RN
ATIMED SURGE
RN MED PROCTORED
SURGE EXAM
PROCTORED EXAM
. A nurse is collecting data from a client who has emphysema. Which of the
following findings should the nurse expect? (Select all that apply.)
1) Dyspnea
2) Barrel chest
3) Clubbing of the fingers
4) Shallow respirations
INCORRECT
5) Bradycardia
Answer Rationale:
Dyspnea is correct. Dyspnea is experienced by clients who have emphysema
due to inadequate oxygen exchange in the lungs.
Barrel chest is correct. The lungs of clients who have emphysema lose their
elasticity, and the diaphragm becomes permanently flattened by overdistention
of the lungs. The muscles of the rib cage also become rigid, and the ribs flare
outward. This produces the barrel chest typical of emphysema clients.
Clubbing of the fingers is correct. Air is trapped in the lungs due to their lack
of elasticity, which decreases oxygenation. Clubbing results from these chronic
low blood-oxygen levels.
Shallow respirations is correct. Clients who have emphysema lose lung
elasticity; consequently, respirations become increasingly shallow and more
rapid.
Bradycardia is incorrect. The heart rate will increase as the heart tries to
compensate for less oxygen being delivered to the tissues.
2. A nurse is caring for a client who has Cushing's syndrome. Which of the
following clinical manifestations should the nurse expect to observe? (Select all
that apply.)
1) Buffalo hump
2) Purple striations
3) Moon face
,INCORRECT
4) Tremors
INCORRECT
5) Obese extremities
Answer Rationale:
Buffalo hump is correct. Cushing's syndrome is a disease caused by an
increased production of cortisol or by excessive use of corticosteroids. Buffalo
hump, a collection of fat between the shoulders, is a common manifestation of
Cushing's syndrome.Purple striations is correct. Purple striations on the skin
of the abdomen, thighs, and breasts are a common manifestation of Cushing's
syndrome. This is due to the collection of body fat in these areas.Moon face is
correct. Moon face is a common manifestation of Cushing's syndrome. Clients
who have this manifestation present with a round, red, full face.Tremors is
incorrect. Tremors are not a common finding of Cushing's syndrome.Obese
extremities is incorrect. Clients who have Cushing's syndrome have truncal
obesity, a protuberant abdomen, with thin extremities, which is due to an
alteration in protein metabolism.
3. A nurse is assisting with the care of a client immediately following a lumbar
puncture. Which of the following actions should the nurse take? (Select all that
apply.)
1) Encourage fluid intake.
2) Monitor the puncture site for hematoma.
INCORRECT
3) Insert a urinary catheter.
INCORRECT
4) Elevate the client’s head of bed.
INCORRECT
5) Apply a cervical collar to the client.
Answer Rationale:
Encourage fluid intake is correct. The nurse should encourage fluids, unless
contraindicated, to replace the cerebrospinal fluid that was removed during the
procedure and reduce the risk for a headache.
A nurse is caring for a client who is in the oliguric phase of acute kidney injury. Which
of the following actions should the nurse take?
1) Provide a diet high in protein.
2) Provide ibuprofen for retroperitoneal discomfort.
3) Monitor intake and output hourly
4) Encourage the client to consume at least 2 L of fluid daily.
, A nurse is reinforcing teaching about an esophagogastroduodenoscopy with a client
who has upper gastric pain. Which of the following statements should the nurse
include in the teaching?
1) "A flexible tube is introduced through the nose during the procedure."
2) "During the procedure you are in a sitting position."
3) "You will remain NPO for 8 hours before the procedure."
4) "You will be awake while the procedure is performed."
A nurse is caring for a client who is difficult to arouse and very sleepy for several
hours following a generalized tonic-clonic seizure. Which of the following descriptions
should the nurse use when documenting this finding in the medical record?
1) Aura phase
2) Presence of automatisms
3) Postictal phase
4) Presence of absence seizures
A nurse is reinforcing teaching with a client who reports right shoulder pain following
a laparoscopic cholecystectomy. Which of the following statements should the nurse
make?
1) "The pain results from lying in one position too long during surgery."
2) "The pain occurs as a residual pain from cholecystitis."
3) "The pain will dissipate if you ambulate frequently."
4) "The pain is caused from the nitrous dioxide injected into the abdomen."
A nurse is checking the suction control chamber of a client's chest tube and notes
that there is no bubbling in the suction control chamber. Which of the following
actions should the nurse take?
1) Notify the provider.
Answer Rationale:
The nurse should check for kinks and take other measures before notifying the
provider.
2) Verify that the suction regulator is on.
3) Continue to monitor the client because this is an expected finding.
4) Milk the chest tube to dislodge any clots in the tubing that may be
occluding it.
A nurse is assisting with the care of a client immediately following a lumbar
puncture. Which of the following actions should the nurse take? (Select all that
apply.)
1) Encourage fluid intake.
2) Monitor the puncture site for hematoma.
3) Insert a urinary catheter.
4) Elevate the client’s head of bed.
5) Apply a cervical collar to the client.
A nurse is assisting with the care of a client who is postoperative following surgical
repair of a fractured mandible. The client’s jaw is wired shut to repair and stabilize
the fracture. The nurse should recognize which of the following is the priority action?
1) Relieve the client's pain.
2) Check the client’s pressure points for redness.
