ATI RN
Free Medical Surgical Certification Practice Questions Questions
Question 1 of 5
The nurse is caring for a post-op colostomy client. The client begins to cry saying, 'I'll never be attractive again with this ugly red thing.' What should be the first action by the nurse?
Correct Answer: D
Rationale: In this scenario, the correct answer is option D: Determine the client's understanding of her colostomy. This is the most appropriate initial action by the nurse because it addresses the client's emotional distress and allows the nurse to assess the client's knowledge and perception of the colostomy. By understanding the client's understanding, the nurse can provide education, support, and address any misconceptions or fears that the client may have. Option A (Arrange a consultation with a sex therapist) is incorrect as it does not address the immediate emotional needs of the client or the underlying issue of body image concerns related to the colostomy. Option B (Suggest sexual positions that hide the colostomy) is inappropriate as it focuses on superficial solutions rather than addressing the client's emotional distress. Option C (Invite the partner to participate in colostomy care) may be beneficial in the long run but does not address the client's immediate emotional needs or concerns. Educationally, this scenario highlights the importance of holistic care in nursing. It emphasizes the need for nurses to address not only the physical aspects of care but also the emotional and psychological well-being of their patients. By prioritizing communication, empathy, and patient education, nurses can provide comprehensive care that promotes healing and overall well-being.
Question 2 of 5
What principle of HIV disease should the nurse keep in mind when planning care for a newborn who was infected in utero?
Correct Answer: B
Rationale: In caring for a newborn infected with HIV in utero, the nurse must consider that option B) "The infant is very susceptible to infections" is correct. HIV compromises the immune system, making the infant highly vulnerable to infections. This susceptibility puts the infant at risk for severe complications and necessitates meticulous infection control measures and prompt treatment of any infections that may arise. Option A is incorrect because HIV does not necessarily have a longer incubation period or slower progression in infants. Option C is incorrect as HIV can impact growth and development due to its effects on the immune system. Option D is incorrect as renal monitoring is not the primary concern when caring for an HIV-infected newborn; infection prevention and immune support are the primary focuses. This educational context highlights the critical importance of understanding the unique needs of infants born with HIV and emphasizes the significance of providing appropriate care to ensure their well-being and quality of life.
Question 3 of 5
Clients with mitral stenosis would likely manifest findings associated with congestion in the:
Correct Answer: A
Rationale: In clients with mitral stenosis, the correct answer is A) Pulmonary circulation. Mitral stenosis is a condition where the mitral valve in the heart is narrowed, leading to impaired blood flow from the left atrium to the left ventricle. This results in increased pressure in the left atrium, which then backs up into the pulmonary circulation, causing congestion in the lungs. This congestion can lead to symptoms like dyspnea, orthopnea, and pulmonary edema. Option B) Descending aorta is incorrect because mitral stenosis primarily affects the left side of the heart and does not directly lead to congestion in the descending aorta. Option C) Superior vena cava is incorrect because mitral stenosis affects the left side of the heart, whereas the superior vena cava carries deoxygenated blood from the upper body to the right atrium. Option D) Bundle of His is incorrect because the bundle of His is part of the electrical conduction system of the heart and is not directly involved in the manifestation of congestion in mitral stenosis. Understanding the pathophysiology of mitral stenosis and its effects on cardiac hemodynamics is crucial for healthcare professionals in providing effective care for patients with this condition. Recognizing the signs and symptoms of congestion in the pulmonary circulation can aid in early detection and management of complications associated with mitral stenosis.
Question 4 of 5
The nurse is caring for a client 2 hours after a right lower lobectomy. During the evaluation of the water-seal chest drainage system, it is noted that the fluid level bubbles constantly in the water seal chamber. On inspection of the chest dressing and tubing, the nurse does not find any air leaks in the system. The next best action for the nurse is to:
Correct Answer: A
Rationale: The correct answer is A) Check for subcutaneous emphysema in the upper torso. After a lobectomy, continuous bubbling in the water seal chamber may indicate air leaking from the lungs into the subcutaneous tissues causing subcutaneous emphysema. This is a critical finding that requires immediate attention to prevent complications like tension pneumothorax. Option B) Reposition the client to a position of comfort is incorrect as the priority is to address the potential complication of subcutaneous emphysema. Option C) Calling the healthcare provider is important, but immediate assessment and intervention take precedence in this situation. Option D) Checking for an increase in thoracic drainage is not the most appropriate action as the primary concern is to assess for subcutaneous emphysema. In an educational context, understanding the importance of prompt assessment and intervention post-operatively is crucial for nurses caring for patients with chest tubes. Recognizing signs of complications and responding appropriately can prevent serious consequences for the patient. Regular education and practice scenarios can help nurses develop critical thinking skills in managing post-operative care effectively.
Question 5 of 5
Ramona Gunther, 18, was diagnosed with Stage II Hodgkins disease and is preparing to receive external radiation therapy. She tells the nurse she is scared 'about having to get radiation treatments all over my body.' Which of the following is the most appropriate response?
Correct Answer: B
Rationale: The dose of radiation is not based on the staging of the disease alone, and there is not enough information to know that the dose will be low. With Stage II, the involved lymph nodes are all on the same side of the diaphragm, so the radiation will be given on that part of the body. The potential of fractures occurs because of the cancer, but the radiation is not given for that reason. She has not stated that she's afraid of being radioactive, so this answer does not address her concern.