RN ATI Med Surg Exam
Total Questions : 52
Showing 25 questions, Sign in for moreA nurse is caring for an older adult client who has a fractured hip and will require rehabilitative care. The client's family asks the nurse for information about this type of care. Which of the following explanations should the nurse provide?
Explanation
A. Teaching the primary caregiver is a component of some rehabilitative care programs, but it's not the primary focus.
B. Emphasizing complete recovery aligns with the goals of rehabilitative care, which aims for maximal restoration of function.
C. Rehabilitative care often starts after the acute phase in the hospital, focusing on recovery and transition back to daily life.
D. While some rehabilitative care might happen in long-term care facilities, it's not exclusively centered there and can occur in various settings.
A nurse is caring for a client who has a prescription for balanced skeletal traction with a Thomas splint for the treatment of a fractured femur. Which of the following interventions should the nurse implement to prevent pressure points from developing around the edges of the splint?
Explanation
A. Removing the weights intermittently helps relieve pressure and prevents tissue damage around the edges of the splint.
B. Applying lotion might increase moisture, leading to skin breakdown, and it may not address the pressure issue.
C. Applying a foot plate might not directly alleviate pressure around the edges of the splint.
D. Repositioning helps with overall comfort and preventing pressure ulcers but may not specifically address the pressure points caused by the splint edges.
A nurse is caring for a client who is postoperative following an intermaxillary fixation as a result of multiple facial fractures. Which of the following types of equipment should the nurse plan to have at the client's bedside?
Explanation
A. An IV infusion pump might not be directly related to the needs of a client following intermaxillary fixation.
B. Wire cutters are essential in case of emergency airway obstruction or any other urgent situation necessitating the removal of the fixation wires.
C. An NG tube may not be specifically required for a client post intermaxillary fixation.
D. A urinary catheter tray may not be directly related to the immediate needs of a client following this procedure.
A nurse is teaching an older adult client who has osteoporosis about beginning a program of regular physical activity. Which of the following recommendations should the nurse make?
Explanation
A. Stretching exercises help improve flexibility and can assist in maintaining and enhancing range of motion without risking bone injury in osteoporosis.
B. High-impact aerobics might pose a risk of fractures in individuals with osteoporosis due to the excessive stress on bones.
C. Riding a bicycle might involve some impact and could potentially increase the risk of fractures.
D. Walking briskly is beneficial for cardiovascular health but might not focus on the bone- strengthening aspects needed for osteoporosis management.
A nurse is caring for a client who has a new short-leg cast on his lower leg to treat an ankle fracture. Which of the following findings requires immediate notification of the provider?
Explanation
A. Ecchymosis (bruising) of the distal foot might be expected after a fracture and casting; however, it doesn't typically indicate an immediate concern unless it's severe or worsening.
B. Some degree of dependent edema (swelling due to gravity) might be common after casting but isn't usually an immediate concern unless it's excessive or increasing rapidly.
C. Moderate pain can be managed initially and might not indicate an urgent situation unless it's severe or unmanageable.
D. Inability to flex the toes could indicate compartment syndrome or nerve damage, which requires immediate attention to prevent further complications like tissue damage or loss of function.
A nurse is caring for a client who has fractures of the symphysis pubis and pelvis. The nurse should monitor the client for which of the following findings of a common complication of pelvic fractures?
Explanation
A. Hematuria (blood in the urine) can occur due to damage to the urinary structures in pelvic fractures, indicating potential injury to the bladder or urethra.
B. Impaired taste, diarrhea, and increased thirst are not typically associated with complications of pelvic fractures and would not be primary concerns in this scenario.
C. Diarrhea, while it can occur due to stress or other factors, isn't typically associated with pelvic fractures.
D. Increased thirst is not a usual complication of pelvic fractures; it's more likely related to conditions like diabetes or dehydration.
A nurse is assessing a client following the application of a leg cast for the treatment of a fracture. If the cast is too tight, which of the following findings should the nurse expect to observe first?
Explanation
A. Inability to move toes might occur if the cast is too tight, but it's not typically the first sign observed.
B. Pallor (pale color) of the toes is an early sign of compromised blood circulation due to constriction from a tight cast.
C. Changes in temperature of the toes might occur later as circulation becomes more compromised.
D. Edema of the toes may occur eventually due to impaired circulation but might not be the first observable sign of a tight cast.
A nurse is assessing a client who has carpal tunnel syndrome. The nurse should expect which of the following findings?
Explanation
A. Cool extremities are not typically associated with carpal tunnel syndrome; it's more related to vascular issues or poor circulation.
B. Decreased radial pulse is not typically a finding in carpal tunnel syndrome; it's more related to arterial or vascular problems.
C. Positive Chvostek's sign indicates neuromuscular irritability due to hypocalcemia, not related to carpal tunnel syndrome.
D. Positive Phalen's sign, where numbness or tingling occurs when the wrist is flexed for 60 seconds, is characteristic of carpal tunnel syndrome due to median nerve compression in the wrist.
