ATI RN Adult
Medical
Surgical 2022
, ATI RN Adult Medical Surgical
1. nurse is caring for a client who has hepatic encephalopathy that is being treated with lactulose. the
client is experiencing excessive stools. which of the following findings is an adverse effect of the
medication?
hypokalemia
Lactulose works by stimulating the production of excess stools to rid the body of excess ammonia.
These excessive stools can result in hypokalemia and dehydration.
2. a nurse is caring for a client who has emphysema and is receiving mechanical ventilation. the client
appears anxious and restless, and the high-pressure alarm is sounding. which of the following
actions should the nurse take first?
instruct the client to allow the machine to breathe for them.
When providing client care, the nurse should first use the least restrictive intervention. Therefore, the
first action the nurse should take is to provide verbal instructions and emotional support to help the
client relax and allow the ventilator to work. Clients can exhibit anxiety and restlessness when trying to
"fight the ventilator."
3. nurse is teaching a client who has a family history of colorectal cancer. to help mitigate this risk,
which of the following dietary alterations should the nurse recommend?
add cabbage to the diet.
To help reduce the risk for colorectal cancer, the client should consume a diet that is high in fiber, low in
fat, and low in refined carbohydrates. Brassica vegetables, such as cabbage, cauliflower, and broccoli, are
high in fiber.
4. a home health nurse is assigned to a client who was recently discharged from a rehabilitation center
after experiencing a right-hemispheric stroke. which of the following neurological deficits should the
nurse expect to find when assessing the client?
visual spatial deficits
left hemianopsia
one-sided neglect
5. a nurse is caring for a client who has viral pneumonia. the client's pulse oximeter readings have
fluctuated between 79% and 88% for the last 30 min. which of the following oxygen delivery systems
should the nurse initiate to provide the highest concentration of oxygen?
nonrebreather mask
,The nurse should initiate a nonrebreather mask to deliver between 80% to 95% oxygen to the client. A
client who has an unstable respiratory status should receive oxygen via a nonrebreather mask.
6. a nurse is caring for a client who has bilateral pneumonia and an SaO2 of 85%. the client has
dyspnea with a productive cough and is using accessory muscles to breathe. which of the following
actions should the nurse take first?
place the client in high-fowler's position.
7. The greatest risk to this client is injury from airway obstruction. Therefore, the priority intervention
the nurse should take is to move the client into high-Fowler's position. High-Fowler's position
facilitates lung expansion and improves ventilation and gas exchange.
nurse is planning care for a client who has extensive burn injuries and is immunocompromised. which of
the following precautions should the nurse include in the plan of care to prevent a Pseudomonas
aeruginosa infection.
avoid placing plants or flowers in the client's room.
Live plants can harbor P. aeruginosa, and this bacterium can infect burn wounds and cause life-
threatening complications. The nurse should ensure no one brings live plants or flowers into the client's
room.
8. an older adult client is brought to an emergency department by a family member. which of the
following assessment findings should cause the nurse to suspect that the client has hypertonic
dehydration?
Urine specific gravity of 1.045
A urine specific gravity greater than 1.030 indicates a decrease in urine volume and an increase in
osmolarity, which is a manifestation of hypertonic dehydration.
9. a nurse in an emergency department is reviewing the providers prescriptions for a client who
sustained a rattlesnake bite to the lower leg. which of the following prescriptions should the nurse
expect?
administer an opioid analgesic to the client.
The nurse should expect a prescription for an opioid analgesic to promote comfort following a
rattlesnake bite.
10. a nurse is assessing a client who has had a suspected stroke. the nurse should place the priority on
which of the following findings?
dysphagia
, Dysphagia indicates that this client is at greatest risk for aspiration due to impaired sensation and
function within the oral cavity. Therefore, the nurse should place priority on this finding.
11. a nurse is teaching a young adult client how to perform testicular self-examination. which of the
following instructions should the nurse include?
roll each testicle between the thumb and fingers.
The nurse should instruct the client to roll each testicle horizontally between the thumbs and fingers to
feel for any lumps deep in the center of the testicle.
12. a nurse is providing instructions to a client who has type 2 diabetes mellitus and a new prescription
for metformin. which of the following statements by the client indicates an understanding of the
teaching?
"I should take this medication with a meal."
The client should take metformin with or immediately following meals to improve absorption and to
minimize gastrointestinal distress.
13. a nurse is teaching a client who has venous insufficiency about self-care. which of the following
statements should the nurse identify as an indication that the client understands the teaching?
"I will wear clean graduated compression stockings every day."
The client should apply a clean pair of graduated compression stockings each day and clean soiled
stockings with mild detergent and warm water by hand.
14. a nurse is assessing a client who has acute cholecystitis. which of the following findings is the nurse's
priority?
tachycardia
When using the urgent vs. nonurgent approach to client care, the nurse should determine that the
priority finding is tachycardia. Tachycardia is a manifestation of biliary colic, which can lead to shock. The
nurse should position the head of the client's bed flat and report this finding immediately to the
provider.
15. a nurse is reviewing the health record of a client who is scheduled for allergy skin testing. the nurse
should postpone the testing and report to the provider with if the following findings?
current medications
The nurse should review the client's medication record and identify medications, including ACE
inhibitors, beta blockers, theophylline, nifedipine, and glucocorticoids, such as prednisone, that can alter
the allergy skin test results. These medications can diminish the client's reaction to the allergens. The
Medical
Surgical 2022
, ATI RN Adult Medical Surgical
1. nurse is caring for a client who has hepatic encephalopathy that is being treated with lactulose. the
client is experiencing excessive stools. which of the following findings is an adverse effect of the
medication?
hypokalemia
Lactulose works by stimulating the production of excess stools to rid the body of excess ammonia.
