ATI RN
ATI RN Adult Medical Surgical 2023 Questions Correct Answers Questions
Extract:
Question 1 of 5
A nurse is assessing a client who has skeletal traction for a femoral fracture. The nurse notes that the weights are resting on the floor. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct answer is D: Reapply the weights to ensure proper traction. When the weights are resting on the floor, it means that there is no longer effective traction on the affected limb.
To maintain proper skeletal traction, the weights should be suspended freely in the air. By reapplying the weights and ensuring they are hanging freely, the nurse can restore the necessary traction force to immobilize the fractured bone and facilitate healing. Removing a weight (choice
A) may compromise the traction. Tying knots in the ropes (choice
B) may alter the mechanics of the traction system. Increasing the elevation of the extremity (choice
C) does not address the issue of the weights resting on the floor.
Question 2 of 5
A nurse is assessing a client who is 24 hr postoperative following a total hip arthroplasty. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct answer is A: Maintain abduction of the affected extremity. After a total hip arthroplasty, maintaining abduction of the affected extremity helps prevent dislocation of the hip prosthesis. This position helps stabilize the hip joint and reduces the risk of complications. Option B (Position the client in high Fowler's position) is incorrect as it does not directly address the postoperative care specific to a total hip arthroplasty. Option C (Encourage the client to cross their legs at the ankles) is incorrect because crossing legs can create pressure on the hip joint and increase the risk of dislocation. Option D (Have the client bend forward at the waist while sitting) is incorrect as this could also increase the risk of hip dislocation.
Question 3 of 5
A nurse is providing discharge teaching to a client following a modified left radical mastectomy with breast expander. Which of the following statements by the client indicates an understanding of the teaching?
Correct Answer: B
Rationale: The correct answer is B: "I should expect less than 25 mL of secretions per day in the drainage devices." This demonstrates an understanding of the need to monitor drainage postoperatively. Excessive drainage can indicate complications like infection or bleeding.
A: Performing strength-building exercises with a 15-pound weight is contraindicated postoperatively as it can strain the surgical site.
C: Waiting 2 months before adding saline to the expander is incorrect. Saline can be added gradually postoperatively.
D: Keeping the left arm flexed at the elbow is not recommended as it can lead to stiffness and limited range of motion.
Question 4 of 5
A nurse is preparing to administer potassium chloride 10 mEq IV over 1 hr to a client. Available is potassium chloride 10 mEq in 100 mL of 0.9% sodium chloride. The nurse should set the infusion pump to deliver how many mL/hr? (Round to the nearest whole number.)
Correct Answer: C
Rationale:
To determine the infusion rate, we first calculate the total volume of the solution to be infused (100 mL) over the total time (1 hr).
Therefore, the infusion pump should be set to deliver 100 mL/hr (
Choice
C). This ensures the correct administration of potassium chloride 10 mEq IV over 1 hr.
Choices A, B, and D are incorrect because they do not accurately reflect the infusion rate required for the specified dose and time frame.
Question 5 of 5
A nurse is caring for a client who has a peripherally inserted central catheter (PICC) line in her left forearm. The client is receiving an antibiotic via intermittent IV bolus every 12 hr. Which of the following actions should the nurse take in managing the client's PICC line?
Correct Answer: D
Rationale:
Correct Answer: D - Flush the catheter with a 0.9% sodium chloride solution after each use.
Rationale: Flushing the catheter with 0.9% sodium chloride solution after each use helps prevent clot formation, maintains patency, and ensures proper functioning of the PICC line. This action also helps prevent infection and occlusions.
Incorrect
Choices:
A: Accessing the catheter using a non-coring needle is not necessary for routine care of a PICC line.
B: Changing the transparent membrane dressing daily may increase the risk of infection and disrupt the integrity of the dressing.
C: Maintaining a continuous IV infusion through the PICC line is not indicated for a client receiving intermittent IV bolus antibiotics.
E, F, G: No additional choices provided.