Med surg- proctored ATI Exam with 100%
Correct Answers 2023/2024
An older adult 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? - ANSWER-Urine Specific
gravity 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.
A nurse in a community clinic is caring for a client who reports an increase
in the frequency of migraine headaches. To help reduce the risk for migraine
headaches, which of the following foods should the nurse recommend the
client avoid? - ANSWER- Aged cheese
Foods that contain tyramine, such as aged cheese and sausage, can trigger
migraine headaches.
A nurse is planning teaching for a client who has bladder cancer and is to
undergo a cutaneous diversion procedure to establish a ureterostomy.
Which of the following statements should the nurse include in the teaching?
- ANSWER-"You should cut the opening of the skin barrier one-eight inch
wider than the stoma."
The client should cut the opening of the skin barrier 0.3 cm (1/8in) wider
than the stoma to minimize irritation of the skin from exposure to urine.
A nurse is providing teaching to a client who has hypothyroidism and is
receiving levothyroxine. The nurse should instruct the client that which of
the following supplements can interfere with the effectiveness of the
medication? - ANSWER- Calcium
Calcium limits the development of osteoporosis in clients who are
postmenopausal and works as an antacid. Calcium supplements can interfere
with the metabolism of a number of medications, including levothyroxine.
The nurse should instruct the client to avoid taking calcium within 4 hr of
levothyroxine administration.
A nurse is conducting an admission history for a client who is to undergo a CT
scan with an IV contrast agent. The nurse should identify that which of the
following findings requires further assessment? - ANSWER-History of asthma
A client who has a history of asthma has a greater risk of reacting to the
contrast dye used during the procedure. Other conditions that can result in
a reaction to contrast media include allergies to foods, such as shellfish,
eggs, milk, and chocolate.
,Med surg- proctored ATI Exam with 100%
Correct Answers 2023/2024
A nurse in an ICU is assessing a client who has a traumatic brain injury.
Which of the following findings should the nurse identify as a component
of Cushing's triad? - ANSWER-Bradycardia
A client who has increased intracranial pressure from a traumatic brain injury
can develop bradycardia, which is one component of Cushing's triad. The
other components of Cushing's triad are severe hypertension and a widened
pulse pressure.
A nurse is planning to irrigate and dress a clean, granulating wound for a
client who has a pressure injury. Which of the following actions should the
nurse take? - ANSWER-Use a 30-mL syringe
The nurse should use a 30-mL to 60-mL syringe with an 18- or 19- gauge
catheter to deliver the ideal pressure of 8 pounds per square inch (psi) when
irrigating a wound. To maintain healthy granulation tissue, the wound
irrigation should be delivered at between 4 and 15 psi.
A nurse in an emergency department is reviewing the provider's
prescriptions for a client who sustained a rattlesnake bite to the lower leg.
Which of the following prescriptions should the expect? - ANSWER-
Administer an opioid analgesic to the client.
The nurse should expect a prescription for an opioid analgesic to promote
comfort following a rattlesnake bite.
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 which of the following findings? (Click on the "Exhibit" button for
additional information about the client). - ANSWER-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 nurse should notify the provider and instruct the client
to discontinue prednisone for 2 weeks before allergy skin testing.
A nurse is a caring for a client who is on bed rest and has a new
prescription for enoxaparin subcutaneous. Which of the following
actions should the nurse take? - ANSWER-Inject the medication into the
anterolateral abdominal wall.
The nurse should inject the medication into the anterolateral or posterolateral
abdominal wall to enhance medication absorption and prevent hematoma
formation.
,Med surg- proctored ATI Exam with 100%
Correct Answers 2023/2024
A nurse is caring for a client who has a stage III pressure injury. Which if the
following findings contribute to delayed wound healing? - ANSWER-Urine
output 25 mL/hr
, Med surg- proctored ATI Exam with 100%
Correct Answers 2023/2024
Urinary output reflects fluid status. Inadequate urine output can indicate
dehydration, which can delay wound healing.
A nurse is caring for a client who has a new prescription for total parenteral
nutrition (TPN). The client is to receive 2,000 kcal per day. The TPN solution
has 500kcal/L. The IV pump should be set at how many mL/hr? (Rounding to
the nearest whole number.) - ANSWER-167 mL/hr
A 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? - ANSWER-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.
A nurse is caring for a client who has a prescription for silver sulfadiazine
cream to be applied to her burn wounds. The nurse should evaluate the
client for which of the following laboratory findings? - ANSWER-Leukopenia
Transient leukopenia is an adverse effect of silver sulfadiazine.
A nurse is teaching a client with systemic erythematosus who has a new
prescription for prednisone. The nurse should instruct the client to monitor for
which of the following adverse effects of this medication? - ANSWER-Infection
The nurse should instruct the client to avoid contact with people who are ill
and monitor for manifestations of an infection such as a fever or a sore
throat. Prednisone can suppress the client's immune response and mask the
manifestations of an infection.
A nurse is providing preoperative teaching to a client who will undergo a
total laryngectomy. Which of the following statements indicates that the
client understands the impact of the surgery? - ANSWER-"I understand that I
will have a permanent tracheostomy after the surgery."
With a partial laryngectomy, the tracheostomy is temporary. This client will
have a total laryngectomy, so the tracheostomy will be permanent.
A nurse is assessing a client who has systemic scleroderma. Which of the
following findings should the nurse expect? - ANSWER-Finger contractures
Scleroderma is a chronic disease that can cause thickening, hardening, or
tightening of the skin, blood vessels, and internal organs. There are 2 types of
scleroderma: localized scleroderma, which mainly affects the skin, and
systemic scleroderma, which can affect internal organs. Manifestations
Correct Answers 2023/2024
An older adult 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? - ANSWER-Urine Specific
gravity 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.
