ATI RN
ATI n200 Med Surg Exam Questions
Extract:
Question 1 of 5
A client describes low back pain that radiates down one leg. Which factors that aggravate the pain increase the likelihood that this client has a herniated disc? (SELECT ALL THAT APPLY)
Correct Answer: B,C,D
Rationale: Dancing, although it can involve movement and stress on the body, is not as directly associated with aggravating a herniated disc compared to the other listed factors. Sneezing and coughing can increase intra-abdominal pressure and aggravate a herniated disc by putting more stress on the affected area of the spine. Lifting a heavy box from a high position requires bending and twisting, which can exacerbate a herniated disc. Prolonged standing or sitting can increase pressure on the spine, especially in the lower back, and aggravate symptoms of a herniated disc. Lying down generally relieves pressure on the spine and is less likely to aggravate a herniated disc.
Question 2 of 5
A patient is prescribed alendronate at 0800 for the treatment of osteoporosis. As the nurse you know you must administer this medication:
Correct Answer: C
Rationale: The patient should not lie down after taking alendronate, as it increases the risk of esophageal irritation. Alendronate should be taken on an empty stomach, and while dairy products should generally be avoided when taking certain medications, this specific instruction applies more to calcium or iron supplements. Alendronate should be taken on an empty stomach, ideally first thing in the morning, with a full glass of water to enhance absorption. The patient must remain upright for 30 minutes to prevent esophageal irritation and reduce the risk of esophageal ulcers. The medication should not be taken with milk or juice, as they can interfere with absorption.
Question 3 of 5
A client is admitted at 0700 with severe dehydration. The doctor orders D5W to run at 150 ml/hr. The client is ordered an IVPB antibiotic every 4 hours, that will be administered in 50 ml of IV fluid over 1 hour. The antibiotic is scheduled to start at 0800. The client is permitted liquids and takes the following: 4 oz gelatin 10 oz apple juice 500 ml of water 16 oz of ice chips which is consumed by the end of the shift Urine output is as follows: At 0900: 100 mL 1100: 250 mL 1330: 290 mL 1445: 250 ml At 1200, the client had 300 mL of a diarrhea stool. Calculate the cumulative fluid balance for the 0700-1500 shift.
Correct Answer: 1270 mL
Rationale: Intake: IV Fluids: D5W: 150 ml/hr from 0700 to 1500 (8 hours) = 150 ml/hr * 8 hr = 1200 ml. Antibiotic: 50 ml every 4 hours, starting at 0800. So, it will be administered at 0800 and 1200 = 50 ml * 2 = 100 ml. Oral Intake: Gelatin: 4 oz = 4 * 30 ml = 120 ml. Apple Juice: 10 oz = 10 * 30 ml = 300 ml. Water: 500 ml. Ice Chips: 16 oz (since ice chips are half liquid) = 16 * 30 ml / 2 = 240 ml.
Total Intake: 1200 ml (D5W) + 100 ml (Antibiotic) + 120 ml (Gelatin) + 300 ml (Apple Juice) + 500 ml (Water) + 240 ml (Ice Chips) = 2460 ml. Output: Urine Output: 0900: 100 ml, 1100: 250 ml, 1330: 290 ml, 1445: 250 ml. Diarrhea Stool: 1200: 300 ml.
Total Output: 100 ml + 250 ml + 290 ml + 250 ml + 300 ml = 1190 ml. Cumulative Fluid Balance: Intake - Output: 2460 ml - 1190 ml = 1270 ml. So, the cumulative fluid balance for the 0700-1500 shift is +1270 ml.
Question 4 of 5
A client diagnosed with cervical spine degeneration has undergone a laminectomy. Which intervention should the nurse implement?
Correct Answer: D
Rationale: Measuring drainage from the Jackson-Pratt drain is important, but this is not the primary intervention to address post-laminectomy complications. The patient should generally be positioned in a neutral, stable position, but not specifically prone with knees elevated, which may be uncomfortable or inappropriate for the cervical region. Narcotics may be required for pain control, especially postoperatively, so advising the patient to avoid them is inappropriate. Following a cervical spine laminectomy, the nurse should assess the client for any signs of nerve or spinal cord injury, such as difficulty speaking or breathing. These symptoms may indicate spinal cord compression or other complications.
Question 5 of 5
A client with osteoarthritis of the left knee will undergo an injection of corticosteroids into the joint. The nurse notes that the primary reason for this injection is to:
Correct Answer: B
Rationale: While corticosteroids can reduce inflammation and pain, they do not directly target edema. The primary purpose of corticosteroid injections into a joint affected by osteoarthritis is to reduce inflammation and pain, providing relief from the symptoms. Corticosteroids do not prevent ankylosis (joint stiffness), which may occur with long-term osteoarthritis. Corticosteroids do not repair cartilage but can help alleviate symptoms related to cartilage degradation.