ATI CAPSTONE MEDICAL SURGICAL ASSESSMENT ALL 100 QUESTIONS AND CORRECT FULLY EXPLAINED SOLUTIONS

ATI CAPSTONE MEDICAL SURGICAL ASSESSMENT 1 & 2 ALL10
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0 QUESTIONS AND CORRECT FULLY EXPLAINED SOLUTIONS
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AND RATIONALES| THE NEWEST 2024 EDITION!!
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Capstone ATI NCLEX Medical Surgical Assessment 1 r r r r r r




A nurse is teaching a client how to administer a medication using an inhaler with aspacer
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. Which of the following instructions should the nurse include
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A. "Wait at least 5 minutes between puffs from the same inhaler"
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B. "Breathe in rapidly when inhaling the medication" r r r r r r



C. "Clean the plastic inhaler cap weekly with cold water"
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D. "Shake the inhaler vigorously prior to use" - ANSWER-r r r r r r r r


D .) "Shake the inhalervigorously prior to use"
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Thoroughly shake the inhaler to disperse the medication because the medication inthe in
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haler can separate easily
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A nurse is planning care for a client who is receiving mechanical ventilation.Wh
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ich of the following actions should the nurse include in the plan
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A. Provide the client with a means of communication r r r r r r r


B. Maintain the head of the client's bed in a flat position r r r r r r r r r r


C. Suction the client's endotracheal tube every 4 hr r r r r r r r



D. Perform oral hygiene for the client every 8 hr - ANSWER- r r r r r r r r r r


A.) Provide the clientwith a means of communication
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Use electronic tablet computer, programmable speech generating device, alphabetboar
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d, pencil and paper, etc
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A nurse is caring for a client who is receiving IV fluid replacement therapy for dehyd
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ration. Which of the following laboratory results indicates effectiveness ofthe treat
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ment

,A. Sodium 165 mEq/L r r


B. Potassium 5.2 mEq/L r r


C. Urine specific gravity 1.020 r r r


D. Hct 62% - ANSWER- r r r



C Urine specific gravity 1.020Within the expected range
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of 1.005-1.030
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A nurse is monitoring the laboratory findings for a client who is postoperative followin
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g a total hip arthroplasty 6 hr ago. Which of the following values indicatesthat the client
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has an increased risk for bleeding
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A. PT 11.5 seconds r r


B. aPTT 35 seconds r r


C. Platelets 80,000 r


D. RBC 4.0 million - ANSWER- r r r r


C Platelets 80,000platelet range is 150,000-400,000
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A nurse is admitting a client who has a cervical spinal cord injury following a motor
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vehicle crash. Which of the following interventions is the nurse's prioritywhile cari
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ng for this client
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A. Change the client's position every 2 hours r r r r r r



B. Pad pressure points at the edges of the client's cervical collar
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C. Palpate the client's abdomen for bladder distention r r r r r r


D. Assist the client with quad coughing - ANSWER- r r r r r r r


D Assist the client with quadcoughing
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The greatest risk to a client who has a cervical spinal cord injury is an obstructed airway;
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the priority is to ensure the client can clear their airway. Apply abdominalpressure as the
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client coughs (quad coughing)r r r




A nurse is caring for a client who is receiving a blood transfusion. Which of the follo
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wing findings indicates that the client is experiencing transfusion-
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associatedcirculatory overload r r




A. Nasuea

,B. Hypothermia
C. Dyspnea
D. Bradycardia - ANSWER-C Dyspnea r r r


Dyspnea is an indication of possible transfusion associated circulatory overload,lea
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ding to hypertension, bounding pulses, and confusion. Dyspnea can also indicate tr
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ansfusion related acute lung injury to an anaphylactic response, whichalso causes w
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heezing, chest tightness, cyanosis, and low BPr r r r r r




A nurse is assessing a client who has lung cancer and is undergoing radiationther
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apy to the chest. Which of the following indicates an adverse effect of thetherapy
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A. Hair loss on the scalp r r r r


B. Sweating at the treatment site r r r r


C. Altered taste sensations r r


D. Intolerance to cold - ANSWER- r r r r


C Altered taste sensations Altered taste is a result of the release of me
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tabolites by dead cells r r r




A nurse is preparing to administer a unit of packed RBCs to a client who has anemia. W
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hich of the following actions should the nurse plan to take (select all thatapply)
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A. Obtain pre-transfusion temperature r r


B. Prime the IV tubing with lactated Ringer's r r r r r r



C. Instruct an assistive personnel to monitor the client during the transfusion
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D. Verify the client's blood type with a second nurse r r r r r r r r


E. Use a 20 gauge IV needle for venous access - ANSWER-
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A, D, EA, complete assessment prior to transfusion
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D, verify identification, blood compatibility, and expiration of product with secondnur
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se

E, the nurse should use a large bore needle to transfuse the PRBCs to reduce therisk of
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cell hemolysis and obstruction of flow
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, A nurse is reviewing the laboratory findings for a client who is dehydrated. Whichof the
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following BUN levels should the nurse expect
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A. 3.6 mg/dl r


B. 8 mg/dL r



C. 18.7 mg/dL r


D. 26 mg/dL - ANSWER-D 26 mg/dL r r r r r




Normal range is 10- r r r


20, and elevated levels indicates renal disease, dehydration,shock, excessive protei
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n in the diet, sepsis, glucocorticoid use, GI bleeding, or other conditions in which bl
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ood is reabsorbed from injured tissues
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A nurse is reviewing ECG strips for several clients. Which of the following imagesshoul
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d the nurse identify as atrial fibrillation
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(cannot insert pictures, read description) r r r r




A. multiple irregular and variable waves at the baseline and irregular R to Rinte
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rvals

B. a rate of 140-180/min
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C. a tachycardia with no identifiable P wave and is determined to originateso
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mewhere other than the ventricles. Rate between 100-280/min r r r r r r r




D. a P wave for every QRS, rate is 60-100/min - ANSWER-
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A.) multiple irregularand variable waves at the baseline and irregular R to R intervals
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A nurse is preparing to admit a client who has a new tracheostomy from the operating ro
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om. Which of the following items is the priority for the nurse to haveavailable in the clie
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nt's room upon admission
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A. Obturator