ATI ADULT MEDICAL SURGICAL Exam Test Questions And Answers

ATI ADULT MEDICAL SURGICAL Exam Test Questions And Answers A nurse is preparing to administer propranolol to several clients. For which of the following clients, should the nurse clarify the prescription with the provider before administration? A) A client who had a myocardial infarction 24 hr ago B) A client who has a heart rate of 98/min C) A client who has hypertension D) A client who has a history of asthma - ANSWER D)A client who has a history of asthma. Propranolol is a nonselective beta-adrenergic blocker. Contraindications include asthma, COPD, and heart failure because the blockade of beta2 receptors in the lungs can cause bronchoconstriction. A nurse is analyzing the ABG results of a client who is in respiratory acidosis. Which of the following mechanisms should the nurse identify as responsible for this acid-base imbalance? A)Breakdown of fatty acids B)Retention of carbon dioxide C)Hyperventilation in response to hypoxia D)Ingestion of large amounts of bicarbonate - ANSWER B)Retention of carbon dioxide Respiratory acidosis results from the retention of carbon dioxide. Retention of carbon dioxide can result from respiratory depression, inadequate chest expansion, airway obstruction, or decreased alveolar-capillary diffusion. A nurse is planning care for a client who has tuberculosis. Which of the following precautions should the nurse implement for this client? A)Contact precautions B)Protective environment precautions C)Droplet precautions D)Airborne precautions - ANSWER D)Airborne precautions Tuberculosis, like measles, chickenpox, and varicella zoster, spreads by airborne transmission of micro-organisms that suspend in the air for prolonged periods. The nurse should implement airborne precautions by placing the client in a negative-pressure airflow room and wearing an N95 respirator mask. A nurse is caring for a client who is 3 hr postoperative and exhibiting signs of hypovolemia. Which of the following findings should the nurse identify as a manifestation of hypovolemia? A)Distended neck veins B)Rapid pulse rate C)Urine output 45 mL/hr D)Decreased respiratory rate - ANSWER B)Rapid pulse rate A client who has hypovolemia has a rapid, weak pulse rate to compensate for the decrease in blood volume in an attempt to increase blood pressure. A nurse is caring for a client who has a prescription for lactated Ringer's by continuous IV infusion to replace output from an NG tube. Which of the following findings should indicate to the nurse that this therapy is effective? A)Decreased NG tube drainage B)Serum osmolality 350 mOsm/L C)Urine specific gravity 1.020 D)Increased hematocrit - ANSWER C)Urine specific gravity 1.020 The concentration of the urine regulated by hydration is measured by the weight of the particles in the urine. A urine specific gravity within the expected reference range of 1.005 to 1.030 indicates that fluid replacement is keeping up with fluid loss from gastric drainage. A nurse in an emergency department is caring for a client who is confused, has a temperature of 40C (104 F), a BP of 74/52 mm Hg, and a diagnosis of exertional heatstroke. Which of the following actions should the nurse take first? A)Measure the client's urine-specific gravity. B)Administer oxygen using a high-concentration mask. C)Initiate gastric lavage with ice water. D)Immerse the client in cold water. - ANSWER B)Administer oxygen using a highconcentration mask The first action the nurse should take when using the airway, breathing, and circulation approach to client care is to ensure that the client has a patent airway and administer oxygen using a high-concentration mask to promote oxygen perfusion to vital organs. A nurse is caring for a client who has chronic venous insufficiency. Which of the following areas should the nurse assess for the presence of a venous ulcer? (You will find hot spots to select in the artwork below. Select only the hot spot that corresponds to your ANSWER.) A)ANKLE - ANSWER A is correct. The nurse should assess the medial malleolus (ankle) of a client who has chronic venous insufficiency for the presence of a venous ulcer. The ankle is the most common area for a venous ulcer. A client who has venous insufficiency can exhibit skin discoloration and edema as well as a large or superficial ulcer with irregular borders at the site of the medial or lateral malleolus that weeps exudate. A pulse is palpable in this area and the client typically experiences a moderate level of pain at the site. A nurse is providing teaching to a client about strategies to manage menopausal symptoms. Which of the following instructions should the nurse include in the teaching? A)"Drink green tea to relieve menopausal hot flashes." B)"Take vitamin D supplements to relieve menopausal hot flashes." C)"Use water-based lubricant during intercourse to reduce discomfort." D)"Apply estrogen cream during intercourse to reduce discomfort." - ANSWER C)"Use water-based lubricant during intercourse to reduce discomfort." The nurse should instruct the client to use water-based lubricants to help relieve vaginal dryness and irritation during sexual intercourse. Atrophic vaginitis is a common manifestation of menopause. A nurse is teaching a client about self-management of their halo fixator device. Which of the following information should the nurse include in the teaching? A)Give each screw a quarter turn daily using the wrench provided. B)Apply powder liberally under the chest portion of the halo fixator device. C)Avoid the use of straws when drinking liquids. D)Place a small pillow under the head while lying supine. - ANSWER D)Place a small pillow under the head while lying supine. The halo fixator device is worn for a period of 8 to 12 weeks and immobilizes the cervical spine, preventing flexion and hyperextension of the neck. The use of a small pillow under the head provides support to the head and neck, preventing additional discomfort and pressure from the device. A home health nurse is inspecting a client's residence for electrical hazards as part of the agency's quality improvement plan. Which of the following findings should the nurse identify as a safety hazard? A)The client's bed has a three-prong plug attached to the electrical cord. B)A protective cover is inserted into an unused outlet. C)An IV pump is plugged into an outlet near a sink. D)An electrical cord is coiled and secured to the floor. - ANSWER C)An IV pump is plugged into an outlet near a sink. The nurse should plug all electrical appliances into outlets away from wet areas. Water conducts electricity and places the client at risk for electrocution. A nurse is providing teaching to a group of clients about the prevention of coronary artery disease. Which of the following information should the nurse include in the teaching? A)Walk 30 min daily at a comfortable pace. B)Limit saturated fat intake to 10% of total daily calories. C)Maintain a BMI of 30.