A nurse in a community clinic is caring for a client who reports an increase
in the frequency of migraine headaches. To help reduce the risk for migraine
headaches, which of the following foods should the nurse recommend the
client avoid? - ANSWER- Aged cheese
Foods that contain tyramine, such as aged cheese and sausage, can trigger
migraine headaches.
A nurse is planning teaching for a client who has bladder cancer and is to
undergo a cutaneous diversion procedure to establish a ureterostomy.
Which of the following statements should the nurse include in the teaching?
- ANSWER-"You should cut the opening of the skin barrier one-eight inch
wider than the stoma."
The client should cut the opening of the skin barrier 0.3 cm (1/8in) wider
than the stoma to minimize irritation of the skin from exposure to urine.
A nurse is providing teaching to a client who has hypothyroidism and is
receiving levothyroxine. The nurse should instruct the client that which of
the following supplements can interfere with the effectiveness of the
medication? - ANSWER- Calcium
Calcium limits the development of osteoporosis in clients who are
postmenopausal and works as an antacid. Calcium supplements can interfere
with the metabolism of a number of medications, including levothyroxine.
The nurse should instruct the client to avoid taking calcium within 4 hr of
levothyroxine administration.
A nurse is conducting an admission history for a client who is to undergo a CT
scan with an IV contrast agent. The nurse should identify that which of the
following findings requires further assessment? - ANSWER-History of asthma
A client who has a history of asthma has a greater risk of reacting to the
contrast dye used during the procedure. Other conditions that can result in
a reaction to contrast media include allergies to foods, such as shellfish,
eggs, milk, and chocolate.
,Med surg- proctored ATI Exam with 100%
Correct Answers 2023/2024
A nurse in an ICU is assessing a client who has a traumatic brain injury.
Which of the following findings should the nurse identify as a component
of Cushing's triad? - ANSWER-Bradycardia
A client who has increased intracranial pressure from a traumatic brain injury
can develop bradycardia, which is one component of Cushing's triad. The
other components of Cushing's triad are severe hypertension and a widened
pulse pressure.
A nurse is planning to irrigate and dress a clean, granulating wound for a
client who has a pressure injury. Which of the following actions should the
nurse take? - ANSWER-Use a 30-mL syringe
The nurse should use a 30-mL to 60-mL syringe with an 18- or 19- gauge
catheter to deliver the ideal pressure of 8 pounds per square inch (psi) when
irrigating a wound. To maintain healthy granulation tissue, the wound
irrigation should be delivered at between 4 and 15 psi.
A nurse in an emergency department is reviewing the provider's
prescriptions for a client who sustained a rattlesnake bite to the lower leg.
Which of the following prescriptions should the expect? - ANSWER-
Administer an opioid analgesic to the client.
The nurse should expect a prescription for an opioid analgesic to promote
comfort following a rattlesnake bite.
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 which of the following findings? (Click on the "Exhibit" button for
additional information about the client). - ANSWER-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 nurse should notify the provider and instruct the client
to discontinue prednisone for 2 weeks before allergy skin testing.
A nurse is a caring for a client who is on bed rest and has a new
prescription for enoxaparin subcutaneous. Which of the following
actions should the nurse take? - ANSWER-Inject the medication into the
anterolateral abdominal wall.
The nurse should inject the medication into the anterolateral or posterolateral
abdominal wall to enhance medication absorption and prevent hematoma
formation.
,Med surg- proctored ATI Exam with 100%
Correct Answers 2023/2024
A nurse is caring for a client who has a stage III pressure injury. Which if the
following findings contribute to delayed wound healing? - ANSWER-Urine
output 25 mL/hr
, Med surg- proctored ATI Exam with 100%
Correct Answers 2023/2024
Urinary output reflects fluid status. Inadequate urine output can indicate
dehydration, which can delay wound healing.
A nurse is caring for a client who has a new prescription for total parenteral
nutrition (TPN). The client is to receive 2,000 kcal per day. The TPN solution
has 500kcal/L. The IV pump should be set at how many mL/hr? (Rounding to
the nearest whole number.) - ANSWER-167 mL/hr
A 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? - ANSWER-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.
A nurse is caring for a client who has a prescription for silver sulfadiazine
cream to be applied to her burn wounds. The nurse should evaluate the
client for which of the following laboratory findings? - ANSWER-Leukopenia
Transient leukopenia is an adverse effect of silver sulfadiazine.
A nurse is teaching a client with systemic erythematosus who has a new
prescription for prednisone. The nurse should instruct the client to monitor for
which of the following adverse effects of this medication? - ANSWER-Infection
The nurse should instruct the client to avoid contact with people who are ill
and monitor for manifestations of an infection such as a fever or a sore
throat. Prednisone can suppress the client's immune response and mask the
manifestations of an infection.
A nurse is providing preoperative teaching to a client who will undergo a
total laryngectomy. Which of the following statements indicates that the
client understands the impact of the surgery? - ANSWER-"I understand that I
will have a permanent tracheostomy after the surgery."
With a partial laryngectomy, the tracheostomy is temporary. This client will
have a total laryngectomy, so the tracheostomy will be permanent.
A nurse is assessing a client who has systemic scleroderma. Which of the
following findings should the nurse expect? - ANSWER-Finger contractures
Scleroderma is a chronic disease that can cause thickening, hardening, or
tightening of the skin, blood vessels, and internal organs. There are 2 types of
scleroderma: localized scleroderma, which mainly affects the skin, and
systemic scleroderma, which can affect internal organs. Manifestations
