During a physical assessment, the nurse examines the lymph nodes of a patient. Which assessment finding would be of most concern to the nurse?

Questions 43

ATI RN

ATI RN Test Bank

ATI Perfusion Quizlet Questions

Question 1 of 9

During a physical assessment, the nurse examines the lymph nodes of a patient. Which assessment finding would be of most concern to the nurse?

Correct Answer: A

Rationale: The correct answer is A. A 2-cm nontender supraclavicular node is of most concern because enlarged and nontender nodes in this area are highly suggestive of malignancies such as lymphoma. Choice B is less concerning as a 1-cm mobile and nontender axillary node is usually benign. Choice C, an inability to palpate any superficial lymph nodes, could be due to factors like obesity or edema, but it is not necessarily a cause for immediate concern. Choice D, firm inguinal nodes in a patient with an infected foot, may indicate a local reaction to infection rather than a systemic issue related to malignancy.

Question 2 of 9

A patient who had a total hip replacement had an intraoperative hemorrhage 14 hours ago. Which laboratory test result would the nurse expect?

Correct Answer: C

Rationale: The correct answer is C: Elevated reticulocyte count. Hemorrhage leads to the release of reticulocytes (immature red blood cells) from the bone marrow into circulation as a compensatory mechanism to replenish lost red blood cells. This response helps in restoring the oxygen-carrying capacity of the blood. Choices A and B, hematocrit of 46% and hemoglobin of 13.8 g/dL, may not reflect the immediate response to hemorrhage within 14 hours. Choice D, decreased white blood cell (WBC) count, is not directly related to the body's response to hemorrhage.

Question 3 of 9

The health care provider orders a liver and spleen scan for a patient who has been in a motor vehicle crash. Which action should the nurse take before this procedure?

Correct Answer: D

Rationale: Before a liver and spleen scan, it is essential to assist the patient to a flat position. This position helps obtain clear images of the liver and spleen. Checking for iodine allergy (Choice A) is more relevant for procedures involving contrast dye, not a liver and spleen scan. Inserting a large-bore IV catheter (Choice B) may not be necessary for this specific procedure. Administering sedatives (Choice C) is not typically required for a liver and spleen scan, as the patient needs to remain still during the procedure.

Question 4 of 9

A patient with pancytopenia of unknown origin is scheduled for the following diagnostic tests. The nurse will provide a consent form to sign for which test?

Correct Answer: A

Rationale: In the case of a patient with pancytopenia of unknown origin, a bone marrow biopsy is usually indicated to determine the cause. A bone marrow biopsy is a minor surgical procedure that requires the patient or guardian to sign a surgical consent form. Abdominal ultrasound (Choice B) is not typically used to diagnose pancytopenia. A Complete Blood Count (CBC) (Choice C) is a routine blood test and does not require a specific consent form. Activated Partial Thromboplastin Time (aPTT) (Choice D) is a coagulation test and not typically performed to diagnose pancytopenia.

Question 5 of 9

The nurse assesses a patient with pernicious anemia. Which assessment finding would the nurse expect?

Correct Answer: C

Rationale: The correct answer is C: Numbness of the extremities. Numbness of the extremities is a common finding in patients with pernicious anemia, which is caused by cobalamin (vitamin B12) deficiency. This deficiency affects the peripheral nervous system, leading to neurological symptoms like numbness and tingling in the extremities. Choices A, B, and D are incorrect: Yellow-tinged sclerae is more indicative of jaundice or liver dysfunction, a shiny smooth tongue is seen in conditions like glossitis, and gum bleeding and tenderness are associated with periodontal disease or vitamin C deficiency, not pernicious anemia.

Question 6 of 9

The nurse reviews the laboratory test results of a patient admitted with abdominal pain. Which information will be most important for the nurse to communicate to the health care provider?

Correct Answer: A

Rationale: The correct answer is A. A low percentage of monocytes can indicate a viral infection. This is crucial information to communicate as it suggests a specific type of infection that may require targeted treatment. Choices B, C, and D do not directly relate to an infectious process and are within normal ranges, so they are not as urgent to communicate to the healthcare provider in this context.

Question 7 of 9

Which assessment finding should the nurse caring for a patient with thrombocytopenia communicate immediately to the healthcare provider?

Correct Answer: B

Rationale: The correct answer is B. Difficulty in arousing the patient may indicate a cerebral hemorrhage, which is life-threatening and requires immediate action. While a low platelet count (choice A) is concerning in thrombocytopenia, it does not require immediate communication unless accompanied by active bleeding or other critical symptoms. Purpura on the oral mucosa (choice C) and large bruises on the patient's back (choice D) are important findings in thrombocytopenia but do not indicate an immediate life-threatening situation like a possible cerebral hemorrhage.

Question 8 of 9

After a patient with pancytopenia undergoes a bone marrow aspiration from the left posterior iliac crest, which action would be important for the nurse to take?

Correct Answer: B

Rationale: After a bone marrow aspiration, it is important to have the patient lie on the left side for 30 to 60 minutes to decrease the risk of bleeding. Elevating the head of the bed to 45 degrees does not directly address the risk of bleeding. Applying a sterile 2-inch gauze dressing to the site is important for wound care but does not specifically address post-procedural positioning. Using a half-inch sterile gauze to pack the wound is not necessary after a bone marrow aspiration.

Question 9 of 9

Which patient should the nurse assign as the roommate for a patient who has aplastic anemia?

Correct Answer: A

Rationale: The correct answer is A because patients with aplastic anemia are at risk for infection due to low white blood cell production. Assigning a roommate with viral pneumonia (choice B), cellulitis (choice C), or multiple abdominal drains (choice D) could expose the patient with aplastic anemia to potential infectious agents, which could further compromise their health.

Access More Questions!

ATI RN Basic


$89/ 30 days

ATI RN Premium


$150/ 90 days