ATI RN
ATI Medical Surgical 2 Final 2024 Assessment Questions
Extract:
Question 1 of 5
A nurse in the emergency department is monitoring a client who has a cervical spinal cord injury from a fall. The nurse should monitor the client for which of the following complications? (Select all that apply.)
Correct Answer: B,C,E
Rationale: A weakened gag reflex, hypotension, and absence of bowel sounds are complications of a cervical spinal cord injury. Polyuria is not typically related, and hyperthermia is less common as a direct complication.
Question 2 of 5
A nurse is assessing a client who has Paget's disease of the bone. Which of the following findings should the nurse expect? (Select all that apply.)
Correct Answer: B,C,D,E
Rationale:
Choice A: Cold extremities are not a typical symptom associated with Paget's disease of the bone. This condition usually does not affect the temperature of the limbs directly.
Choice B: Skeletal pain is a common symptom in Paget's disease due to the abnormal bone remodeling process. The affected bones may become painful, especially in the pelvis, spine, skull, and long bones.
Choice C: Visual loss can occur if Paget's disease affects the skull, leading to increased pressure on the nerves associated with vision. This pressure can result in visual impairment or loss.
Choice D: Cranial enlargement is a possible finding in Paget's disease when the skull is involved. The abnormal bone growth can cause the skull to increase in size.
Choice E: An abnormal gait may develop if Paget's disease affects the legs, causing the bones to bow and leading to difficulty walking.
Question 3 of 5
A nurse is observing a newly licensed nurse who is performing a focused skin assessment on a client who reports a skin condition. Which of the following questions by the newly licensed nurse requires intervention?
Correct Answer: C
Rationale: Asking about the emotional impact of a skin condition is appropriate and empathetic, supporting holistic care. Questions about diet, stress, and sleep are also relevant, as they can influence or be affected by skin conditions. The document incorrectly marks C as requiring intervention, but no intervention is needed for any of these questions.
Question 4 of 5
A nurse is caring for a client with a chronic wound. Which of the following is a systemic cause of chronic wounds?
Correct Answer: B
Rationale: Malnutrition is indeed a systemic cause of chronic wounds. Adequate nutrition is essential for wound healing, as it provides the necessary proteins, vitamins, and minerals that play a crucial role in the repair process. Protein-energy malnutrition, deficiencies in vitamins C and D, zinc, and other nutrients can impair wound healing and lead to chronic wounds.
Question 5 of 5
A nurse is caring for a client who has fibrocystic breasts. The client asks the nurse, 'What will happen to my fibrocystic breast changes after menopause?' Which of the following statements is an appropriate response by the nurse?
Correct Answer: D
Rationale: The most appropriate response is that the manifestations usually go away after menopause. Fibrocystic breast changes are linked to hormonal fluctuations, and after menopause, when these fluctuations cease, the symptoms of fibrocystic breasts typically resolve.