ATI RN
ATI n200 Med Surg Exam Questions
Extract:
Question 1 of 5
A client with osteoarthritis of the left knee will undergo an injection of corticosteroids into the joint. The nurse notes that the primary reason for this injection is to:
Correct Answer: B
Rationale: While corticosteroids can reduce inflammation and pain, they do not directly target edema. The primary purpose of corticosteroid injections into a joint affected by osteoarthritis is to reduce inflammation and pain, providing relief from the symptoms. Corticosteroids do not prevent ankylosis (joint stiffness), which may occur with long-term osteoarthritis. Corticosteroids do not repair cartilage but can help alleviate symptoms related to cartilage degradation.
Question 2 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 3 of 5
A client with traumatic injuries has a comminuted open fracture of the femur that has been placed in an external fixator. The nurse recognizes that compartment syndrome is associated with which clinical assessment finding?
Correct Answer: D
Rationale: Scratching around pin sites is more indicative of skin irritation or infection, not compartment syndrome. Accumulation of flaky skin is generally unrelated to compartment syndrome and might be a sign of poor circulation or prolonged immobility. Dry serosanguineous drainage is common after surgery and would not specifically indicate compartment syndrome. Compartment syndrome is a serious condition where increased pressure within a muscle compartment can lead to ischemia and tissue damage. Pain, particularly pain that is out of proportion to the injury or pain when the limb is at rest, is a classic sign.
Question 4 of 5
A physical therapist is helping nursing students to understand the correct use of ambulatory devices. The students realize that the correct statement(s) made is/are: (SELECT ALL THAT APPLY)
Correct Answer: B,C,D
Rationale: The cane should be held on the stronger side to support the weaker side. Rubber caps prevent the cane from slipping, enhancing safety. Moving the walker first provides stability before the client steps into it. Adequate upper body strength is necessary to use a standard walker effectively. Body weight should be supported on the hands, not the axillae, to avoid nerve damage.
Question 5 of 5
A client has been treated for low back pain which radiates down the posterior right leg. The client now has a new onset of urinary and bowel incontinence and weakness in both lower extremities. What is the nurse's first action?
Correct Answer: D
Rationale: Obtaining a walker does not address the acute neurological symptoms. Applying a diaper addresses the incontinence but not the underlying cause. Inserting a Foley catheter manages urinary incontinence but delays necessary evaluation. Notifying the physician is critical as these symptoms suggest cauda equina syndrome, a surgical emergency.