ATI Nursing 137 Exam 3 Fall 2023

Extract:

Question 1 of 5

A client reports pain in the left wrist after falling while playing basketball. After assessing the wrist,which of the following assessment finding would make the nurse suspect a fracture?

A. Dull throbbing pain that increases with rest.B. Dull ache.C. Sharp pain that increases with movement.D. Deep pain in the wrist.

Correct Answer: C

Rationale: Sharp pain that worsens with movement is a common fracture sign due to bone movement, unlike dull pain or aches which suggest strain or other issues.

Question 2 of 5

The nurse tests the function of Cranial Nerve XI while performing a physical examination on a client. Which statement best describes the response the nurse should expect if Cranial Nerve XI is intact?

A. When the client sticks out the tongue it is in the midline and without tremors or deviation.B. Client follows an object with eyes without nystagmus or strabismus.C. Client demonstrates the ability to hear normal conversation.D. Client moves the head and shoulders against resistance with equal strength.

Correct Answer: D

Rationale: CN XI (accessory) controls head and shoulder movement against resistance.
Tongue, eye, and hearing tests assess other nerves.

Question 3 of 5

The nurse has completed a peripheral vascular assessment on a client. Which of the following would the nurse document as expected findings?

A. Capillary refill <5 seconds.B. Radial pulses 2+ with regular rate and rhythm bilaterally.C. Feet pale and cool to the touch.D. Right ankle 1+ edema with no perceptible swelling of the leg.

Correct Answer: B

Rationale: Radial pulses 2+ bilaterally indicate normal circulation. Capillary refill <5 seconds is normal but typically <2-3 seconds; pale feet or edema suggest issues.

Question 4 of 5

The nurse is percussing a client's abdomen during a physical assessment. The nurse observes an area of dullness above the right costal margin of approximately 11 cm. Which of the following actions should the nurse take?

A. Recognizes this dullness as indicative of an enlarged liver and refers the client to a providerB. Document the presence of hepatomegalyC. Ask additional health history questions regarding alcohol intakeD. Recognizes this finding as normal and proceed with the examination

Correct Answer: A

Rationale: Dullness over 11 cm suggests liver enlargement (normal ~6-12 cm but context matters), warranting referral. Documentation or history alone delays evaluation.

Question 5 of 5

The nurse is performing an assessment and finds that the client has a non-tarry and black stool. Which of the following subjective data should the nurse document as normal findings consistent with non-tarry black stool?

A. Client reports taking an iron supplementB. Client has dry heavesC. The client reports eating red meat prior to the assessmentD. Client reports loss of appetite

Correct Answer: C

Rationale: Consuming red meat can cause black stools due to its breakdown products, a normal finding. Iron supplements darken stools differently, while dry heaves and appetite loss are unrelated.

ATI Nursing 137 Exam 3 Fall 2023 | Nurselytic

Nurselytic

ATI RN

ATI RN