ATI Medical Surgical Proctored Exam 2019 Quizlet

ATI Medical Surgical Proctored Exam 2019 Quizlet Related

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An elderly male client reports to the clinic nurse that he is experiencing increasing nocturia with difficulty initiating his urine stream. He reports a weak urine flow and frequent dribbling after voiding. Which nursing action should be implemented?

  • A. Obtain a urine specimen for culture and sensitivity.
  • B. Encourage the client to schedule a digital rectal exam.
  • C. Advise the client to maintain a voiding diary for one week.
  • D. Instruct the client in effective techniques for cleansing the glans penis.
Correct Answer: B

Rationale: The correct answer is B: Encourage the client to schedule a digital rectal exam. This option is correct because the client's symptoms of nocturia, weak urine flow, and difficulty initiating urine stream suggest potential prostate issues, such as benign prostatic hyperplasia (BPH). A digital rectal exam can help assess the size and condition of the prostate gland. It is an essential step in diagnosing BPH or other prostate conditions.

Other choices are incorrect because:
A: Obtaining a urine specimen for culture and sensitivity is not the priority in this case, as the client's symptoms are more indicative of a prostate issue rather than a urinary tract infection.
C: Maintaining a voiding diary may provide information on the frequency and volume of urine output, but it does not address the underlying cause of the client's symptoms.
D: Instructing the client in cleansing techniques for the glans penis is not relevant to the reported symptoms and does not address the potential prostate issue.

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A client receiving total parenteral nutrition (TPN) through a central line suddenly develops dyspnea, chest pain, and a drop in blood pressure. What should the nurse do first?

  • A. Stop the TPN infusion.
  • B. Notify the healthcare provider.
  • C. Place the client in Trendelenburg position.
  • D. Administer oxygen at 2 liters/minute.
Correct Answer: C

Rationale: The correct answer is C: Place the client in Trendelenburg position. This is the first action to take in a client with suspected air embolism, a potential complication of central line insertion. Placing the client in Trendelenburg position with the head down and the legs elevated can help prevent air from reaching the heart and lungs. This action can help stabilize the client's condition before further interventions can be implemented.

Stopping the TPN infusion (choice A) can be important, but the priority in this situation is to address the potential air embolism. Notifying the healthcare provider (choice B) can be done after the immediate intervention. Administering oxygen (choice D) is important, but placing the client in Trendelenburg position takes precedence in this emergency situation.

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.

Which assessment finding indicates a client's readiness to leave the nursing unit for a bronchoscopy?

  • A. Client denies allergies to contrast media.
  • B. Skin prep to insertion site completed.
  • C. On-call sedation administered.
  • D. Oxygen at 2 L/minute via nasal cannula.
Correct Answer: C

Rationale: Rationale: Option C, on-call sedation administered, is the correct answer because sedation is essential for bronchoscopy to ensure the client is comfortable and cooperative during the procedure. Sedation helps reduce anxiety and discomfort, making the procedure more tolerable. Options A, B, and D are incorrect as they do not directly indicate readiness for the procedure. Denying allergies to contrast media (A) is important but not specific to bronchoscopy readiness. Skin prep completion (B) is part of the pre-procedure preparation but does not confirm readiness. Oxygen administration (D) is a routine care measure and does not indicate readiness for bronchoscopy.

When evaluating a client's understanding of wearing a Holter monitor, which statement made by the client would indicate to the nurse that the client understands the procedure?

  • A. I must record any symptoms occurring with my activity.
  • B. I am not looking forward to staying in bed for 24 hours.
  • C. I really am dreading the frequent blood drawing.
  • D. I know that I shouldn't get close to my microwave oven.
Correct Answer: A

Rationale: The correct answer is A because it demonstrates the client understands the purpose of wearing a Holter monitor—to record symptoms related to activity. This shows the client comprehends the importance of monitoring symptoms accurately. Choices B, C, and D are incorrect because they do not relate to the purpose of wearing a Holter monitor or indicate an understanding of the procedure. B focuses on personal preference, C on unrelated procedures, and D on irrelevant safety precautions.

When a client expresses, 'I don't know how I will go on' while discussing feelings related to a recent loss, the nurse remains silent. What is the most likely reason for the nurse's behavior?

  • A. The nurse is indicating disapproval of the statement.
  • B. The nurse is showing respect for the client's loss.
  • C. Silence is mirroring the client's sadness.
  • D. Silence enables the client to contemplate what was expressed.
Correct Answer: D

Rationale: The correct answer is D because the nurse's silence allows the client to reflect on and process their emotions after expressing uncertainty about the future. By remaining silent, the nurse gives the client space to explore their feelings and thoughts without interruption. This can help the client gain insight and come to terms with their emotions.

A: The nurse's silence does not indicate disapproval, as it is a common therapeutic technique.
B: While the nurse may be showing respect for the client's loss, the primary reason for the silence is to facilitate the client's reflection.
C: Although silence can sometimes mirror the client's emotions, the main purpose here is to enable contemplation rather than direct mirroring.

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