Questions 44

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ATI RN Test Bank

ATI Custom Medical Surgical Nurse Exam 2 Questions

Extract:


Question 1 of 5

A client who has a lower-leg cast reports skin irritation around the upper edge of the cast. Which of the following actions should the nurse take?

Correct Answer: B

Rationale: Petaling the cast edges with adhesive strips smooths them, preventing skin irritation. Scratching, lotion, or bivalving are inappropriate for this issue.

Question 2 of 5

A nurse is assisting with the plan of care for an older adult client who is 4 hr postoperative following an open reduction and internal fixation of a fractured femur. Which of the following interventions should the nurse include in the plan of care?

Correct Answer: B

Rationale: Checking capillary refill every 4 hours monitors blood flow to the extremity, ensuring adequate circulation post-surgery. Other options are not standard or necessary.

Question 3 of 5

A nurse is reinforcing teaching with a client who has an ankle sprain. Which of the following instructions should the nurse include?

Correct Answer: C

Rationale: Elevating the ankle to heart level reduces swelling per the RICE method. Tight compression, weight-bearing, and heat in the first 24 hours can worsen the injury.

Question 4 of 5

A nurse is collecting data from a client who is 6 days post craniotomy for removal of an intracerebral aneurysm. The nurse should monitor the client for which of the following manifestations of increased intracranial pressure?

Correct Answer: D

Rationale: Hypertension can indicate increased intracranial pressure post-craniotomy. Edema, diarrhea, and decreased pulses are not typical manifestations.

Question 5 of 5

A nurse is assisting with caring for a client who has a new concussion following a motor-vehicle crash. The nurse should monitor the client for which of the following manifestations of increased intracranial pressure?

Correct Answer: D

Rationale: Lethargy indicates increased intracranial pressure, a serious complication of concussion. Nuchal rigidity, Battle’s sign, and polyuria are not typical signs of increased ICP.

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