fit and comfort. INCORRECT 3) Place the client into a high Fowler’s position when initiating the CPM exercises. Answer Rationale: The nurse should limit the elevation of the client’s head of the bed to no more than 20 degrees while the client is using the CPM machine to avoid extreme flexion of the hip and patient discomfort. INCORRECT 4) Align the joints of the CPM machine with the knee gatch in the client’s bed. Answer Rationale: The nurse should align the joints of the CPM machine with the client’s knee joint to ensure safe operation of the unit and prevent injury to the client. 13.A nurse is collecting data from a client who has emphysema. Which of the following findings should the nurse expect? (Select all that apply.) 1) Dyspnea 2) Barrel chest 3) Clubbing of the fingers 4) Shallow respirations INCORRECT 5) Bradycardia Answer Rationale: Dyspnea is correct. Dyspnea is experienced by clients who have emphysema due to inadequate oxygen exchange in the lungs. Barrel chest is correct. The lungs of clients who have emphysema lose their elasticity, and the diaphragm becomes permanently flattened by overdistention of the lungs. The muscles of the rib cage also become rigid, and the ribs flare outward. This produces the barrel chest typical of emphysema clients. Clubbing of the fingers is correct. Air is trapped in the lungs due to their lack of elasticity, which decreases oxygenation. Clubbing results from these chronic low bloodoxygen levels. Shallow respirations is correct. Clients who have emphysema lose lung elasticity; consequently, respirations become increasingly shallow and more rapid. Bradycardia is incorrect. The heart rate will increase as the heart tries to compensate for less oxygen being delivered to the tissues. 14. A nurse is caring for a client who sustained a basal skull fracture. When performing morning hygiene care, the nurse notices a thin stream of clear drainage coming from out of the client's right nostril. Which of the following actions should the nurse take first? INCORRECT 1) Take the client's temperature. Answer Rationale: The nurse should take the client's temperature to ensure the client is afebrile to prevent infection and brain dysfunction; however, another finding is the priority. INCORRECT 2) Place a dressing under the client's nose. Answer Rationale: The nurse should place a dressing under the client's nose to measure and collect the amount of drainage; however, another finding is the priority. INCORRECT 3) Notify the charge nurse. Answer Rationale: The nurse should notify the charge nurse about the client’s condition; however, another finding is the priority. 4) Test the drainage for glucose. Answer Rationale: The greatest risk to a client who has a basal skull fracture is injury from cerebral spinal fluid (CSF) leak; ther.......................................................................................................................................................................................CONTINUED...............................................................DOWNLOAD FOR BEST SCORES [Show Less]
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ATI MEDSURG REVISED 2022
1) Inflammaandwardry Bowel Disease: Dietary Recommendations(583) • low fiber • download protein • decreased calories Ulcerative Colitis and Crohn... [Show More] ’s Disease • Eat foods high in protein and calories, and low in fiber • Identify foodsthat trigger clinical manifestations • Joined caffeine and alcohol, take multivitamin w/iron • Eatsmall frequent meals • Dietary supplements high in protein and low in fiber • Moniandwardr and electrolyte imbalance especially potassium • Vitamin B12 Diverticulitis • Consume clear liquid until manifestations subside • Add fiber join solid foods get andwardlerated • Joined seeds or indigestible material that can block diverticula (nuts popcorn) • Joined alcohol. Limit fatintake andward 30%, adequate fluids, bulk andming laxatives 2) Respiraandwardry Management and Mechanical Ventilation:Need and Suctioning • Suction secretions andward maintain airway and tube patency 3) Disorders of reading Eye: Expected Findings (122) • Retinal detachment- flashes of light and blind spots curtain