ATIMED SURGE
RN MED PROCTORED
SURGE EXAM
PROCTORED EXAM
. A nurse is collecting data from a client who has emphysema. Which of the
following findings should the nurse expect? (Select all that apply.)
1) Dyspnea
2) Barrel chest
3) Clubbing of the fingers
4) Shallow respirations
INCORRECT
5) Bradycardia
Answer Rationale:
Dyspnea is correct. Dyspnea is experienced by clients who have emphysema
due to inadequate oxygen exchange in the lungs.
Barrel chest is correct. The lungs of clients who have emphysema lose their
elasticity, and the diaphragm becomes permanently flattened by overdistention
of the lungs. The muscles of the rib cage also become rigid, and the ribs flare
outward. This produces the barrel chest typical of emphysema clients.
Clubbing of the fingers is correct. Air is trapped in the lungs due to their lack
of elasticity, which decreases oxygenation. Clubbing results from these chronic
low blood-oxygen levels.
Shallow respirations is correct. Clients who have emphysema lose lung
elasticity; consequently, respirations become increasingly shallow and more
rapid.
Bradycardia is incorrect. The heart rate will increase as the heart tries to
compensate for less oxygen being delivered to the tissues.
2. A nurse is caring for a client who has Cushing's syndrome. Which of the
following clinical manifestations should the nurse expect to observe? (Select all
that apply.)
1) Buffalo hump
2) Purple striations
3) Moon face
,INCORRECT
4) Tremors
INCORRECT
5) Obese extremities
Answer Rationale:
Buffalo hump is correct. Cushing's syndrome is a disease caused by an
increased production of cortisol or by excessive use of corticosteroids. Buffalo
hump, a collection of fat between the shoulders, is a common manifestation of
Cushing's syndrome.Purple striations is correct. Purple striations on the skin
of the abdomen, thighs, and breasts are a common manifestation of Cushing's
syndrome. This is due to the collection of body fat in these areas.Moon face is
correct. Moon face is a common manifestation of Cushing's syndrome. Clients
who have this manifestation present with a round, red, full face.Tremors is
incorrect. Tremors are not a common finding of Cushing's syndrome.Obese
extremities is incorrect. Clients who have Cushing's syndrome have truncal
obesity, a protuberant abdomen, with thin extremities, which is due to an
alteration in protein metabolism.
3. A nurse is assisting with the care of a client immediately following a lumbar
puncture. Which of the following actions should the nurse take? (Select all that
apply.)
1) Encourage fluid intake.
2) Monitor the puncture site for hematoma.
INCORRECT
3) Insert a urinary catheter.
INCORRECT
4) Elevate the client’s head of bed.
INCORRECT
5) Apply a cervical collar to the client.
Answer Rationale:
Encourage fluid intake is correct. The nurse should encourage fluids, unless
contraindicated, to replace the cerebrospinal fluid that was removed during the
procedure and reduce the risk for a headache.
A nurse is caring for a client who is in the oliguric phase of acute kidney injury. Which
of the following actions should the nurse take?
1) Provide a diet high in protein.
2) Provide ibuprofen for retroperitoneal discomfort.
3) Monitor intake and output hourly
4) Encourage the client to consume at least 2 L of fluid daily.
, A nurse is reinforcing teaching about an esophagogastroduodenoscopy with a client
who has upper gastric pain. Which of the following statements should the nurse
include in the teaching?
1) "A flexible tube is introduced through the nose during the procedure."
2) "During the procedure you are in a sitting position."
3) "You will remain NPO for 8 hours before the procedure."
4) "You will be awake while the procedure is performed."
A nurse is caring for a client who is difficult to arouse and very sleepy for several
hours following a generalized tonic-clonic seizure. Which of the following descriptions
should the nurse use when documenting this finding in the medical record?
1) Aura phase
2) Presence of automatisms
3) Postictal phase
4) Presence of absence seizures
A nurse is reinforcing teaching with a client who reports right shoulder pain following
a laparoscopic cholecystectomy. Which of the following statements should the nurse
make?
1) "The pain results from lying in one position too long during surgery."
2) "The pain occurs as a residual pain from cholecystitis."
3) "The pain will dissipate if you ambulate frequently."
4) "The pain is caused from the nitrous dioxide injected into the abdomen."
A nurse is checking the suction control chamber of a client's chest tube and notes
that there is no bubbling in the suction control chamber. Which of the following
actions should the nurse take?
1) Notify the provider.
Answer Rationale:
The nurse should check for kinks and take other measures before notifying the
provider.
2) Verify that the suction regulator is on.
3) Continue to monitor the client because this is an expected finding.
4) Milk the chest tube to dislodge any clots in the tubing that may be
occluding it.
A nurse is assisting with the care of a client immediately following a lumbar
puncture. Which of the following actions should the nurse take? (Select all that
apply.)
1) Encourage fluid intake.
2) Monitor the puncture site for hematoma.
3) Insert a urinary catheter.
4) Elevate the client’s head of bed.
5) Apply a cervical collar to the client.
A nurse is assisting with the care of a client who is postoperative following surgical
repair of a fractured mandible. The client’s jaw is wired shut to repair and stabilize
the fracture. The nurse should recognize which of the following is the priority action?
1) Relieve the client's pain.
2) Check the client’s pressure points for redness.
