ATI LPN
Medical Surgical ATI Proctored Exam Questions
Question 1 of 5
After undergoing rigid fixation for a mandibular fracture from a fight, what area of care should the nurse prioritize for discharge education for this client?
Correct Answer: C
Rationale: The correct answer is C because promoting adequate nutrition is crucial for optimal healing of mandibular fractures. Malnutrition can delay recovery and impair bone healing. The nurse should prioritize educating the client on ways to maintain a balanced diet, such as consuming foods rich in protein, vitamins, and minerals. A: Resumption of activities of daily living is important, but nutrition is more critical for healing. B: Pain control is essential, but ensuring proper nutrition is a higher priority for optimal recovery. D: Strategies for promoting adequate nutrition is redundant and less specific compared to the correct answer.
Question 2 of 5
A client returns to the unit after a neck dissection. The surgeon placed a Jackson-Pratt drain in the wound. When assessing the wound drainage over the first 24 postoperative hours, what finding would prompt the nurse to notify the health care provider immediately?
Correct Answer: B
Rationale: The correct answer is B: 60 mL of milky or cloudy drainage. This finding could indicate the presence of an infection, which is a serious complication post-neck dissection. Milky or cloudy drainage may contain pus, indicating the need for immediate intervention to prevent further complications. A: Presence of small blood clots in the drainage is relatively common and may not necessarily indicate a problem unless there are large clots or excessive bleeding. C: Spots of drainage on the dressings surrounding the drain are expected and do not necessarily warrant immediate notification unless there is excessive leakage. D: 120 mL of serosanguinous drainage is within the expected range for the first 24 hours postoperatively and may not be a cause for immediate concern unless there are other symptoms present.
Question 3 of 5
When working with a client who has chronic constipation, what should be included in client teaching to promote normal bowel function?
Correct Answer: C
Rationale: The correct answer is C: Consume high-residue, high-fiber foods. High-fiber foods promote regular bowel movements by adding bulk to the stool, making it easier to pass. Fiber also helps in maintaining bowel health and preventing constipation. Glycerin suppositories (A) should not be used regularly as they can lead to dependence. Limiting physical activity (B) is not recommended as exercise can aid in promoting bowel peristalsis. Resisting the urge to defecate (D) can worsen constipation and lead to complications. In summary, promoting high-fiber diet is the most effective way to help manage chronic constipation.
Question 4 of 5
A client admitted with acute diverticulitis has experienced a sudden increase in temperature and reports a sudden onset of exquisite abdominal tenderness. The nurse's rapid assessment reveals that the client's abdomen is uncharacteristically rigid on palpation. What is the nurse's best response?
Correct Answer: B
Rationale: The correct answer is B: Contact the primary care provider promptly and report these signs of perforation. Rationale: 1. Sudden increase in temperature, sudden onset of exquisite abdominal tenderness, and uncharacteristically rigid abdomen are signs of perforation in diverticulitis. 2. Promptly contacting the primary care provider allows for immediate evaluation and intervention. 3. Perforation is a serious complication that requires urgent medical attention to prevent further complications like sepsis. Summary of other choices: A: Administering a Fleet enema is not appropriate and can worsen the condition of a perforated diverticulum. C: Inserting an NG tube is not indicated for a perforated diverticulum and may exacerbate the situation. D: Reporting the client may be obstructed is not accurate based on the signs presented and does not address the urgency of perforation.
Question 5 of 5
When planning care for a 16-year-old with appendicitis presenting with right lower quadrant pain, what should the nurse prioritize as a nursing diagnosis?
Correct Answer: B
Rationale: The correct answer is B: Risk for infection related to possible rupture of the appendix. This is the priority nursing diagnosis because appendicitis can lead to a life-threatening condition if the appendix ruptures. The nurse needs to monitor for signs of worsening infection such as fever and increased pain. A: Imbalanced nutrition is not the priority as it is secondary to the risk of infection. C: Constipation is not the priority as it is not directly related to the life-threatening complication of appendicitis. D: Chronic pain is also not the priority as the risk of infection and potential rupture take precedence in the care of the patient.