UPDATED ATI RN Adult Medical Surgical 2023 exam with correct answers

Seizure precautions - ANSWER Ensure client has IV access for seizure medication administration. Postoperative lab values - ANSWER Report Hgb level of 8 g/dL to provider as an indicator of postoperative hemorrhage or anemia. ESWL procedure - ANSWER Expect stone fragments in the urine after extracorporeal shock wave lithotripsy. Airborne precautions - ANSWER Initiate airborne precautions for a client with anorexia, low-grade fever, night sweats, and productive cough, as these are manifestations of tuberculosis. TPN administration - ANSWER Administer dextrose 10% in water until new TPN bag arrives to avoid drop in blood glucose level. Levothyroxine interaction - ANSWER Instruct client to avoid taking calcium within 4 hr of levothyroxine administration, as calcium can interfere with the effectiveness of the medication. Mechanical ventilation anxiety - ANSWER Instruct client to allow the machine to breathe for them to reduce anxiety and restlessness associated with fighting the ventilator. Adverse effect of enalapril - ANSWER Identify orthostatic hypotension as an adverse effect of enalapril. Delayed wound healing - ANSWER Identify urine output of 25 mL/hr as a finding that contributes to delayed wound healing. Hypothyroidism and opioid analgesic - ANSWER Instruct client to void every 4 hours to decrease the risk of urinary retention, which is an adverse effect of opioid analgesics. Portal hypertension - ANSWER Obtain vital signs first when caring for a client who is vomiting blood mixed with food after a meal, as this indicates a potential rupture of esophageal varices. Gastrectomy postoperative instructions - ANSWER Instruct client to avoid drinking fluids with meals, eat several small meals per day, consume high-protein snacks, and avoid highly seasoned foods. Cushing's triad - ANSWER Identify bradycardia as a component of Cushing's triad in a client with increased intracranial pressure from a traumatic brain injury. Client coping with diabetes diagnosis - ANSWER Recognize the client's change in behavior of inspecting feet daily as an indication of successful coping with the diagnosis. Inguinal hernia assessment - ANSWER Palpate location C to verify the presence of an inguinal hernia. Rattlesnake bite treatment - ANSWER Expect a prescription for an opioid analgesic to promote comfort following a rattlesnake bite. Hemodialysis treatment - ANSWER Perform a 12-lead ECG, place the client in Trendelenburg position, administer a 0.9% sodium chloride 200 mL IV bolus, apply oxygen at 2 L/min via nasal cannula, and notify the provider immediately. Client rights - ANSWER Ensure a client signs informed consent before receiving a placebo during a research trial. Omeprazole action - ANSWER Instruct the client that omeprazole provides relief by suppressing gastric acid production. Physical therapy referral - ANSWER Refer a client who is receiving preoperative teaching for a right knee arthroplasty to physical therapy to begin understanding postoperative exercises and physical restrictions. Droplet precautions - ANSWER Instruct an assistive personnel (AP) to wear a mask when coming within 3 ft of a client who has bacterial meningitis. Stress incontinence and weight loss - ANSWER Recommend weight loss to reduce excess abdominal pressure and mitigate the risk of stress incontinence. Hypokalemia and bowel sounds - ANSWER Expect hypoactive bowel sounds in a client with hypokalemia. Diagnostic results follow-up - ANSWER Follow up on PCO2 level, WBC count, chest X- ray, and oxygen saturation level. Neurological event follow-up - ANSWER Follow up on visual disturbances, tingling of the lips, hand grasps, and expressive aphasia. Testicular self-examination - ANSWER Instruct the client to roll each testicle between the thumb and fingers to feel for any lumps deep in the center of the testicle. Hyperthyroidism assessment - ANSWER Report blood pressure of 170/80 mm Hg to the provider as a priority finding. Muscle cramps and tingling sensation - ANSWER Administer calcium carbonate to a client experiencing muscle cramps and tingling sensation in the hands. Seizure intervention - ANSWER Turn the client to the side during a seizure to prevent aspiration. Medication to withhold prior to cardioversion - ANSWER Instruct the client to withhold digoxin for 48 hr prior to cardioversion. Sildenafil and nitroglycerin - ANSWER Inform the client that they cannot use sildenafil if they are taking nitroglycerin due to the risk of significant hypotension. Magnesium sulfate adverse effects - ANSWER Monitor for respiratory paralysis as an adverse effect of magnesium sulfate. Erythropoietin therapy - ANSWER Explain that the medication is taken to increase energy levels by increasing hematocrit and reducing fatigue. Chronic glomerulonephritis manifestation - ANSWER Identify hyperkalemia as a manifestation of chronic glomerulonephritis. Feverfew interaction - ANSWER Advise the client that naproxen interacts with feverfew and can increase the risk of bleeding. Colorectal cancer risk reduction - ANSWER Recommend adding cabbage to the diet to help reduce the risk of colorectal cancer. Dysphagia bedside item - ANSWER Place a suction machine at the client's bedside to clear the airway as needed and reduce the risk of aspiration. Contrast dye assessment - ANSWER Further assess a client's history of asthma before a CT scan with IV contrast agent due to the risk of a reaction to the dye. Exophthalmos assessment - ANSWER Identify image D as indicating exophthalmos in a client with Graves' disease. Role change risk - ANSWER Recognize that a client with multiple sclerosis and progressive difficulty ambulating is at risk for experiencing a role change. Lactulose adverse effect - ANSWER Identify hypokalemia as an adverse effect of lactulose due to excessive stools.