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ATI MED SURG PROCTORED EXAM 2024 REAL EXAM QUESTIONS WITH WELL DETAILED AND EXPLANED ANSWER KEY. BEST STUDY MATERIAL TO HELP YOU PA

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ATI MED SURG PROCTORED EXAM 2024 REAL EXAM QUESTIONS WITH WELL DETAILED AND EXPLANED ANSWER KEY. BEST STUDY MATERIAL TO HELP YOU PASS 1. A nurse is caring for a client who has HIV. Which of the following laboratory values is the nurse's priority? A. Positive Western blot test Rationale: The client is already identified as HIV positive. Therefore, another value is the priority. B. CD4-T-cell count 180 cells/mm3 Rationale: A CD4-T-cell count of less than 180 cells/mm3 indicates that the client is severely immune- compromised and is at high risk for infection. Therefore, this value is the priority for thenurse to report to the provider. C. Platelets 150,000/mm3 Rationale: The client's platelet count is within the expected reference range. Therefore, another value is the priority. D. WBC 5,000/mm3 Rationale: The client's WBC count is within the expected reference range. Therefore, another value is the priority. 2. A nurse is assessing a client who is admitted for elective surgery and has a history of Addison's disease. Which of the following findings should the nurse expect? A. Hyperpigmentation Rationale: Addison's disease is an endocrine disorder that occurs when the adrenal glands do not produce enough of the hormone cortisol, and in some cases, the hormone aldosterone. The disease is characterized by weight loss, muscle weakness, fatigue, low blood pressure, and hyperpigmentation (darkening) of the skin in both exposed and non-exposed parts of the body. B. Intention tremors Rationale: Intention tremors may be seen in multiple sclerosis, a neuromuscular disorder that primarily affects the central nervous system. C. Hirsutism Rationale: Addison's disease results in loss of body hair, called vitiligo. D. Purple striations Rationale: Purple striations on the skin of the abdomen, thighs, and breasts are a common manifestation in Cushing's syndrome. Hyperpigmentation can be seen as well. 3. A nurse is caring for a client who is 1 day postoperative following a subtotal thyroidectomy. The client reports a tingling sensation in the hands, the soles of the feet, and around the lips. For which of the following findings should the nurse assess the client? Created on:02/03/2023 Page 1 A. Chvostek's sign Rationale: The nurse should suspect that the client has hypocalcemia, a possible complication following subtotal thyroidectomy. Manifestations of hypocalcemia include numbness and tingling in the hands, the soles of the feet, and around the lips, typically appearing between 24 and 48 hr after surgery. To elicit Chvostek's sign, the nurse should tap the client's face at a point just below and in front of the ear. A positive response would be twitching of the ipsilateral (same side only) facial muscles, suggesting neuromuscular excitability due to hypocalcemia. B. Babinski's sign Rationale: Babinski's sign is a diagnostic test for brain damage or upper motor neuron damage. It is positive if the toes flare up when the nurse strokes the plantar aspect of the foot. C. Brudzinski's sign Rationale: Brudzinski's sign is an indication of meningeal irritation, such as in clients who have meningitis. With the client supine, the nurse should place one hand behind his head and places her other hand on his chest. The nurse then raises the client's head with her hand behind his head, while the hand on his chest restrains him and prevents him from rising. Flexion of the client's lower extremities constitutes a positive sign. D. Kernig's sign Rationale: Kernig's sign is an indication of meningeal irritation, such as in clients who have meningitis. The nurse performs the maneuver with the client supine with his hips and knees in flexion. The inability to extend the client's knees fully without causing pain constitutes a positive test. 4. A nurse is reviewing laboratory values for a client who has systemic lupus erythematosus (SLE). Which of the following values should give the nurse the best indication of the client's renal function? A. Serum creatinine Rationale: A renal function disorder reduces the excretion of creatinine, resulting in increased levels of blood creatinine. Creatinine is a specific and sensitive indicator of renal function. B. Blood urea nitrogen (BUN) Rationale: The BUN is used as a gross index of glomerular function and the production and excretion of urea. High-protein diets, rapid-protein catabolism, and dehydration are conditions that will cause an elevation in the BUN. This is not the best indication of the client's renal function. C. Serum sodium Rationale: Serum sodium is affected by urinary output but may also be falsely affected by hemodilution and hemoconcentration. This is not the best indication of the client's renal function. D. Urine-specific gravity Rationale: Due to the body's compensatory mechanisms and ability to maintain glomerular filtration rate (GFR) until 75% of renal function is lost, this is not the best indication of the client's renal function. Created on:02/03/2023 Page 2

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lOMoARcPSD|21646696




ATI MED SURG PROCTORED EXAM 2024 REAL EXAM QUESTIONS
WITH WELL DETAILED AND EXPLANED ANSWER KEY. BEST STUDY
MATERIAL TO HELP YOU PASS


1.A nurse is caring for a client who has HIV. Which of the following laboratory values is the nurse's priority?

