ATI RN
ATI Medical Surgical 2 Final 2024 Assessment Questions
Extract:
Question 1 of 5
A nurse is assessing a client who has a left lower arm fracture.Which of the following findings indicates impaired venous return in the client's affected arm?
Correct Answer: D
Rationale: Increasing edema is a sign of impaired venous return. When veins are unable to effectively return blood to the heart, fluid can accumulate in the tissues, leading to edema. Ecchymosis indicates bleeding or injury but not specifically impaired venous return. Acute pain is expected with a fracture and does not directly suggest venous issues. A bounding distal pulse suggests increased arterial flow, not impaired venous return.
Question 2 of 5
A nurse is providing care for an older adult client who has diabetes insipidus (DI). The nurse should monitor the client for which of the following neurological effects?
Correct Answer: C
Rationale: Ataxia, which is a lack of muscle coordination affecting speech, eye movements, the ability to swallow, walking, picking up objects, and other voluntary movements, can be a neurological effect of DI if severe dehydration and electrolyte imbalance affect the brain. Symptoms such as confusion and muscle cramps can also be associated with ataxia, making it a relevant neurological effect to monitor in a client with DI.
Question 3 of 5
A nurse is providing teaching to a client who has had a total abdominal hysterectomy and bilateral salpingo-oophorectomy for uterine cancer. Which of the following instructions should the nurse include in the teaching?
Correct Answer: C
Rationale: Artificial lubrication helps manage vaginal dryness post-surgery due to decreased estrogen levels.
Question 4 of 5
A nurse is caring for a client who has hypovolemic shock. Which of the following should the nurse recognize as an expected finding?
Correct Answer: C
Rationale: Oliguria, or low urine output, is an expected finding in hypovolemic shock. As the blood volume decreases, the kidneys receive less blood flow, leading to reduced urine production. This is a protective mechanism to conserve body fluids, but it also indicates the severity of fluid loss and the need for urgent intervention.
Question 5 of 5
A charge nurse is teaching a group of healthcare workers about hand hygiene to prevent infection. Which of the following information should the charge nurse include in the teaching?
Correct Answer: C
Rationale: Chlorhexidine is recommended for hand hygiene in immunocompromised patients due to its broad-spectrum antimicrobial activity. Artificial nails should be avoided, not just trimmed. Soap and water are required for C. difficile, as alcohol-based rubs are ineffective. Hand hygiene before eye drops should ensure clean hands, with no specific preference for alcohol-based rubs.