ATI RN Adult Medical Surgical 2023 Questions

ATI RN Adult Medical Surgical 2023 Questions Related

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Medical History: Cerebrovascular accident (CVA) 2 years ago, Coronary artery disease, Hypertension, Hyperlipidemia. A nurse is reviewing the client's medical record. After reviewing the medical history, the nurse must determine which of the following actions to take.

For each potential provider’s prescription, the nurse must select if the action is Anticipated, Nonessential, or Contraindicated for the client.

  • A. Encourage the client to cough
  • B. Elevate the head of the bed
  • C. Assist the client to the bathroom
  • D. Decrease oxygen to 1.5 L/min via nasal cannula
  • E. Keep the client’s head in a midline position
  • F. Initiate seizure precautions
Correct Answer: B, A, C, A

Rationale: The correct answer is based on the rationale below:

1. Elevate the head of the bed (B): This action is Anticipated as it helps prevent aspiration and promotes optimal respiratory function.
2. Encourage the client to cough (A): Also Anticipated as coughing helps clear secretions and maintain airway patency.
3. Assist the client to the bathroom (C): This is Non-essential unless there are specific concerns about the client's mobility or urgency.
4. Decrease oxygen to 1.5 L/min via nasal cannula (A): Contraindicated as it may compromise oxygenation, especially without proper assessment and orders.

Other choices:
- Keeping the client's head in a midline position (E) is not provided in the question stem, so it cannot be evaluated.
- Initiating seizure precautions (F) is not relevant to the client's immediate care based on the information given

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A nurse is providing teaching for a client who is taking isoniazid (INH) for tuberculosis. Which of the following statements by the client indicates an understanding of the teaching?

  • A. I plan to take this medication for 1 week.
  • B. I should take an antacid with each dose of this medication.
  • C. This medication may cause my blood pressure to increase.
  • D. I will have my liver function tested while I am taking this medication.
Correct Answer: D

Rationale: The correct answer is D: "I will have my liver function tested while I am taking this medication." This is the correct answer because isoniazid (INH) is known to potentially cause liver toxicity. Monitoring liver function tests is crucial to detect any signs of liver damage early. Choice A is incorrect as INH treatment for tuberculosis typically lasts 6-9 months, not just 1 week. Choice B is incorrect because antacids can decrease the absorption of INH. Choice C is incorrect as INH does not typically cause an increase in blood pressure.

A nurse working in an outpatient clinic is planning a community education program about reproductive cancers. The nurse should identify which of the following manifestations as a possible indication of cervical cancer?

  • A. Painless vaginal bleeding
  • B. Frequent diarrhea
  • C. Urinary hesitancy
  • D. Unexplained weight gain
Correct Answer: A

Rationale: The correct answer is A: Painless vaginal bleeding. Cervical cancer can present with abnormal vaginal bleeding, which may include bleeding between periods, after intercourse, or post-menopause. This is due to the abnormal growth of cells in the cervix. Frequent diarrhea (B), urinary hesitancy (C), and unexplained weight gain (D) are not typical manifestations of cervical cancer. Diarrhea and urinary hesitancy are more commonly associated with gastrointestinal or urinary tract issues, while unexplained weight gain can be linked to various factors such as hormonal imbalances or dietary changes.

A nurse is planning care for a client who has developed nephrotic syndrome. Which of the following dietary recommendations should the nurse include?

  • A. Increase phosphorus intake
  • B. Decrease carbohydrate intake
  • C. Decrease protein intake
  • D. Increase potassium intake
Correct Answer: C

Rationale: The correct answer is C: Decrease protein intake. Nephrotic syndrome causes protein loss through urine, leading to hypoalbuminemia and edema. Decreasing protein intake can help reduce proteinuria and decrease the workload on the kidneys. Increasing phosphorus intake (A) can worsen kidney function. Decreasing carbohydrate intake (B) is not directly related to managing nephrotic syndrome. Increasing potassium intake (D) is not recommended as it can lead to hyperkalemia in individuals with kidney issues.

A nurse is caring for a client who requires protective isolation following a hematopoietic stem cell transplant. Which of the following interventions should the nurse implement to protect the client from infection?

  • A. Make sure the client's room has positive pressure airflow.
  • B. Make sure dietary plates and utensils are disposable.
  • C. Wear an N95 respirator when providing direct client care.
  • D. Monitor the client's temperature once every 6 hr.
Correct Answer: A

Rationale: Correct Answer: A: Make sure the client's room has positive pressure airflow.

Rationale:
1. Positive pressure airflow prevents contaminated air from entering the room, reducing the risk of infections.
2. It helps maintain a clean environment by keeping airborne pathogens out.
3. Protects the client who has a compromised immune system post-transplant.

Summary of Incorrect Choices:
B: Disposable utensils are important but do not directly protect the client from airborne infections.
C: N95 respirators are for the healthcare provider's protection, not the client's.
D: Monitoring temperature is essential but does not directly prevent infections in a protective isolation setting.

A nurse is administering packed RBCs to a client. The client reports chills, lower back pain, and nausea 10 min after the infusion begins. Which of the following actions should the nurse take first?

  • A. Collect a urine sample
  • B. Check the clients' vital signs
  • C. Stop the infusion
  • D. Administer oxygen to the client
Correct Answer: C

Rationale: The correct answer is C: Stop the infusion. The client is showing signs of a transfusion reaction, which can be serious. Stopping the infusion is the first priority to prevent further complications. Vital signs should be checked next to assess the client's condition. Collecting a urine sample is not a priority in this situation. Administering oxygen may be necessary depending on the client's condition, but stopping the infusion takes precedence.

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