ATI RN
ATI Advanced Med Surg Exam 4 Questions
Question 1 of 5
A nurse is caring for an older adult client who has a WBC count of 2,000/mm3 after three rounds of chemotherapy. Which of the following actions should the nurse take?
Correct Answer: C
Rationale: Serving cooked fruit with meals can help minimize the risk of foodborne illnesses, which is critical for a client with a low WBC count due to chemotherapy-induced immunosuppression.
Extract:
Nurses Notes
1730: Report received from PACU:
Indwelling urinary catheter draining 850 mL dark red urine with clots, taped to left thigh, taut, no kinks. Continuous bladder irrigation with sterile water running.
22 g peripheral IV to left forearm: lactated Ringer's 125 mL/hr continuous infusion via pump.
Surgical incision to suprapubic area covered with gauze dressing with minimal amount of sanguineous drainage.
Post Op Day 1
0800:
Indwelling urinary catheter draining pink urine with small clots, attached to securement device on thigh, drainage bag attached to bed Catheter tube without kinks and patent, 150 mL in last 8hr.
Pain level 7 on 0 to 10 scale. Receiving morphine via PCA per pain management.
Scrotal and penile is edematous along with decreased urinary output Ecchymosis to skin surrounding surgical incision, moderate amount of serous drainage, cleansed with wound cleanser, patted dry, covered with 4X4 gauze dressing
Reports feeling bloated. Bowel sounds hypoactive. Last bowel movement day before surgery.
Vital Signs
Post Op Day 0
1730
Temperature: 37.3°C (99.2°F) oral
Heart rate: 72/min
Respiratory rate: 16/min.
Blood pressure: 116/68 mm Hg
Sa02: 98 % on room air
Post Op Day 1
0800
Temperature: 36.7°C (98.1°F) oral
Heart rate: 84/min
Respiratory rate: 20/min
Blood pressure: 148/76 mm Hg
Sa02-98% on room air
Question 2 of 5
A nurse is caring for a client who has had an open radical prostatectomy. For each potential provider's prescription, click to specify if the potential prescription is anticipated, nonessential, or contraindicated for the client.
| Options | Anticipated | Nonessential | Contraindicated |
|---|---|---|---|
| Administer a docusate sodium suppository. | |||
| Apply ice to the scrotum and penis. | |||
| Administer an antispasmodic medication. | |||
| Place the client in the sitting position while in bed. | |||
| Teach the client how to use a leg bag. |
Correct Answer: A,B,C,E
Rationale: A: Docusate sodium prevents constipation, common post-surgery. B: Ice reduces scrotal/penile edema. C: Antispasmodics manage catheter-related spasms. D: Sitting may not be necessary and could cause discomfort. E: Leg bag education is essential for catheter management.
Extract:
Physical Examination
January:
Weight 70.5 kg (155 lb)
BMI 24
February:
Weight 69 kg (152 lb)
BMI 23
Diagnostic Results
January:
Complete Blood Count:
RBC count 4.2 (4.2 to 5.4)
WBC count 5,500/mm3 (5,000 to 10,000/mm3)
Hgb 12 g/dl (12 g/dL to 16 g/dL)
Het 37% (37% to 47%)
Platelet count: 150,000/mm2 (150,000 to 400,000/mm
February:
Complete Blood Count
WBC count: 4,500/mm2 (5,000 to 10.000/mm3)
RBC count 4 (4.2 to 5.4)
Hgb: 14 g/dL (15 g/dl to 16 g/dl
Het 36 (376 to 4796)
Platelet count: 140,000/mm(150.000 to 400,000/mm3)
Nurses' Notes
January:
Client reports fatigue and nausea following chemotherapy treatments. States, "It just makes me not want to eat. When I do eat, the food taste funny."
Client teaching: Instructed client to attempt to eat small meals several times daily, to eat food cold or at room temperature, to avoid fried foods. Encourage client to rest before eating meals.
Oral mucosa is inflamed.
Client teaching: Instructed client to avoid mouthwashes that contain alcohol, to increase water intake to 2 or more liters daily, and to avoid hot foods.
Reviewed laboratory findings and stressed the need to protect self from illness due to immunosuppression.
Client teaching: Instructed client to not eat raw or undercooked meat, to drink only pasteurized milk, and to boil water before drinking it take temperature daily and report fever, avoid crowds, wash hands frequently with antimicrobial soap.
Reviewed laboratory findings and stressed need for bleeding precautions. Client states, "I’ve had bleeding from these ulcers in my mouth.”
Client teaching Use an electric razor take a stool softener if constipation occurs, avoid coarse-textured foods.
February
Client has experienced weight loss of 1.5 kg (3 B), has experienced decrease in hct and high, WBC and platelet count.
Client reports still not able to consume much food has increased intake
of water. Oral mucosa with less inflammation.
Client reports no bleeding episodes.
Question 3 of 5
A nurse is caring for a client who has cancer and is undergoing chemotherapy. Which of the following assessments indicates an improvement in the client's condition? (Select all that apply.)
Correct Answer: A,C,D
Rationale: A: A decrease in WBC count may indicate reduced chemotherapy-induced immunosuppression. C: Absence of bleeding episodes suggests improved mucosal integrity. D: Reduced oral inflammation indicates effective interventions. E: Weight loss does not indicate improvement.
Extract:
Question 4 of 5
The nurse teaches patients about drug therapy after a kidney transplant. Which statement by the patient would indicate a need for further instructions?
Correct Answer: A
Rationale: The statement about stopping Tacrolimus is incorrect as it is typically required lifelong to prevent organ rejection.
Question 5 of 5
A nurse is caring for a client who has heart failure and a prescription for digoxin 125 mcg PO daily. Available is digoxin PO 0.25 mg/tablet. How many tablets 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.)
Correct Answer: 0.5
Rationale: 125 mcg = 0.125 mg. Available is 0.25 mg/tablet. 0.125 ÷ 0.25 = 0.5 tablets.