A nurse is caring for a client who has an acute ankle sprain. Which of the following actions should the nurse take? (Select all that apply.)
Explanation
A. Placing a compression bandage helps reduce swelling and provides support to the injured ankle.
B. Heat should generally be avoided in the acute phase of an injury as it can increase swelling.
C. Rest is crucial in the initial phase of an ankle sprain to allow healing and prevent further injury.
D. Elevating the ankle above heart level helps reduce swelling by promoting venous return.
E. Performing passive range-of-motion exercises in the acute phase of a sprain might further damage the injured tissues.
A nurse is caring for a client who has a cast in place for a fractured tibia. Which of the following nursing actions is the priority immediately after the provider has applied the cast?
Explanation
A. Performing range of motion might be necessary but isn't the priority immediately after the cast is applied.
B. Checking capillary refill distal to the cast is crucial to ensure adequate circulation and detect any potential circulation compromise.
C. Teaching about cast care is important but not the immediate priority once the cast is applied.
D. Managing pain is important, but ensuring adequate circulation and preventing complications related to circulation is the priority immediately after cast application
A nurse is caring for a client who is postoperative hip arthroplasty and has a new prescription for enoxaparin 1 mg/kg/dose subcutaneous every 12 hr. The client weighs 95 lbs. How many mg should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
Explanation
- To calculate the dose of enoxaparin, convert the client's weight from pounds to kilograms by dividing by 2.2.
- The client weighs 95 lbs / 2.2 = 43.18 kg.
- Multiply the client's weight in kilograms by the prescribed dose of 1 mg/kg to get the total dose in mg.
- The total dose is 43.18 kg x 1 mg/kg = 43.18 mg.
- Round the answer to the nearest tenth as instructed.
- The rounded answer is 43.2 mg.
- The nurse should administer 43.2 mg of enoxaparin per dose subcutaneously every 12 hr.
A nurse is caring for a client who has acute osteomyelitis. Which of the following interventions is the nurse's priority?
Explanation
A. While adequate nutrition is important for healing, the priority in acute osteomyelitis is initiating antibiotic therapy to address the infection.
B. Administering antibiotics promptly is crucial in treating osteomyelitis and preventing its spread or worsening.
C. Antipyretic therapy might be necessary if the client has a fever, but addressing the infection with antibiotics takes priority.
D. Pain management is important, but in acute osteomyelitis, addressing the infection with antibiotics is the priority.
A nurse is caring for a client who has a severe gangrenous infection of the right lower extremity. The nurse should plan preoperative teaching based on the possibility of which of the following amputation procedures?
Explanation
A. Preoperative teaching should be realistic and focus on managing pain expectations post- amputation. Gradual reduction in severe pain might be an achievable goal.
B. Telling the client the pain will disappear soon might set unrealistic expectations.
C. Saying the client will likely have only a tingling sensation might not address the potential for pain post-amputation adequately.
D. Phantom pain is a real sensation, not purely psychological, but addressing immediate post-amputation pain management takes precedence in preoperative teaching.
A nurse is preparing to administer naproxen 500 mg PO BID for a client who has osteoarthritis. The amount available is naproxen 125 mg/5 mL oral suspension. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Explanation
- To calculate the dose of naproxen oral suspension, use the formula: Dose (mL) = Desired (mg) / Available (mg) x Volume (mL)
- In this case, the desired dose is 500 mg and the available dose is 125 mg/5 mL
- Plug in the values and simplify: Dose (mL) = 500 / 125 x 5
- Dose (mL) = 20
- The nurse should administer 20 mL of naproxen oral suspension per dose
A nurse is preparing to administer indomethacin 75 mg PO bid. Available is indomethacin 25 mg/5mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Explanation
- To calculate the dose of indomethacin, use the formula: Dose (mL) = Ordered dose (mg) / Available dose (mg/mL) x 5 mL
- Substitute the values: Dose (mL) = 75 mg / 25 mg/5 mL x 5 mL
- Simplify and solve: Dose (mL) = 15 mL
- The nurse should administer 15 mL of indomethacin per dose.
A nurse is preparing to administer moxifloxacin 400 mg by intermittent IV bolus over 60 min. Available is moxifloxacin 400 mg in 250 mL dextrose 5% (DSW). The drop factor of the manual IV tubing is 15 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Explanation
- To calculate the infusion rate, use the formula: gtt/min = (volume x drop factor) / time
- Plug in the values from the question: gtt/min = (250 mL x 15 gtt/mL) / 60 min
- Simplify and solve: gtt/min = 62.5
- Round to the nearest whole number: gtt/min = 63
- The nurse should set the manual IV infusion to deliver 63 gtt/min
A nurse is preparing a client who is postoperative following a below-the-knee amputation for a leg prosthesis fitting. Which of the following actions should the nurse take?
