ATI RN
ATI n269 Med Surg Comprehensive Exam Questions
Extract:
Question 1 of 5
A nurse is assessing a client who has meningitis. Which of the following findings should the nurse expect?
Correct Answer: A
Rationale: A severe headache is a hallmark symptom of meningitis. The inflammation of the meninges (the protective membranes covering the brain and spinal cord) typically causes intense headache, along with other symptoms such as fever, nausea, and photophobia.
Extract:
Nurses notes
Laboratory
Diagnostic Results
Vital Signs
Two weeks ago
0900:
Received client alert and oriented. Lung sounds with crackles bilaterally, respirations with dyspnea observed on exertion. Heart sounds with S3 auscultated. 1+ jugular venous distention. Capillary refill in 3 seconds in bilateral upper and in 4 seconds in bilateral lower extremities. Pulses in bilateral upper extremities at +2; pulses in bilateral lower extremities +1 and cool to touch with +1 pitting edema.
Client reports worsening shortness of breath over the last couple of months. Client states "I thought I was just gaining weight, but I think my heart may not be working right." Client also reports that both their legs are swollen, and they get short of breath while walking or doing any type of activity. Denies chest pain or palpitations and reports blood pressure is controlled.
Today
0830:
Follow-up appointment with client who reports feeling a little better. Lung sounds clear bilaterally, respirations with dyspnea observed on exertion. Heart sounds with S3 auscultated. Jugular vein distention absent. Capillary refill in 3 seconds in bilateral upper extremities and in 4 seconds in bilateral lower extremities. Pulses in bilateral upper and lower extremities at +2 and no edema to extremities. Skin warm and dry to touch, color appropriate for genetic background. Client reports less shortness of breath, but admits they still get a "little winded when doing activities."
Question 2 of 5
The nurse is reviewing the client's assessment findings. Which of the following findings indicates that the client's condition has improved or has not changed since their two-week follow-up appointment?
| Options | Improved | No change |
|---|---|---|
| Blood Pressure | ||
| Jugular Venous Distention | ||
| Lung sounds | ||
| Serum Potassium | ||
| Weight | ||
| Dyspnea | ||
| Oxygen saturation |
Correct Answer: A,B,C,D,E
Rationale: Blood pressure, jugular venous distention, lung sounds, serum potassium, and weight have improved, indicating better heart failure management. Dyspnea and oxygen saturation remain unchanged, showing no worsening.
Extract:
Question 3 of 5
A nurse is assessing a client who reports numbness and pain in his right palm, index finger, and middle finger. The client reports working with a keyboard most of the time while at work. The nurse suspects carpal tunnel syndrome. Which of the following tests should the nurse request that the client perform?
Correct Answer: B
Rationale: Holding the wrist at a 90-degree flexion is a classic test for carpal tunnel syndrome, known as the Phalen's test. This maneuver increases pressure on the median nerve, which can reproduce symptoms of numbness and tingling in the fingers, a characteristic sign of carpal tunnel syndrome.
Question 4 of 5
A nurse is assessing the elastic bandage on the stump of a client who had a right below-the-knee amputation. Which of the following findings should the nurse identify as a complication?
Correct Answer: B
Rationale: Pitting edema around the stump dressing is a complication. This could indicate poor circulation, infection, or fluid retention, which requires prompt assessment and intervention to prevent further complications.
Question 5 of 5
A nurse is caring for a client who has Cushing's syndrome. Which of the following interventions should the nurse expect to perform? (Select all that apply.)
Correct Answer: A,C,D,E
Rationale: Assessing for neck vein distention, blood glucose levels, daily weight, and irregular heart rate are appropriate for Cushing's syndrome due to fluid retention, hyperglycemia, weight gain, and potential electrolyte imbalances. Postural hypotension is not typical.