CAPSTONE ATI NCLEX MEDICAL SURGICAL ASSESSMENT 1
QUESTIONS AND CORRECT DETAILED ANSWERS LATEST
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A nurse is monitoring the laboratory findings for a client who is
postoperative following a total hip arthroplasty 6 hr ago. Which of the
following values indicates that the client has an increased risk for bleeding
A. PT 11.5 seconds
B. aPTT 35 seconds
C. Platelets 80,000
D. RBC 4.0 million - CORRECT ANSWERS C Platelets 80,000
platelet range is 150,000-400,000
A nurse is admitting a client who has a cervical spinal cord injury following
a motor vehicle crash. Which of the following interventions is the nurse's
priority while caring for this client
A. Change the client's position every 2 hours
B. Pad pressure points at the edges of the client's cervical collar
C. Palpate the client's abdomen for bladder distention
D. Assist the client with quad coughing - CORRECT ANSWERS D Assist the
client with quad coughing
The greatest risk to a client who has a cervical spinal cord injury is an
obstructed airway; the priority is to ensure the client can clear their airway.
Apply abdominal pressure as the client coughs (quad coughing)
A nurse is caring for a client who is receiving a blood transfusion. Which of
the following findings indicates that the client is experiencing transfusion-
associated circulatory overload
,CAPSTONE ATI NCLEX MEDICAL SURGICAL ASSESSMENT 1
QUESTIONS AND CORRECT DETAILED ANSWERS LATEST
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A. Nasuea
B. Hypothermia
C. Dyspnea
D. Bradycardia - CORRECT ANSWERS C Dyspnea
Dyspnea is an indication of possible transfusion associated circulatory
overload, leading to hypertension, bounding pulses, and confusion.
Dyspnea can also indicate transfusion related acute lung injury to an
anaphylactic response, which also causes wheezing, chest tightness,
cyanosis, and low BP
A nurse is assessing a client who has lung cancer and is undergoing
radiation therapy to the chest. Which of the following indicates an adverse
effect of the therapy
A. Hair loss on the scalp
B. Sweating at the treatment site
C. Altered taste sensations
D. Intolerance to cold - CORRECT ANSWERS C Altered taste sensations
Altered taste is a result of the release of metabolites by dead cells
A nurse is preparing to administer a unit of packed RBCs to a client who has
anemia. Which of the following actions should the nurse plan to take (select
all that apply)
A. Obtain pre-transfusion temperature
B. Prime the IV tubing with lactated Ringer's
C. Instruct an assistive personnel to monitor the client during the
transfusion
, CAPSTONE ATI NCLEX MEDICAL SURGICAL ASSESSMENT 1
QUESTIONS AND CORRECT DETAILED ANSWERS LATEST
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D. Verify the client's blood type with a second nurse
E. Use a 20 gauge IV needle for venous access - CORRECT ANSWERS A, D, E
A, complete assessment prior to transfusion
D, verify identification, blood compatibility, and expiration of product with
second nurse
E, the nurse should use a large bore needle to transfuse the PRBCs to
reduce the risk of cell hemolysis and obstruction of flow
A nurse is reviewing the laboratory findings for a client who is dehydrated.
Which of the following BUN levels should the nurse expect
A. 3.6 mg/dl
B. 8 mg/dL
C. 18.7 mg/dL
D. 26 mg/dL - CORRECT ANSWERS D 26 mg/dL
Normal range is 10-20, and elevated levels indicates renal disease,
dehydration, shock, excessive protein in the diet, sepsis, glucocorticoid use,
GI bleeding, or other conditions in which blood is reabsorbed from injured
tissues
A nurse is reviewing ECG strips for several clients. Which of the following
images should the nurse identify as atrial fibrillation
(cannot insert pictures, read description)
QUESTIONS AND CORRECT DETAILED ANSWERS LATEST
DOWNLOAD 2024/2025 BEST EXAM SOLUTION GRADED A+
FOR SUCCESS
A nurse is monitoring the laboratory findings for a client who is
postoperative following a total hip arthroplasty 6 hr ago. Which of the
following values indicates that the client has an increased risk for bleeding
A. PT 11.5 seconds
B. aPTT 35 seconds
C. Platelets 80,000
D. RBC 4.0 million - CORRECT ANSWERS C Platelets 80,000
platelet range is 150,000-400,000
A nurse is admitting a client who has a cervical spinal cord injury following
a motor vehicle crash. Which of the following interventions is the nurse's
priority while caring for this client
A. Change the client's position every 2 hours
B. Pad pressure points at the edges of the client's cervical collar
C. Palpate the client's abdomen for bladder distention
D. Assist the client with quad coughing - CORRECT ANSWERS D Assist the
client with quad coughing
The greatest risk to a client who has a cervical spinal cord injury is an
obstructed airway; the priority is to ensure the client can clear their airway.
Apply abdominal pressure as the client coughs (quad coughing)
A nurse is caring for a client who is receiving a blood transfusion. Which of
the following findings indicates that the client is experiencing transfusion-
associated circulatory overload
,CAPSTONE ATI NCLEX MEDICAL SURGICAL ASSESSMENT 1
QUESTIONS AND CORRECT DETAILED ANSWERS LATEST
DOWNLOAD 2024/2025 BEST EXAM SOLUTION GRADED A+
FOR SUCCESS
A. Nasuea
B. Hypothermia
C. Dyspnea
D. Bradycardia - CORRECT ANSWERS C Dyspnea
Dyspnea is an indication of possible transfusion associated circulatory
overload, leading to hypertension, bounding pulses, and confusion.
Dyspnea can also indicate transfusion related acute lung injury to an
anaphylactic response, which also causes wheezing, chest tightness,
cyanosis, and low BP
A nurse is assessing a client who has lung cancer and is undergoing
radiation therapy to the chest. Which of the following indicates an adverse
effect of the therapy
A. Hair loss on the scalp
B. Sweating at the treatment site
C. Altered taste sensations
D. Intolerance to cold - CORRECT ANSWERS C Altered taste sensations
Altered taste is a result of the release of metabolites by dead cells
A nurse is preparing to administer a unit of packed RBCs to a client who has
anemia. Which of the following actions should the nurse plan to take (select
all that apply)
A. Obtain pre-transfusion temperature
B. Prime the IV tubing with lactated Ringer's
C. Instruct an assistive personnel to monitor the client during the
transfusion
, CAPSTONE ATI NCLEX MEDICAL SURGICAL ASSESSMENT 1
QUESTIONS AND CORRECT DETAILED ANSWERS LATEST
DOWNLOAD 2024/2025 BEST EXAM SOLUTION GRADED A+
FOR SUCCESS
D. Verify the client's blood type with a second nurse
E. Use a 20 gauge IV needle for venous access - CORRECT ANSWERS A, D, E
A, complete assessment prior to transfusion
D, verify identification, blood compatibility, and expiration of product with
second nurse
E, the nurse should use a large bore needle to transfuse the PRBCs to
reduce the risk of cell hemolysis and obstruction of flow
A nurse is reviewing the laboratory findings for a client who is dehydrated.
Which of the following BUN levels should the nurse expect
A. 3.6 mg/dl
B. 8 mg/dL
C. 18.7 mg/dL
D. 26 mg/dL - CORRECT ANSWERS D 26 mg/dL
Normal range is 10-20, and elevated levels indicates renal disease,
dehydration, shock, excessive protein in the diet, sepsis, glucocorticoid use,
GI bleeding, or other conditions in which blood is reabsorbed from injured
tissues
A nurse is reviewing ECG strips for several clients. Which of the following
images should the nurse identify as atrial fibrillation
(cannot insert pictures, read description)