ATI RN
ATI Medsurg Proctored Final Exam Questions
Extract:
Question 1 of 5
A client reports skin dryness, redness, and scaling after radiation. What should the nurse advise?
Correct Answer: A
Rationale: The correct answer is A: Apply hydrating lotions. After radiation, skin can become dry and irritated. Hydrating lotions help to moisturize the skin and reduce dryness, redness, and scaling. They provide a protective barrier and promote skin healing. Advising the client to apply hydrating lotions is essential in maintaining skin integrity post-radiation.
Choice B: Scrubbing the area vigorously can further damage the skin and exacerbate irritation.
Choice C: Covering the area with adhesive bandages can trap moisture and lead to skin maceration.
Choice D: Avoiding moisturizing the skin can worsen dryness and discomfort.
Question 2 of 5
A nurse assesses a client in skeletal traction. What indicates infection at the pin sites?
Correct Answer: B
Rationale: The correct answer is B: Fever. Infection at the pin sites in skeletal traction commonly presents with systemic signs like fever. Fever is a typical response to infection as the body tries to fight off the invading pathogens. Pallor, bradycardia, and elevated blood pressure are not specific indicators of infection at pin sites. Pallor may indicate poor perfusion, bradycardia is a slow heart rate which is not typically associated with infection, and elevated blood pressure can be a response to various stressors but not a specific sign of infection at pin sites. In summary, fever is the most reliable indicator of infection at pin sites due to its systemic nature.
Question 3 of 5
A nurse is caring for a postoperative client. Which procedure places the client at highest risk for DVT?
Correct Answer: B
Rationale: The correct answer is B: Hip arthroplasty. This procedure involves prolonged immobility, causing blood stasis and increasing the risk of deep vein thrombosis (DVT). The reduced blood flow in the legs can lead to clot formation. Appendectomy (
A), cholecystectomy (
C), and tonsillectomy (
D) are not typically associated with prolonged immobility like hip arthroplasty, thus lower DVT risk.
Question 4 of 5
A nurse assesses a client 2 hours after TURP. What indicates a complication?
Correct Answer: B
Rationale: The correct answer is B: Burgundy-colored urine output. This indicates a complication post-TURP due to potential bleeding. Clear urine output (
A) is normal. Mild pain at the incision site (
C) is expected. Temperature of 98.6°F (
D) is within normal range.
Question 5 of 5
A nurse is assessing a client before a packed RBC transfusion. What data is most important to obtain?
Correct Answer: B
Rationale: The correct answer is B: Temperature. Before a packed RBC transfusion, it is crucial to assess the client's temperature as hyperthermia can indicate a possible transfusion reaction. Monitoring temperature helps in early detection and intervention. Blood pressure (
A) is important but not the most crucial in this context. Respiratory rate (
C) and oxygen saturation (
D) are relevant but may not indicate an immediate issue with the transfusion. Other choices are not provided.