Med-Surg ATI Capstone 2021 QUESTIONS WITH RATIONALED ANSWERS.

Med-Surg ATI Capstone 2021 QUESTIONS WITH RATIONALED ANSWERS. a nurse is caring for a client who is receiving warfarin for anticoagulation therapy. Which of the following laboratory test results indicates to the nurse that the client needs an increase in the dosage? a. aPtt 38 seconds B. inr 1.1 c. Pt 22 seconds D. D dimer negativ: e B. CORRECT: inr of 1.1 is within the expected reference range for a client who is not receiving warfarin. However, this value is subthera- peutic for anticoagulation therapy. the nurse should expect the client to receive an increased dosage of warfarin until the inr is 2 to 3. 9. a nurse is providing teaching for a client who is scheduled for a bone marrow biopsy of the iliac crest. Which of the following statements made by the client indicates an understanding of the teaching? a. "this test will be performed while i am lying flat on my back." B. "i will need to stay in bed for about an hour after the test." c."this test will determine which antibiotic i should take for treatment." D."i will receive general anesthesia for the test.": B. CORRECT: the nurse should inform the client of the need to stay on bed rest for 30 to 60 min following the test to reduce the risk for bleeding. 10. a nurse is reviewing the plan of care for a client who has systemic lupus erythematosus (sLE). the client reports fatigue, joint tenderness, swelling, and difficulty urinating. Which of the following laboratory findings should the nurse anticipate? (select all that apply.) a. positive ana titer b. increased hemoglobin C. 2+ urine protein d. increased serum C3 and C4 E. Elevatedbun: a. CORRECT: a positive antinu- clear antibody (ana) titer is an expected finding in a client who has sLE. the ana test identifies the presence of antibodies produced against the client's own dna. C. CORRECT: increased urine protein is an expected finding due to kidney injury as a result of sLE. E. CORRECT: Elevated bun is an expected finding due to kidney injury in a client who has sLE. 11. a nurse is teaching a client who has sLE about self care. Which of the following statements by the client indicates an understanding of the teaching? a. "i should limit my time to 10 minutes in the tanning bed." b. "i will apply powder to any skin rash." 5 / 35 C."i should use a mild hair shampoo." d."i will inspect my skin once a month for rashes.": C. CORRECT: a client who has sLE should use a mild hair shampoo that does not irritate the scalp. 12. a nurse is discussing gout with a client who is concerned about developing the disorder. Which of the following findings should the nurse identify as risk factors for this disease? (select all that apply.) a. diuretic use b. obesity C. deep sleep deprivation d. depression E. Cardiovascular disease: a. CORRECT: the use of diuretics is a risk factor for gout. b. CORRECT: obesity is a risk factor for gout. E. CORRECT: Cardiovascular disease is a risk factor for gout. 13. a nurse is assessing a client who has a new diagnosis of sLE. Which of the following findings should the nurse expect? a. Weight gain b. petechiae on thighs C. systolic murmur d. alopecia: d. CORRECT: alopecia (hair loss) is an expected finding in a client who has sLE. 14. a nurse is caring for a client who has sLE and is experiencing an episode of raynaud's phenomenon. Which of the following findings should the nurse anticipate? a. swelling of joints of the fingers b. pallor of toes with cold exposure C. Feet that become reddened with ambulation d. Client report of intense feeling of heat in the fingers: b. CORRECT: pallor of the extremities occurs in raynaud's phenomenon in a client who has sLE and has been exposed to cold or stress. 15. a nurse is caring for a client who has a new diagnosis of gastroe- sophageal reflux disease (gErD). The nurse should anticipate prescriptions for which of the following medications? (select all that apply.) a. antacids B. histamine2 receptor antagonists C. opioid analgesics 6 / 35 D. Fiber laxatives E. proton pump inhibitors: a. CORRECT: antacids neutralize gastric acid which irritates the esophagus during reflux. B. CORRECT: histamine2 receptor antagonists decrease acid secretion, which contributes to reflux. E. CORRECT: proton pump inhibitors decrease gastric acid production, which contributes to reflex. 16. a nurse is admitting a client who has bleeding esophageal varices. The nurse should anticipate a prescription for which of the following med- ications? a. propranolol B. Metoclopramide C. ranitidine D. Vasopressin: D. CORRECT: Vasopressin constricts blood vessels and is used to treat bleeding esophageal varices. 17. a nurse is completing an assessment of a client who has gErD. Which of the following is an expected finding? a. absence of saliva B. loss of tooth enamel C. sweet taste in mouth D. absence of eructation: B. CORRECT: Tooth erosion is an expected finding in a client who has gErD. 18. a nurse is teaching a client who has a hiatal hernia. Which of the following client statements indicates an understanding of the teaching? a."i can take my medications with soda." B. "peppermint tea will increase my indigestion." C."Wearing an abdominal binder will limit my symptoms." D."i will drink hot chocolate at bedtime to help me sleep." E. "i can lift weights as a way to exercise.": B. CORRECT: peppermint decreas- es lEs pressure and should be avoided by the client who has a hiatal hernia 19. a nurse is completing discharge teaching to a client who is postoperative following fundoplication. Which of the following statements by the client indicates understanding of the teaching? a. "When sitting in my lounge chair after a meal, i will lower the back of it." B. "i will try to eat three large meals a day." C."i will elevate the head of my bed on blocks." 7 / 35 D."When sleeping, i will lay on my left side.": C. CORRECT: after a fundoplica- tion, the client is instructed to elevate the head of the bed to limit reflux.