ATI RN
ATI RN Adult Medical Surgical 2023 Questions Correct Answers Questions
Extract:
Question 1 of 5
A nurse is caring for a client who has a new diagnosis of type 2 diabetes mellitus and has a referral for dietary consult. The client tells the nurse, 'I will have to eat whatever the dietitian tells me.' Which of the following statements by the nurse encourages the client's involvement in their plan of care?
Correct Answer: C
Rationale: The correct answer is C because it encourages the client's involvement in their plan of care by actively engaging them in the decision-making process. By offering to assist the client in making a list of foods they like for the dietitian, the nurse is promoting client autonomy and empowerment. This approach helps the client feel more in control of their dietary choices and encourages collaboration between the client, nurse, and dietitian.
Choice A is incorrect as it does not actively involve the client in decision-making.
Choice B acknowledges the client's feelings but does not directly engage them in the process.
Choice D focuses on the client's responsibilities but does not promote active participation.
Question 2 of 5
A nurse is planning care for a client who is 12 hr postoperative following a kidney transplant. Which of the following actions should the nurse include in the plan of care?
Correct Answer: B
Rationale: The correct answer is B: Assess urine output hourly. This is important postoperatively to monitor kidney function and ensure adequate perfusion. Hourly assessment allows for early detection of any changes in urine output, which can indicate complications such as acute kidney injury. Checking blood pressure every 8 hours (
Choice
A) may be necessary but is less critical in the immediate postoperative period. Administering opioids PO (
Choice
C) can mask changes in the client's condition and should be avoided until kidney function is stable. Monitoring for hypokalemia (
Choice
D) is important but not the priority in the immediate postoperative period.
Question 3 of 5
A nurse is caring for a client who has acute heart failure and received morphine IV 30 min ago. Which of the following findings should the nurse identify as an indication that the medication was effective?
Correct Answer: A
Rationale: The correct answer is A: Decreased anxiety. Morphine is often used to relieve pain and anxiety in patients with acute heart failure. The nurse should expect a reduction in anxiety as a positive response to the medication. Emesis (choice
B) is not a typical indication of morphine effectiveness. Increased respiratory rate (choice
C) may indicate respiratory depression, a potential adverse effect of morphine. Decreased urinary output (choice
D) could suggest decreased cardiac output, which is not necessarily a sign of morphine effectiveness in this case.
Question 4 of 5
A nurse is monitoring an older adult client who has an exacerbation of chronic lymphocytic leukemi The nurse notes petechiae on the client's skin. Which of the following actions should the nurse take?
Correct Answer: C
Rationale: The correct answer is C: Institute bleeding precautions. Petechiae are tiny red or purple spots on the skin caused by bleeding under the skin. In chronic lymphocytic leukemia, the client's platelet count may be low, leading to an increased risk of bleeding. By instituting bleeding precautions, the nurse can help prevent injuries that could result in further bleeding. Determining the client's blood type (
A) is not necessary in this situation. Avoiding IV pain medication (
B) is not directly related to managing petechiae. Implementing airborne precautions (
D) is not relevant to the client's presentation with petechiae.
Question 5 of 5
A nurse is caring for a client who has emphysema. Which of the following interventions should the nurse include in the client's plan of care?
Correct Answer: D
Rationale: The correct answer is D. Teaching the client a breathing exercise with a longer inhalation phase helps improve lung capacity and strengthen respiratory muscles, which are essential for clients with emphysema. This intervention can help the client breathe more effectively and reduce shortness of breath. Option A is incorrect because limiting fluid intake is not a standard intervention for emphysema. Option B is incorrect as administering oxygen is not specific to improving lung function. Option C is incorrect as incentive spirometry is more effective if done for longer durations.