These excessive stools can result in hypokalemia and dehydration.
2. a nurse is caring for a client who has emphysema and is receiving mechanical ventilation. the client
appears anxious and restless, and the high-pressure alarm is sounding. which of the following
actions should the nurse take first?
instruct the client to allow the machine to breathe for them.
When providing client care, the nurse should first use the least restrictive intervention. Therefore, the
first action the nurse should take is to provide verbal instructions and emotional support to help the
client relax and allow the ventilator to work. Clients can exhibit anxiety and restlessness when trying to
"fight the ventilator."
3. nurse is teaching a client who has a family history of colorectal cancer. to help mitigate this risk,
which of the following dietary alterations should the nurse recommend?
add cabbage to the diet.
To help reduce the risk for colorectal cancer, the client should consume a diet that is high in fiber, low in
fat, and low in refined carbohydrates. Brassica vegetables, such as cabbage, cauliflower, and broccoli, are
high in fiber.
4. a home health nurse is assigned to a client who was recently discharged from a rehabilitation center
after experiencing a right-hemispheric stroke. which of the following neurological deficits should the
nurse expect to find when assessing the client?
visual spatial deficits
left hemianopsia
one-sided neglect
5. a nurse is caring for a client who has viral pneumonia. the client's pulse oximeter readings have
fluctuated between 79% and 88% for the last 30 min. which of the following oxygen delivery systems
should the nurse initiate to provide the highest concentration of oxygen?
nonrebreather mask
,The nurse should initiate a nonrebreather mask to deliver between 80% to 95% oxygen to the client. A
client who has an unstable respiratory status should receive oxygen via a nonrebreather mask.
6. a nurse is caring for a client who has bilateral pneumonia and an SaO2 of 85%. the client has
dyspnea with a productive cough and is using accessory muscles to breathe. which of the following
actions should the nurse take first?
place the client in high-fowler's position.
7. The greatest risk to this client is injury from airway obstruction. Therefore, the priority intervention
the nurse should take is to move the client into high-Fowler's position. High-Fowler's position
facilitates lung expansion and improves ventilation and gas exchange.
nurse is planning care for a client who has extensive burn injuries and is immunocompromised. which of
the following precautions should the nurse include in the plan of care to prevent a Pseudomonas
aeruginosa infection.
avoid placing plants or flowers in the client's room.
Live plants can harbor P. aeruginosa, and this bacterium can infect burn wounds and cause life-
threatening complications. The nurse should ensure no one brings live plants or flowers into the client's
room.
8. an older adult client is brought to an emergency department by a family member. which of the
following assessment findings should cause the nurse to suspect that the client has hypertonic
dehydration?
Urine specific gravity of 1.045
A urine specific gravity greater than 1.030 indicates a decrease in urine volume and an increase in
osmolarity, which is a manifestation of hypertonic dehydration.
9. a nurse in an emergency department is reviewing the providers prescriptions for a client who
sustained a rattlesnake bite to the lower leg. which of the following prescriptions should the nurse
expect?
administer an opioid analgesic to the client.
The nurse should expect a prescription for an opioid analgesic to promote comfort following a
rattlesnake bite.
10. a nurse is assessing a client who has had a suspected stroke. the nurse should place the priority on
which of the following findings?
dysphagia
, Dysphagia indicates that this client is at greatest risk for aspiration due to impaired sensation and
function within the oral cavity. Therefore, the nurse should place priority on this finding.
11. a nurse is teaching a young adult client how to perform testicular self-examination. which of the
following instructions should the nurse include?
roll each testicle between the thumb and fingers.
The nurse should instruct the client to roll each testicle horizontally between the thumbs and fingers to
feel for any lumps deep in the center of the testicle.
12. a nurse is providing instructions to a client who has type 2 diabetes mellitus and a new prescription
for metformin. which of the following statements by the client indicates an understanding of the
teaching?
"I should take this medication with a meal."
The client should take metformin with or immediately following meals to improve absorption and to
minimize gastrointestinal distress.
13. a nurse is teaching a client who has venous insufficiency about self-care. which of the following
statements should the nurse identify as an indication that the client understands the teaching?
"I will wear clean graduated compression stockings every day."
The client should apply a clean pair of graduated compression stockings each day and clean soiled
stockings with mild detergent and warm water by hand.
14. a nurse is assessing a client who has acute cholecystitis. which of the following findings is the nurse's
priority?
tachycardia
When using the urgent vs. nonurgent approach to client care, the nurse should determine that the
priority finding is tachycardia. Tachycardia is a manifestation of biliary colic, which can lead to shock. The
nurse should position the head of the client's bed flat and report this finding immediately to the
provider.
15. a nurse is reviewing the health record of a client who is scheduled for allergy skin testing. the nurse
should postpone the testing and report to the provider with if the following findings?
current medications
The nurse should review the client's medication record and identify medications, including ACE
inhibitors, beta blockers, theophylline, nifedipine, and glucocorticoids, such as prednisone, that can alter
the allergy skin test results. These medications can diminish the client's reaction to the allergens. The
