ATI LPN
ATI PN Adult Medical Surgical 2020 with NGN II Questions
Extract:
Question 1 of 5
A nurse is assisting with care for a client who received a tuberculin skin test 72 hours ago. When collecting data from the test site, which of the following findings indicates a need for further testing?
Correct Answer: A
Rationale: A palpable induration greater than 10 mm indicates possible tuberculosis exposure, necessitating further diagnostic testing.
Question 2 of 5
A nurse is assisting in the plan of care for a client who has constipation after receiving opioid medication for incisional pain. Which of the following actions should the nurse take first?
Correct Answer: A
Rationale: Auscultating bowel sounds first assesses bowel motility, guiding subsequent interventions for opioid-induced constipation.
Question 3 of 5
A nurse is assisting with the care of a client who is at 38 weeks of gestation and in labor. Which of the following findings should the nurse report to the charge nurse immediately?
Correct Answer: C
Rationale: Fetal heart rate with absent variability indicates potential fetal distress, requiring immediate reporting to ensure timely intervention.
Question 4 of 5
A nurse is caring for a client who has partial-thickness burns on 50% of his body and is receiving total parenteral nutrition. The nurse should actively monitor the client for which of the following?
Correct Answer: A
Rationale:
Total parenteral nutrition can cause hyperglycemia due to high glucose content, requiring regular monitoring of serum glucose levels to manage potential complications.
Question 5 of 5
A nurse is collecting data about immunizations from a 65-year-old client who has no identified risk factors for disease. The nurse should identify the client's need for which of the following immunizations?
Correct Answer: D
Rationale: The herpes zoster vaccine is recommended for adults 65 and older to prevent shingles, a common concern in this age group.