ATI RN
ATI Custom Medical Surgical Nurse Exam 2 Questions
Question 1 of 5
A nurse in an urgent care center is caring for a client who fell and injured her ankle. The ankle appears swollen and ecchymotic. Which of the following interventions should the nurse take? (Select all that apply)
Correct Answer: A,D,E
Rationale: Applying a compression bandage reduces swelling and supports the injured area. Elevating the foot promotes venous return to decrease swelling. Checking toes for color, temperature, and sensation assesses for nerve or vascular damage. Heat can increase swelling and inflammation, and encouraging range of motion may worsen the injury.
Question 2 of 5
While collecting data from a client who has a cast on his right leg, a nurse locates an area on the cast that feels warm to the touch. Which of the following findings should the nurse identify as a complication to the client's condition?
Correct Answer: B
Rationale: A warm area on the cast suggests an underlying infection due to increased blood flow as the body fights the infection. Uneven cast drying, pressure, or poor circulation do not typically cause warmth.
Question 3 of 5
A nurse is collecting data from a client who has rheumatoid arthritis. Which of the following is an expected finding for this client?
Correct Answer: B
Rationale: Boutonniere deformity is a characteristic hand deformity in rheumatoid arthritis, involving a bent middle finger joint and hyperextended fingertip.
Tophi are associated with gout, osteoma with benign bone tumors, and Heberden's nodules with osteoarthritis.
Question 4 of 5
A nurse is receiving a transfer report for a client who has a head injury. The client has a Glasgow Coma Scale (GCS) score of 3 for eye-opening, 5 for best verbal response, and 5 for best motor response. Which of the following is an appropriate conclusion based on this data?
Correct Answer: D
Rationale: A GCS score of 3 for eye-opening indicates the client opens their eyes in response to voice, making option D correct. The client is not unconscious, can make vocal sounds (verbal score of 5), and may not follow commands (motor score of 5 indicates localizing pain).
Question 5 of 5
A nurse is assisting a client who is postoperative following a total hip arthroplasty into a supine position. Which of the following actions is appropriate to prevent hip dislocation?
Correct Answer: C
Rationale: A wedge pillow between the legs maintains proper alignment and prevents leg crossing or adduction, reducing the risk of hip dislocation. Trochanter rolls prevent external rotation, sandbags prevent foot drop, and footboards prevent plantar flexion contractures, none of which directly prevent dislocation.