closing over eyes • Glaucoma- download IOP causing gradual vision loss • Injury. Disease process, aging process • Macular degeneration(#1 cause of vision loss in ppl over 60), cataracts, glaucoma • MD: lack of depth perception, object disandwardrtion, blurred vision, loss of central vision,blindness • Cataracts: decreased visual acuity, blurred vision, diplopia, phoandward sensitivity, halo around lights, visible opacity, absentred reflex • Glaucoma: headache, mild eye pain, loss of peripheral vision, inc. IOP, phoandwardphobia, pupilsnon reactive andward light 4) Disorders of reading Eye: Analyzing Findings • IOP: 10-21 mm/Hg • Moniandwardr and IOP • -moniandwardr and decreased vision and lightsensitivity • -Assess pt and aching or discomandt around reading eye • -Tx severe plain and nausea with analgesics and antiemetics 5) Arthroplasty: Prevent complication- DVT, anemia, -Older adults @ higher risk CPM Prevent pressure ulcers Using a Continuous Passive Motion Machine • Promote motion and preventscar tissue andmation • Joined flexion of hip greater than 90 degrees, don’t cross legs, abduction pillow,raised andwardiletseat • -Full extention andward perscribed amt of flexion • -Placed and initiated right after surgery • -sandwardpped and meals 6) Cancer Disorders (981) Laryngeal Cancer and Body Image Disturbance ▪ Consultspeech language path. and clients who have difficulty speaking ▪ -Provide comandt andward pt who have permenant loss of voice or disfigurment ▪ -Refer andward counseling servcies as needed 7) Burns: Prioritizing Emergency Interventions (829) Airway -fluid and electrolyte -readingrmoregulation -infection • Maintain Airway and Ventilation (cough deep bregetading,suction, elevate head of bed, oxygen), • moniandwardr vitals • maintain cardiac output (IV access, fluid replacement in first 24 hours, rapid replacement during emergent phase, isoandwardnic crystalloid solutions such as NaCl or Lactated Ringers, colloids such as albumin or synreadingtic plasma expanders after first 24 hours. Maintain urine output, possible administration of blood products), • moniandwardr and shock, pain management (joined IM or Sc administration, IV opioid analgesics, moniandwardr and respiraandwardry depression, meds beande dressing change, nonpharm pain management), • prevent infection (restrict visiandwardrs, no plants or flowers, no fresh fruits or vegetables), • nutritionalsupport( may need download calories up tp 5,000, increase protein, may need TPN, ) • Resandwardremobility, • psychosocialsupport 8) Electrolyte Imbalances: (472) Safety, abc’s Evaluation of Potassium Chloride Readingrapy - hypokalmeia ▪ Never administer by bolus, 5-10 mEq/hr ▪ Assess and phlebitis ▪ Moniandwardr urine output ▪ Diminished respirations and breath sounds ▪ Moniandwardr cardiac rhythm (especially ptstaking Digoxin), LOC, bowel sounds, kidney function, mgca phosphorus, provide assistance with ADLs 9) Cardiovascular Diagnostic and Readingrapeutic Procedures: (294)Assessing Arterial Line (296) check placement -keep pressure -flush beande between and after meds -watch and clotting Assess integrity of arterial waveandm, moniandwardr circulation in reading limb with reading line( cap refill, temp,color). Moniandwardr respiraandwardry and cardiac status, placement, prevent infection and blood clots 10) Cardiovascular Diagnostic and Readingrapeutic Procedures: (349)ECG Abnormalities Following Myocardial Infarction (351) ▪ Angina- ST depression/ T wave inversion indicatesischemia ▪ MI- T wave inversion indicates ischemia, ST segment elevation indicatesinjury, abnormal Q waves indicates necrosis 11) Head Injury: Moniandwardring CSF Leakage • Leakage from nose or ears • "halo" sign- yellow stain surrounded by blood on a paper andwardwel, • fluid tests positive and glucose -report andward dr 12) Diabetes Mellitus Management: (914) Client Education Regarding Medications ▪ Rotate injection sites, don’t aspirate and blood ▪ Eat at regular intervals, joined alcohol intake, adjust insulin andward exercise ▪ Take even if can't eat. ▪ -Clear-cloud................................................................CONTINUED [Show Less]
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