ATI RN
RN ATI Adult Medsurg Proctored Exam 2023 With NGN Questions
Extract:
Question 1 of 5
A home health nurse is assisting a client with planning care for a family member who has Alzheimers disease. Which of the following instructions should the nurse include?
Correct Answer: A
Rationale: The correct answer is A: Review the daily schedule with the client every morning. This instruction is important for individuals with Alzheimer's disease as it helps provide structure and routine, which can help reduce confusion and anxiety. By reviewing the daily schedule, the client can be prepared for the day's activities, promoting a sense of familiarity and independence.
Option B is incorrect because limiting fluid intake can lead to dehydration and other health issues. Option C is incorrect as individuals with Alzheimer's disease may struggle with complex tasks and may become frustrated. Option D is incorrect because social interactions are important for mental stimulation and emotional well-being, restricting them can lead to increased confusion and isolation.
Question 2 of 5
A nurse is caring for a client who has developed acute respiratory distress syndrome (ARDS). Which of the following findings should the nurse identify as a manifestation of this syndrome?
Correct Answer: B
Rationale:
Correct
Answer: B - Refractory hypoxemia.
Rationale: ARDS is characterized by severe hypoxemia that persists despite high levels of oxygen therapy, known as refractory hypoxemia. This occurs due to ventilation-perfusion mismatch and impaired gas exchange in the alveoli. The other choices are not typical manifestations of ARDS:
A: Bronchoconstriction is more commonly seen in asthma or COPD.
C: Pulmonary hypertension may develop as a complication of ARDS but is not a direct manifestation.
D: Pleural effusion may occur in ARDS but is not a defining characteristic.
Question 3 of 5
An emergency room nurse is assessing a client who has asthma and difficulty breathing. Which of the following findings should indicate to the nurse that the client is experiencing status asthmaticus?
Correct Answer: B
Rationale: The correct answer is B: Use of accessory muscles. In status asthmaticus, a severe and life-threatening asthma exacerbation, the client's airways are severely constricted, leading to inadequate air exchange. The use of accessory muscles (such as intercostal and supraclavicular muscles) indicates significant respiratory distress as the body tries to compensate for the difficulty in breathing. Mild wheezing (choice
A) may be present in asthma but does not necessarily indicate status asthmaticus. Decreased respiratory rate (choice
C) is not consistent with the increased respiratory effort seen in status asthmaticus. Productive cough (choice
D) is more indicative of conditions such as bronchitis or pneumonia, not necessarily status asthmaticus.
Question 4 of 5
A nurse is teaching a client who has a new prescription for phenytoin to treat a seizure disorder. Which of the following adverse effects should the nurse instruct the client to report immediately to the provider?
Correct Answer: C
Rationale: The correct answer is C: Skin rash. This is because phenytoin can cause severe and potentially life-threatening skin reactions like Stevens-Johnson syndrome or toxic epidermal necrolysis. These reactions can progress rapidly, so immediate medical attention is crucial. Drowsiness (
A) is a common side effect of phenytoin but not typically an emergency. Gingival hyperplasia (
B) and mild nausea (
D) are common side effects that do not require immediate reporting.
Question 5 of 5
A nurse is monitoring a client following a lumbar laminectomy. The client has a drain and indwelling urinary catheter. The nurse should identify which of the following findings as an indication of a complication of the surgery?
Correct Answer: C
Rationale: The correct answer is C: Clear drainage on the dressings. Clear drainage may indicate a cerebrospinal fluid leak, which is a serious complication following a lumbar laminectomy. Cerebrospinal fluid is a clear fluid that surrounds the brain and spinal cord, and its leakage can lead to infection and other complications. Red-tinged drainage (choice
A) may be expected initially due to surgical trauma. Cloudy urine in the catheter (choice
B) is more likely related to urinary tract infection. Mild back pain at the surgical site (choice
D) is common after this surgery and does not necessarily indicate a complication.