ATI PN Adult Medical Surgical 2019

ATI PN Adult Medical Surgical 2019 Related

Review ATI PN Adult Medical Surgical 2019 related questions and content

The nurse is planning care for a 16-year-old with juvenile rheumatoid arthritis (JRA). The nurse includes activities to strengthen and mobilize the joints and surrounding muscles. Which physical therapy regimen should the nurse encourage the adolescent to implement?

  • A. Exercise in a swimming pool.
  • B. Splint affected joints during activity.
  • C. Perform passive range of motion exercises twice daily.
  • D. Begin a training program of lifting weights and running.
Correct Answer: A

Rationale: The correct answer is A: Exercise in a swimming pool. This option is ideal for a 16-year-old with JRA because it provides a low-impact environment that helps strengthen muscles and improve joint mobility without putting excessive stress on the joints. Swimming also helps reduce pain and stiffness associated with JRA.

Choice B (Splint affected joints during activity) is incorrect because splinting may restrict movement and hinder muscle strengthening. Choice C (Perform passive range of motion exercises twice daily) is not as effective as active exercises in improving muscle strength and joint mobility. Choice D (Begin a training program of lifting weights and running) can be too high-impact and may exacerbate joint inflammation and pain in individuals with JRA.

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What action should the nurse take to prevent tracheal tissue damage in a client with a tracheostomy?

  • A. Secure the tracheostomy ties firmly.
  • B. Change the tracheostomy tube daily.
  • C. Use the minimal leak technique when inflating the cuff.
  • D. Clean the stoma with hydrogen peroxide.
Correct Answer: C

Rationale: The correct action to prevent tracheal tissue damage in a client with a tracheostomy is to use the minimal leak technique when inflating the cuff (Choice C). This technique helps maintain proper cuff pressure, preventing excessive pressure on the tracheal tissue. Securing the tracheostomy ties firmly (Choice A) may cause pressure ulcers on the neck. Changing the tracheostomy tube daily (Choice B) is unnecessary and may introduce infection. Cleaning the stoma with hydrogen peroxide (Choice D) can be too harsh and damaging to the delicate tracheal tissue.

The healthcare provider is caring for a patient who is taking warfarin (Coumadin). Which laboratory value should the healthcare provider monitor closely?

  • A. Platelet count.
  • B. Prothrombin time (PT).
  • C. Hemoglobin level.
  • D. White blood cell count.
Correct Answer: B

Rationale: The correct answer is B: Prothrombin time (PT). Warfarin is an anticoagulant medication that works by inhibiting clotting factors. Monitoring PT is essential to ensure the patient's blood is clotting within the desired range to prevent both bleeding and clotting events. Platelet count (A) assesses the quantity of platelets, not the clotting function. Hemoglobin level (C) evaluates red blood cell count and oxygen-carrying capacity. White blood cell count (D) assesses immune function and infection risk, not clotting ability. PT is directly related to warfarin's mechanism of action, making it the most crucial parameter to monitor.

A client with a history of chronic heart failure is experiencing severe shortness of breath and has pink, frothy sputum. Which action should the nurse take first?

  • A. Administer morphine sulfate.
  • B. Place the client in a high Fowler's position.
  • C. Initiate continuous ECG monitoring.
  • D. Prepare the client for intubation.
Correct Answer: B

Rationale: The correct action for the nurse to take first is to place the client in a high Fowler's position (Choice B). This position helps improve lung expansion and oxygenation by reducing pressure on the diaphragm and improving ventilation. With severe shortness of breath and pink, frothy sputum, the priority is to optimize respiratory function. Administering morphine sulfate (Choice A) may be indicated later for pain and anxiety but is not the immediate priority. Initiating continuous ECG monitoring (Choice C) is important but not as urgent as addressing the respiratory distress. Preparing the client for intubation (Choice D) should be considered if respiratory distress worsens, but initial interventions should focus on improving oxygenation through positioning.

The nurse is caring for a client with hyperthyroidism. Which intervention should the nurse implement to manage the client's condition?

  • A. Provide a high-calorie diet.
  • B. Encourage frequent rest periods.
  • C. Restrict fluid intake.
  • D. Administer a stool softener.
Correct Answer: B

Rationale: The correct answer is B: Encourage frequent rest periods. For a client with hyperthyroidism, rest is crucial to conserve energy and support the body's recovery. Hyperthyroidism is characterized by increased metabolic rate, leading to fatigue and weakness. Rest periods help reduce metabolic demands and prevent exhaustion. A high-calorie diet (choice A) may be necessary to support increased metabolism but is not the priority. Restricting fluid intake (choice C) can lead to dehydration, which should be avoided in hyperthyroidism. Administering a stool softener (choice D) is unrelated to managing hyperthyroidism.

A client is scheduled for a colonoscopy. Which instruction should the nurse provide?

  • A. Eat a light breakfast on the day of the procedure.
  • B. You will need to drink a bowel preparation solution before the procedure.
  • C. Avoid all liquids for 24 hours before the procedure.
  • D. You can continue taking your blood thinners until the day of the procedure.
Correct Answer: B

Rationale: The correct answer is B because drinking a bowel preparation solution helps clear the colon for better visualization during the colonoscopy. This step is crucial to ensure accuracy of the procedure. Choice A is incorrect as the client should have a clear liquid diet the day before the procedure. Choice C is incorrect as hydration is important, but clear liquids are allowed. Choice D is incorrect because blood thinners may need to be adjusted prior to the procedure to reduce bleeding risk.

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