ATI RN
ATI Medical Surgical Proctored Exam Questions
Question 1 of 5
Total parenteral nutrition(TPN), is one of the home therapies being used for Chelsea Mann, 35, with acute ulcerative colitis causing massive diarrhea. She and her family will need instruction about:
Correct Answer: A
Rationale: Prevention of infection, and potential septicemia, is of prime importance for someone with a central catheter. Mixing TPN is a very specialized procedure, and should be done under laminar airflow by a pharmacist. IV pumps are machines that do malfunction, but the safest thing to do would be to get the manufacturer to do the repair. Having neighbors be a support to Chelsea and her family may not be possible. More information would be necessary prior to choosing this as an option for a nursing diagnosis.
Question 2 of 5
A client had a hemicolectomy performed two days ago. Today, the nurse assessed the incision and discovered a small part of the abdominal viscera protruding through the incision. This complication of wound healing is known as:
Correct Answer: D
Rationale: Excoriation is an abrasion of the epidermis, or of any organ coating of the body, caused by trauma, chemicals, burns, or other causes. Dehiscence is a partial to complete separation of the wound edges with no abdominal tissue protrusion. Decortication is removal of the surface layer of an organ or structure, such as removing the fibrinous peel from the visceral pleura in thoracic surgery. Evisceration occurs when the incision separates and the contents of the cavity spill out.
Question 3 of 5
A 72-year-old male client had the Foley catheter removed today, which was inserted during the transurethral resection of the prostate (TURP). The client is concerned about the urinary incontinence he has experienced since removal of the Foley catheter. The nurse should explain to the client that:
Correct Answer: B
Rationale: The correct answer is B: urinary incontinence is usually temporary. This response is accurate because after the removal of a Foley catheter following a TURP procedure, it is common for patients to experience temporary urinary incontinence due to the bladder needing time to regain its normal function. This explanation reassures the client that his current experience is a normal part of the recovery process and is likely to improve over time with proper management and support. Option A: he should not be concerned, because it will be quickly resolved. This option is incorrect because it may provide false reassurance and not address the client's concerns adequately. It is essential to acknowledge the client's worries and provide accurate information to empower him during his recovery. Option C: he should notify the nurse when this happens. While it is important for the client to communicate any changes or concerns with the healthcare team, this option does not provide the client with the necessary information about the expected course of urinary incontinence post-Foley catheter removal. Option D: this is related to the bladder spasms and will soon stop. This option is incorrect as it provides a specific cause for the incontinence without acknowledging the broader context of post-TURP recovery, which involves multiple factors contributing to urinary symptoms beyond just bladder spasms. In an educational context, it is crucial for nurses to provide accurate and comprehensive information to patients regarding common postoperative experiences like urinary incontinence. By explaining the temporary nature of this symptom, nurses can help alleviate patient anxiety, promote understanding of the recovery process, and enhance overall patient satisfaction and compliance with care plans.
Question 4 of 5
A 54-year-old client has cholelithiasis and is admitted for an elective cholecystectomy. The client is 5 feet 3 inches tall, weighs 205 pounds, and has smoked one pack of cigarettes per day for 35 years. The client will be NPO at midnight. When the client's spouse asks why the client cannot have breakfast the morning before surgery, the nurse should explain:
Correct Answer: B
Rationale: The client's size has nothing to do with an NPO status. Clients are at greatest risk for aspiration and vomiting during surgery when food and/or liquids are in the stomach. Preparation on the morning of surgery is time consuming, but it does not affect a client's NPO status. The gallbladder lies under the surface of the liver and is a part of the biliary tract, not the intestinal tract. Cholecystectomy does not involve the intestinal tract or its contents.
Question 5 of 5
A client is scheduled for a cholecystectomy in the morning. In planning the postoperative care, the priority nursing diagnosis for the client will be at high-risk for:
Correct Answer: D
Rationale: The client may have a knowledge deficit, but reducing the risk for knowledge deficit is not a postoperative priority nursing diagnosis. The client will have a Foley catheter for a day or two after the surgery. Urinary retention is usually not a problem once the Foley catheter is removed. A client having a cholecystectomy should not be physically impaired. The client is encouraged to begin ambulating soon after surgery. Because of the location of the incision, the cholecystectomy client is reluctant to breath deeply and is at risk for developing pneumonia. These clients have to be reminded and encouraged to take deep breaths.