ATI Medical Surgical Proctored Exam 2019 Quizlet

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A recently widowed middle-aged female client presents to the psychiatric clinic for evaluation and tells the nurse that she has 'little reason to live.' She describes one previous suicidal gesture and admits to having a gun in her home. To maintain the client's confidentiality and to help ensure her safety, which action is best for the nurse to implement?

  • A. Encourage the client to remove the gun from her possession.
  • B. Notify the client's healthcare provider of the availability of the weapon.
  • C. Contact a person of the client's choosing to remove the weapon from the home.
  • D. Call the local police department and have the weapon removed from the home.
Correct Answer: C

Rationale: The correct answer is C: Contact a person of the client's choosing to remove the weapon from the home. This option respects the client's autonomy and confidentiality while ensuring her safety.

1. Encouraging the client to remove the gun (Option A) may not guarantee immediate action and could potentially escalate the situation.
2. Notifying the client's healthcare provider (Option B) could breach confidentiality and may not result in immediate intervention.
3. Calling the police (Option D) could lead to a loss of trust and may not be necessary if the situation can be handled discreetly by someone the client trusts.

Therefore, option C is the best course of action as it respects the client's autonomy, maintains confidentiality, and ensures prompt removal of the weapon to enhance the client's safety.

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In which situation is it most important for the registered nurse (RN) working on a medical unit to provide direct supervision?

  • A. A graduate nurse needs to access a client's implanted port to start an infusion of Ringer's Lactate.
  • B. A postpartum nurse pulled to the unit needs to start a transfusion of packed red blood cells.
  • C. A practical nurse is preparing to assist the healthcare provider with a lumbar puncture at the bedside.
  • D. An unlicensed assistive personnel is preparing to weigh an obese bedfast client using a bed scale.
Correct Answer: A

Rationale: The correct answer is A because accessing an implanted port for infusion is a specialized skill that requires direct supervision to ensure the safety and accuracy of the procedure. Step 1: A graduate nurse may not have sufficient experience with accessing ports. Step 2: The RN needs to ensure proper technique and prevent complications. Step 3: Direct supervision allows for immediate intervention if any issues arise. Other choices are incorrect because B: starting a transfusion is within the scope of practice for a nurse, C: assisting with a lumbar puncture can be done under indirect supervision, and D: weighing a client is a task that can be delegated to unlicensed personnel with proper training.

The client is prescribed clozapine (Clozaril), and the nurse plans to educate them about its purpose. Which statement should the nurse provide?

  • A. It will help you function better in the community.
  • B. The medication will help you think more clearly.
  • C. You will be able to cope with your symptoms.
  • D. It will improve your grooming and hygiene.
Correct Answer: B

Rationale: The correct answer is B: "The medication will help you think more clearly." This is the most appropriate statement to educate the client about clozapine. Clozapine is an antipsychotic medication used to treat schizophrenia and helps with cognitive symptoms such as disorganized thinking. Choice A is too vague and doesn't specify the medication's intended effect. Choice C is too general and doesn't focus on cognitive improvement. Choice D is incorrect as clozapine does not specifically target grooming and hygiene but rather cognitive symptoms.

A healthcare provider is preparing to administer a scheduled dose of intravenous (IV) metoprolol (Lopressor) to a client. The client's apical pulse is 58 beats/minute. What action should the healthcare provider take?

  • A. Administer the medication as prescribed.
  • B. Hold the medication and notify the healthcare provider.
  • C. Give half the prescribed dose and recheck the pulse in 30 minutes.
  • D. Administer the medication and then recheck the pulse in 30 minutes.
Correct Answer: B

Rationale: The correct answer is B: Hold the medication and notify the healthcare provider. The rationale is that metoprolol is a beta-blocker that can further decrease heart rate. With a low apical pulse of 58 beats/minute, administering metoprolol can potentially cause bradycardia or further slow down the heart rate to dangerous levels. Holding the medication and notifying the healthcare provider allows for further assessment and potential adjustment of the dosage or consideration of alternative treatments.

Incorrect choices:
A: Administering the medication as prescribed can lead to bradycardia and potential harm to the client.
C: Giving half the prescribed dose and rechecking the pulse in 30 minutes can still lead to further bradycardia and potential harm.
D: Administering the medication and then rechecking the pulse in 30 minutes is not appropriate as the initial pulse rate is already low, and waiting to recheck could lead to adverse effects before intervention.

When assessing a client reporting severe pain in the right lower quadrant of the abdomen, which sign would most likely indicate appendicitis?

  • A. Rebound tenderness at McBurney's point.
  • B. Positive Murphy's sign.
  • C. Rovsing's sign.
  • D. Cullen's sign.
Correct Answer: A

Rationale: The correct answer is A: Rebound tenderness at McBurney's point. McBurney's point is located in the right lower quadrant and is a classic sign of appendicitis. Rebound tenderness at this point indicates inflammation in the peritoneum, suggesting appendicitis. Choices B, C, and D are not specific to appendicitis. Positive Murphy's sign is related to cholecystitis, Rovsing's sign is seen in acute appendicitis but is not as specific as rebound tenderness at McBurney's point, and Cullen's sign is associated with acute pancreatitis.

The client with a history of heart failure is taking furosemide (Lasix). Which laboratory result should the nurse monitor closely?

  • A. Serum sodium.
  • B. Serum potassium.
  • C. Serum calcium.
  • D. Serum magnesium.
Correct Answer: B

Rationale: The correct answer is B: Serum potassium. Furosemide is a loop diuretic that can cause potassium loss, leading to hypokalemia. Hypokalemia can exacerbate cardiac arrhythmias in patients with heart failure. Monitoring serum potassium levels is crucial to prevent complications.

Incorrect choices:
A: Serum sodium - Furosemide may cause hyponatremia, but it is less critical compared to hypokalemia in a client with heart failure.
C: Serum calcium - Furosemide does not directly affect calcium levels significantly in most cases.
D: Serum magnesium - While furosemide can cause hypomagnesemia, monitoring potassium is more essential in this scenario due to its impact on cardiac function.

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