Explanation
A. Removing and re-wrapping the stump daily might disrupt wound healing and proper shaping of the stump.
B. Securing the elastic bandage to the lowest joint might not provide optimal support or shaping for the prosthesis fitting.
C. Wrapping the stump in a figure-eight configuration with an elastic bandage helps in shaping and reducing swelling, aiding in proper prosthesis fitting.
D. Performing passive range-of-motion exercises might be important but not specifically related to preparing for a leg prosthesis fitting.
A nurse in the emergency department is caring for a client who has a compression fracture of a spinal vertebra. During transport to the facility, the client was medicated with intravenous morphine. On arrival, the neurosurgeon determined urgent surgical intervention is indicated for the fracture. Staff members have been unable to reach the client's family. Which of the following actions should the nurse anticipate the neurosurgeon taking?
Explanation
A. Delaying the surgery might not be feasible in cases of urgent surgical intervention.
B. Naloxone reversal might not be necessary if the client's level of consciousness and respiratory status are stable after the morphine administration.
C. In emergency situations where the client is incapacitated, implied consent may be invoked when urgent surgical intervention is required, and efforts to contact family have been unsuccessful.
D. Asking the client to sign a surgical consent form might not be possible if the client is incapacitated due to injury or medications.
A nurse at an urgent care center is caring for four clients who all have leg or foot injuries. Which of the following client reports should suggest to the nurse that the client has an ankle sprain?
Explanation
A. Being hit by another soccer player might cause various injuries but might not specifically suggest an ankle sprain.
B. Twisting the foot while running bases in baseball commonly results in ankle injuries like sprains.
C. Ankle pain after running a long distance might indicate overuse or strain but not necessarily a sprain.
D. Dropping a weight on the lower leg could cause various injuries but might not specifically indicate an ankle sprain.
A nurse is caring for a client who is in Buck's traction. Which of the following actions should the nurse take? (Select all that apply.)
Explanation
A. Positioning weights against the foot of the bed might not be a standard procedure in caring for a client in Buck's traction.
B. Examining the skin under the traction splint is important to assess for any skin breakdown or irritation.
C. Monitoring peripheral pulses in the affected extremity is crucial to ensure adequate circulation distal to the traction.
D. Assessing the temperature of the affected extremity is important to detect changes that might indicate circulatory compromise.
E. Adjusting the prescribed weights every shift might not be a nursing responsibility unless specifically instructed by the healthcare provider.
A nurse is preparing to administer indomethacin 75 mg PO bid. Available is indomethacin 25 mg/5mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Explanation
- To calculate the mL per dose, use the formula: mL = (mg x 5) / 25
- Plug in the given values: mL = (75 x 5) / 25
- Simplify the equation: mL = 15
- Round the answer to the nearest whole number: mL = 15
- The nurse should administer 15 mL of indomethacin per dose.
A nurse is assessing a client who reports numbness and pain in his right palm, index finger, and middle finger. The client reports working with a keyboard most of the time while at work. The nurse suspects carpal tunnel syndrome. Which of the following tests should the nurse request that the client perform?
Explanation
A. Holding the wrist at a 90-degree flexion for about a minute might reproduce symptoms associated with carpal tunnel syndrome, aiding in the diagnosis.
B. Extending the right arm upward isn't a specific test for carpal tunnel syndrome.
C. Flexing the right arm at the elbow might not specifically test for symptoms related to carpal tunnel syndrome.
D. Holding the right arm straight might not specifically test for symptoms associated with carpal tunnel syndrome.
A nurse is caring for a client who has a fractured tibia as a result of a fall. The client's x-ray shows that the bone is splintered into several pieces around the shaft. The nurse should identify that the client has which of the following types of fractures?
Explanation
A. Transverse fractures occur straight across the bone.
B. Oblique fractures occur at an angle across the bone.
C. Impacted fractures occur when the bone is crushed or driven into itself.
D. Comminuted fractures involve the bone being broken into several fragments or pieces.
A nurse is teaching a client who is scheduled for dual-energy x-ray absorptiometry (DXA) to screen for osteoporosis. Which of the following instructions should the nurse include in the teaching?
Explanation
A. Fasting is not necessary for a DXA scan.
B. Lying flat for an extended period after a DXA scan is not required.
C. Removing jewelry is important as metal objects might interfere with the imaging during the DXA scan.
D. Emptying the bladder before the test might enhance comfort during the procedure but is not directly related to the DXA scan process.
A nurse is assessing a client who has a puncture wound on his foot. Which of the following findings is a manifestation of acute osteomyelitis?
Explanation
A. Bradycardia is not typically associated with acute osteomyelitis.
B. Numbness of toes might suggest nerve involvement but is not a specific manifestation of acute osteomyelitis.
C. Localized erythema (redness) around the site of the puncture wound is a classic sign of inflammation and infection seen in acute osteomyelitis.
D. Hypothermia is not typically associated with acute osteomyelitis.
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