A. Positive Western blot test

Rationale: The client is already identified as HIV positive. Therefore, another value is the priority.

B. CD4-T-cell count 180 cells/mm3

Rationale: A CD4-T-cell count of less than 180 cells/mm3 indicates that the client is severely
immune- compromised and is at high risk for infection. Therefore, this value is the
priority for thenurse to report to the provider.

C. Platelets 150,000/mm3

Rationale: The client's platelet count is within the expected reference range. Therefore, another
value is the priority.

D. WBC 5,000/mm3

Rationale: The client's WBC count is within the expected reference range. Therefore, another
value is the priority.




2.A nurse is assessing a client who is admitted for elective surgery and has a history of Addison's
disease. Which of the following findings should the nurse expect?

A. Hyperpigmentation

Rationale: Addison's disease is an endocrine disorder that occurs when the adrenal glands do
not produce enough of the hormone cortisol, and in some cases, the hormone
aldosterone. The disease is characterized by weight loss, muscle weakness, fatigue,
low blood pressure, and hyperpigmentation (darkening) of the skin in both exposed
and non-exposed parts of the body.

B. Intention tremors

Rationale: Intention tremors may be seen in multiple sclerosis, a neuromuscular disorder that
primarily affects the central nervous system.

C. Hirsutism

Rationale: Addison's disease results in loss of body hair, called vitiligo.

D. Purple striations

Rationale: Purple striations on the skin of the abdomen, thighs, and breasts are a common
manifestation in Cushing's syndrome. Hyperpigmentation can be seen as well.

, lOMoARcPSD|21646696




3.A nurse is caring for a client who is 1 day postoperative following a subtotal thyroidectomy. The
client reports a tingling sensation in the hands, the soles of the feet, and around the lips. For which
of the following findings should the nurse assess the client?

Created on:02/03/2023 Page 1

, lOMoARcPSD|21646696




A. Chvostek's sign

Rationale: The nurse should suspect that the client has hypocalcemia, a possible complication
following subtotal thyroidectomy. Manifestations of hypocalcemia include numbness
and tingling in the hands, the soles of the feet, and around the lips, typically
appearing between 24 and 48 hr after surgery. To elicit Chvostek's sign, the nurse
should tap the client's face at a point just below and in front of the ear. A positive
response would be twitching of the ipsilateral (same side only) facial muscles,
suggesting neuromuscular excitability due to hypocalcemia.

B. Babinski's sign

Rationale: Babinski's sign is a diagnostic test for brain damage or upper motor neuron
damage. It is positive if the toes flare up when the nurse strokes the plantar aspect
of the foot.

C. Brudzinski's sign

Rationale: Brudzinski's sign is an indication of meningeal irritation, such as in clients who have
meningitis. With the client supine, the nurse should place one hand behind his head
and places her other hand on his chest. The nurse then raises the client's head
with her hand behind his head, while the hand on his chest restrains him and
prevents him from rising. Flexion of the client's lower extremities constitutes a
positive sign.

D. Kernig's sign

Rationale: Kernig's sign is an indication of meningeal irritation, such as in clients who have
meningitis. The nurse performs the maneuver with the client supine with his hips
and knees in flexion. The inability to extend the client's knees fully without causing
pain constitutes a positive test.




4.A nurse is reviewing laboratory values for a client who has systemic lupus erythematosus (SLE).
Which of the following values should give the nurse the best indication of the client's renal
function?

A. Serum creatinine

Rationale: A renal function disorder reduces the excretion of creatinine, resulting in increased
levels of blood creatinine. Creatinine is a specific and sensitive indicator of renal
function.

B. Blood urea nitrogen (BUN)

Rationale: The BUN is used as a gross index of glomerular function and the production and
excretion of urea. High-protein diets, rapid-protein catabolism, and dehydration are
conditions that will cause an elevation in the BUN. This is not the best indication of
the client's renal function.

C. Serum sodium

Rationale: Serum sodium is affected by urinary output but may also be falsely affected by
hemodilution and hemoconcentration. This is not the best indication of the client's renal
function.

D. Urine-specific gravity

Rationale: Due to the body's compensatory mechanisms and ability to maintain glomerular
filtration rate (GFR) until 75% of renal function is lost, this is not the best indication
of the client's renal function.

, lOMoARcPSD|21646696




Created on:02/03/2023 Page 2

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