ATI RN
ATI Medical Surgical Proctored Exam 2023 With NGN Questions and Correct Answers Questions
Extract:
Question 1 of 5
A nurse is assessing a client who is taking telmisartan. The nurse should identify that which of the following findings indicates that the medication has been effective?
Correct Answer: B
Rationale: The correct answer is B: Decrease in blood pressure. Telmisartan is an angiotensin II receptor blocker used to treat hypertension by lowering blood pressure.
Therefore, a decrease in blood pressure would indicate that the medication has been effective.
Choice A, blood glucose of 110 mg/dL, is unrelated to the action of telmisartan.
Choice C, increase in urinary output, is not a direct effect of telmisartan.
Choice D, respiratory rate of 10/min, is not a typical indicator of the effectiveness of telmisartan in managing hypertension.
Question 2 of 5
A nurse is assessing a client who is postoperative following an open reduction and internal fixation (ORIF) of the femur. Which of the following assessments should be the nurse's priority?
Correct Answer: B
Rationale: The correct answer is B: Pain assessment. Pain assessment should be the nurse's priority because postoperative pain management is crucial for the client's comfort, recovery, and overall well-being. Uncontrolled pain can lead to complications such as decreased mobility, respiratory issues, and delayed healing. Assessing and managing pain promptly can also prevent potential complications and promote early mobilization. The other choices are not the nurse's priority in this scenario. The Braden Scale assesses the risk of pressure ulcers, Morse Fall Risk Scale assesses the risk of falls, and nutritional assessment is important but not the priority immediately post-ORIF surgery.
Question 3 of 5
A nurse is caring for a client who is 3 hours postoperative following a total knee arthroplasty. Which of the following actions should the nurse take to prevent venous thromboembolism?
Correct Answer: A
Rationale:
Correct
Answer: A. Encourage the client to perform circumduction of the foot.
Rationale:
1. Circumduction of the foot promotes blood flow in the lower extremity, preventing stasis and reducing the risk of venous thromboembolism.
2. This action helps in maintaining muscle tone and preventing blood clots in the postoperative period.
3. Encouraging mobility also prevents complications like deep vein thrombosis.
Summary of Incorrect
Choices:
B. Keeping the client's knees in a flexed position may restrict blood flow and increase the risk of thromboembolism.
C. Massaging the client's legs can dislodge blood clots and lead to embolism.
D. Limiting fluid intake can increase the risk of dehydration and thickening of blood, which can contribute to thrombus formation.
Question 4 of 5
A nurse is caring for a client who requires protective isolation following a hematopoietic stem cell transplant. Which of the following interventions should the nurse implement to protect the client from infection?
Correct Answer: A
Rationale:
Correct
Answer: A
Rationale:
1. Positive pressure airflow in the client's room helps prevent airborne contaminants from entering, reducing the risk of infection.
2. This intervention creates a controlled environment suitable for clients with compromised immune systems.
3. The positive pressure airflow system pushes air out of the room, minimizing the risk of external pathogens entering.
4. This measure is crucial in protective isolation to protect the client from infections during the vulnerable post-transplant period.
Summary:
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Choice B is not directly related to infection prevention in protective isolation.
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Choice C is important for respiratory infections but is not a primary intervention for protective isolation.
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Choice D is relevant but does not directly address infection prevention measures in protective isolation.
Question 5 of 5
A nurse is caring for a client who has left-sided heart failure. Which of the following manifestations should the nurse expect?
Correct Answer: A
Rationale: The correct answer is A: Crackles. Left-sided heart failure causes fluid buildup in the lungs, leading to pulmonary congestion. Crackles are indicative of fluid in the alveoli, a common sign of pulmonary edema in heart failure. Decreased urine output (
B), daytime oliguria (
C), and halo vision (
D) are not specific to left-sided heart failure. Decreased urine output and oliguria are more associated with kidney dysfunction, while halo vision is related to eye conditions like cataracts.