ATI RN
ATI Med Surg Exam 9 Questions
Extract:
Question 1 of 5
A client receiving parenteral nutrition by central venous access reports feeling unwell. The nurse assesses the client and suspects that the central line has become infected. Which of the following findings indicate that the client has developed a systemic infection? Select all that apply.
Correct Answer: B,E,F
Rationale: Purulent drainage at intravenous insertion site is a finding of a local infection that can spread systemically, indicating bacterial invasion and inflammation (
Choice
B). Leukocytosis indicates increased white blood cell production in response to a systemic infection, detectable by blood test (
Choice E). Fever is a systemic infection sign due to immune system activation and pyrogen release, measurable by thermometer (
Choice F). Edema may indicate fluid overload or impaired venous return, not specifically systemic infection (
Choice
A). Redness at the insertion site suggests local inflammation, not necessarily systemic spread (
Choice
C). Nausea is a non-specific symptom possibly related to parenteral nutrition side effects or other conditions, not a direct indicator of systemic infection (
Choice
D).
Question 2 of 5
A nurse is caring for a client who is experiencing a seizure. Which of the following actions should the nurse take? (Select all that apply)
Correct Answer: D,E
Rationale: Loosening restrictive clothing improves breathing and circulation, and placing a pillow under the head prevents injury. Placing the client supine risks aspiration, restraints can cause injury, and inserting a bite stick can damage teeth or obstruct the airway.
Question 3 of 5
Which of the following is a feature of complex partial seizures?
Correct Answer: C
Rationale: Having involuntary facial movements, such as lipsmacking, is a feature of complex partial seizures. Complex partial seizures often originate from the temporal lobe and can cause automatisms like chewing, swallowing, or picking. Fixed and dilated eyes are associated with brain death or severe brain injury, not complex partial seizures. Involuntary groaning sounds are more typical of simple partial seizures, which do not impair awareness or cause automatisms.
Question 4 of 5
A client diagnosed with contact dermatitis is receiving education from the nurse. Which of the following therapies will the nurse recommend to the client?
Correct Answer: D
Rationale: Avoidance is the best therapy for contact dermatitis as it involves identifying and eliminating exposure to the allergen or irritant, allowing the skin to heal and preventing further reactions.
Question 5 of 5
A client diagnosed with Barrett's esophagus asks how he developed this. Which of the following responses by the nurse is most accurate?
Correct Answer: B
Rationale: This is the correct answer because gastroesophageal reflux disorder (GER
D) is the most common risk factor for developing Barrett's esophagus. GERD causes stomach acid to flow back into the esophagus, leading to inflammation and cellular changes over time, resulting in Barrett's esophagus.