ATI RN ADULT MEDICAL SURGICAL PROCTORED EXAM 2019 WITH NGN QUESTIONS

1. A nurse is assessing for compartment syndrome in a client who has a short leg cast. Which of the following findings should the nurse identify as a manifestation of this condition? A. Bounding pedal pulse B. Capillary refill less than 2 seconds C. Pain that increases with passive movement D. Areas of warmth on the cast - C. Pain that increases with passive movement 2. A nurse is providing teaching to a client who has a severe form of stage II Lyme disease. Which of the following statements made by the client reflects an understanding of the teaching? A. "I will need to take antibiotics for 1 year" B. "My partner will need to take an antiviral medication" C. "My joints ache because I have Lyme disease" D. "I will bruise easily because I have Lyme disease" - C. "My joints ache because I have Lyme disease" 3. A nurse is preparing to administer phenytoin 600 mg PO daily to a client. The amount available is oral solution 125 mg/5 mL. How many mL should the nurse administer? - 24 4. A nurse is caring for a client who has an arterial line. Which of the following actions should the nurse take? A. Flush the line before administering antibiotics B. Position the client in Trendelenburg to obtain measurements C. Have the client bear down when readings are obtained D. Place a pressure bag around the flush solution - D. Place a pressure bag around the flush solution 5. A nurse is updating the plan of care for a client who is receiving chemotherapy. Which of the following findings should the nurse identify as the priority? A. Report of sore throat B. Report of memory loss C. Alopecia D. Mucositis - A. Report of sore throat 6. A nurse is reviewing the medical record of a client who has systemic lupus erthematosus (SLE). Which of the following findings should the nurse expect? A. Facial butterfly rash B. Bradycardia C. Esophagitis D. Interstitial fibrosis - A. Facial butterfly rash 7. A nurse is planning care for a client who is postoperative following a parathyroidectomy. Which of the following actions should the nurse identify as the priority? A. Use pillows to support the client's head and neck B. Offer opioid medication C. Place a tracheostomy tray at the bedside D. Place the client in semi-Fowler's position - C. Place a tracheostomy tray at the bedside 8. A nurse is assessing a client who has diabetes insipidus. Which of the following findings should the nurse expect? A. Low urine specific gravity B. Hypertension C. Bounding peripheral pulses D. Hyperglycemia - A. Low urine specific gravity 9. A nurse is providing teaching to a client who has stage II cervical cancer and is scheduled for brachytherapy. Which of the following instructions should the nurse include? A. "You will have an implant placed twice each month for the duration of the treatment" B. "You should remain at least 6 feet away from others between treatments" C. "You should expect to have blood in your urine for a few days after treatment" D. "You will need to stay still in the bed during each treatment session" - D. "You will need to stay still in the bed during each treatment session" 10. A nurse is planning care for a client who is scheduled for a thoracentesis. Which of the following interventions should the nurse include in the plan? A. Encourage the client to take deep breaths after the procedure B. Assist the client to hold their arms up during the procedure C. Instruct the client to remain NPO after midnight prior to the procedure D. Keep the client on bedrest for 8 hr following the procedure - A. Encourage the client to take deep breaths after the procedure 11. A nurse is caring for a client who is receiving a blood transfusion. The client becomes restless, dyspneic, and has crackles noted to the lung bases. Which of the following actions should the nurse anticipate taking? A. Administer an antihistamine B. Slow the infusion rate C. Give the client a corticosteriod D. Elevate the client's lower extremities - B. Slow the infusion rate 12. A nurse is providing teaching to a client who has end-stage kidney disease and is waiting for a kidney transplant. Which of the following information should the nurse provide? A. Kidney donation must come from a living donor B. Immunosuppressive therapy is necessary until the donated kidney begins producing urine C. Hemodialysis is sometimes required following surgery D. Kidney transplant recipients can resume their regular diet following surgery - C. Hemodialysis is sometimes required following surgery 13. A nurse is caring for a client who has hypothyroidism. Which of the following manifestations should the nurse expect? A. Constipation B. Insomnia C. Tachycardia D. Diaphoresis - A. Constipation 14. A nurse is providing preoperative teaching for a client who is scheduled for a mastectomy. Which of the following statements should the