ATI RN
ATI n200 Med Surg Exam Questions
Extract:
Question 1 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 2 of 5
A nurse is teaching a client about avoiding a gout attack. In evaluating the client's recall of a low purine diet, which dietary choice would indicate to the nurse that the client needs more teaching?
Correct Answer: C
Rationale: Fried chicken is not considered a high-purine food, though fried foods should be eaten in moderation for general health. Baked chicken with broccoli and baked potato is a low-purine meal, suitable for managing gout. Anchovies are high in purines, which can increase uric acid levels and trigger a gout attack. A low-purine diet should avoid foods high in purines, including organ meats, Treasured meat, shellfish, and certain fish like anchovies. Turkey burger with coleslaw and baked chips is also appropriate for a low-purine diet, as turkey is a lean meat and doesn't significantly elevate uric acid levels.
Question 3 of 5
A client is admitted with a dislocation of the right shoulder. The nurse knows this is an orthopedic emergency and that the priority for treatment will be:
Correct Answer: A
Rationale: The priority in treating a dislocated joint is to realign the dislocated bones to their proper position, which is crucial to prevent damage to the surrounding nerves, blood vessels, and muscles. This should be done promptly under medical supervision, often requiring sedation or pain management. Teaching the client to avoid contact sports is important for long-term care, but not an immediate priority in the acute phase. Applying a sling helps support the joint, but it is not the first priority; realignment of theJ
Question 4 of 5
The nurse is assessing clients for their risk of developing Scleroderma. Which of these clients should the nurse consider at lowest risk?
Correct Answer: B
Rationale: Lupus is associated with a higher risk of autoimmune conditions, including Scleroderma. A male working as a teacher is less likely to have occupational or genetic predispositions for Scleroderma. Chemical exposure can increase the risk of developing Scleroderma. A family history of Scleroderma raises the genetic risk of developing the condition.
Question 5 of 5
A client develops an inflamed, very painful right great toe overnight and the physician diagnoses gout. Treatment with colchicine is begun at 0.6 mg PO every two hours. For which side effect of this drug should the nurse assess?
Correct Answer: B
Rationale: Cold, pale feet are not a typical side effect of colchicine. Diarrhea is a well-known side effect of colchicine, commonly used to treat acute gout flares. The nurse should monitor for gastrointestinal symptoms. Menorrhagia (heavy menstrual bleeding) is not associated with colchicine. Rash is not a common side effect of colchicine but can occur. The nurse should primarily monitor for gastrointestinal symptoms like diarrhea.