nurse make? A. "You should accept your body image change before discharge" B. "It is important for you to look at the incisional site when the dressings are removed" C. "I will refer you to community resources that can provide support" D. "The scar will remain red and raised for many years after surgery" - C. "I will refer you to community resources that can provide support" 15. A nurse is caring for a client who had a nephrostomy tube inserted 12 hr ago. Which of the following findings should the nurse report to the provider? A. The client's urinary output has increased B. The client reports back pain C. The client's urine color is red tinged D. The client's BUN is 18 mg/dL - B. The client reports back pain 16. A nurse is teaching a family about the care of a patient who has a new diagnosis of Alzheimer's disease. Which of the following information should the nurse include in the teaching? A. Position tabletop clocks with multi-colored backgrounds throughout the home B. Explain how to complete a task while having the client do the task C. Place a calendar on the wall with days and weeks included D. Create complete outfits and allow the client to select one each day - D. Create complete outfits and allow the client to select one each day 17. A nurse is caring for a client who has breast cancer and tells the nurse that they would like to have acupunture because it provides greater relief than pain medication. Which of the following statements should the nurse make? A. "Acupuncture is not an approved treatment for cancer pain" B. "I can speak to the provider about incorporating acupuncture into your treatment plan" C. "I will ask the provider to prescribe a stronger medication to help ease your pain" D. "I can contact a family member or spiritual advisor for you to speak with" - B. "I can speak to the provider about incorporating acupuncture into your treatment plan" 18. A nurse is caring for a client following extubation of an edotracheal tube 10 min ago. Which of the following findings should the nurse report to the provider immediately? A. Stridor B. Oral secretions C. Hoarseness D. Sore throat - A. Stridor 19. A nurse is reviewing the laboratory findings of a client who developed chest pain 6 hr ago. The nurse should identify which of the following findings as an indication of a myocardial infarction (MI)? A. Creatine kinase (CK-MB) 85 mg/dL B. High-density lipoprotein (HDL) 65 mg/dL C. Alanine aminotransferase (ALT) 28 units/L D. Troponin I 8 ng/mL - D. Troponin I 8 ng/mL 20. A nurse is preparing to administer a blood transfusion to a client who has anemia. Which of the following actions should the nurse take first? A. Obtain the client's vital signs B. Describe the blood transfusion procedure to the client C. Check for the type and number of units of blood to administer D. Initiate a peripheral IV line - C. Check for the type and number of units of blood to administer 21. A nurse is reviewing the laboratory results of a client who has aplastic anemia. Which of the following findings indicates a potential complication? A. RBC count 5.2 million/mm^3 B. WBC count 2,000/mm^3 C. Platelets 380,000/mm^3 D. Potassium 4 mEq/L - B. WBC count 2,000/mm^3 22. A nurse is providing discharge teaching to a client who is postoperative following a modified radical mastectomy. Which of the following instructions should the nurse include? A. Flex the affected arm when ambulating B. Numbness can occur along the inside of the affected arm C. Begin active range-of-motion exercises 1 day after surgery D. Dress in clothing that fits snugly - B. Numbness can occur along the inside of the affected arm 23. A nurse is preparing to present a program about prevention of atherosclerosis at a health far. Which of the following recommendations should the nurse plan to include? (Select all that apply.) A. Follow a smoking cessation program B. Maintain an appropriate weight C. Eat a low-fat diet D. Increase fluid intake E. Decrease intake of complex carbohydrates - A, B, C 24. A nurse is caring for a client who has homonymous hemianopsia as a result of a stroke. To reduce the risk of falls when ambulating, the nurse should provide which of the following instructions to the client? A. "Wear an eye patch over one eye" B. "Make sure to have a staff member walk on your stronger side" C. "Scan the environment by turning your head from side to side" D. "Make sure to look at your feet while walking" - C. "Scan the environment by turning your head from side to side" 25. A nurse is caring for a client who has a pneumothorax and a closed-chest drainage system. Which of the following findings is an indication of lung reexpansion? A. The chest tube is draining serosanguineous fluid at 65 mL/hr B. The client tolerates gentle milking of the tubing C. Bubbling in the water seal chamber has ceased D. There is tidaling in the water seal chamber - C. Bubbling in the water seal chamber has ceased 26. A nurse is providing discharge teaching to a client who is to self-administer heparin subcutaneously. Which of the following statements by the client indicates an understanding of the teaching? A. "I can expect to have blood in my urine during the first week of injections" B. "I will floss my teeth after each meal" C. "I will gently massage the site after I inject my medication" D. "I will use an electric razor to shave" - D. "I will use an electric razor to shave" 27. A nurse is providing follow-up care for a client who is sustained a compound fracture 3 weeks ago. The nurse should recognize that an unexpected finding for which of the following laboratory values is a manifestation of osteomyelitis and should be reported to the provider? A. Sedimentation rate B. Hematocrit C. Calcium D. Acid phosphatase - A. Sedimentation rate 28. A nurse is performing a preoperative assessment for a client. The nurse should identify that an allergy to which of the following foods can indicate a latex allergy? A. Shellfish B. Peanuts C. Avocados D. Eggs - C. Avocados 29. A nurse is caring for a client who has DKA. Which of the following findings should indicate to the nurse that the client's condition is improving? A. Potassium 3.5 mEq/L B. pH 7.28 C. Glucose 272 mg/dL D. HCO3 14 mEq/L - C. Glucose 272 mg/dL 30. A nurse is caring for a client who has diabetic ketoacidosis (DKA). Which of the following should the nurse plan to administer? A. 240 mL (8oz) of orange juice B. 1 ampule of 50% dextrose IV bolus C. NPH insulin 60 units subcutaneous D. Regular insulin 20 units IV bolus - D. Regular insulin 20 units IV bolus 31. A nurse is evaluating the plan of care for four clients after 2 days of hospitalization. The nurse should identify the need to revise the plan for which of the following clients? A. A client who is taking potassium supplements, has a potassium level of 3.2 mEq/L and reports constipation B. A client who has Alzeimer's Disease (AD), has a room near the nurse's station, and is agitated C. A client who is postoperative following abdominal surgery and reports feeling that something "popped" when they coughed D. A client who has a conductive hearing loss, speaks softly, and is scheduled for a cerumen removal - C. A client who is postoperative following abdominal surgery and reports feeling that something "popped" when they coughed 32. A nurse is providing teaching to a client who has a new prescription for psyllium. Which of the following information should the nurse include in the teaching? A. Drink 240 mL (8 oz) of water after administration B. Expect results in 4 to 6 hr C. Take this medication before meals to increase appetite D. Reduce dietary fiber intake to improve medication absorption - A. Drink 240 mL (8 oz) of water after administration 33. A nurse is providing discharge instructions to a client who has laryngeal cancer and is receiving radiation therapy. Which of the following statements by the client indicates an understanding of the teaching? A. "I will wear a badge to measure how much radiation I am receiving" B. "I will remove the markings on my skin after each radiation treatment" C. "I will avoid direct exposure to the sun" D. "I will rinse my mouth with a commercial mouthwash" - C. "I will avoid direct exposure to the sun" 34. A nurse is admitting a client who has active tuberculosis. Which of the following types of transmission precautions should the nurse initiate? A. Airborne B. Droplet C. Contact D. Protective environment - A. Airborne 35. A nurse is reviewing the medical record of a client who has osteomyelitis and a prescription for gentamicin. Which of the following findings from the client's medical record should indicate to the nurse the need to withhold the medication and notify the provider? A. WBC count B. Temperature C. Blood pressure D. Serum creatinine - D. Serum creatinine 36. A nurse is providing teaching to a client who is perimenopausal and has a prescription for hormone replacement therapy. For which of the following adverse effects should the nurse instruct the client to notify the provider? (Select all that apply.) A. Night sweats B. Calf pain C. Vaginal dryness D. Numbness in the arms E. Intense headache - B, D, E 37. A nurse is planning discharge teaching for a client who has an external fixation device for a fracture of the lower extremity. Which of the following instructions should the nurse include in the plan of care? A. Secure the straps firmly around the boot B. Remove the device before showering C. Use crutches with rubber tips D. Adjust the screws to maintain alignment - C. Use crutches with rubber tips 38. A nurse is teaching a group of newly licensed nurses about pain management for older adult clients. Which of the following statements by a newly licensed nurse indicates an understanding of the teaching?