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ATI RN Med Surg Custom Exam 2 Questions

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Question 1 of 5

A nurse is caring for a client and identifies an infiltration at the IV catheter site. Identify the order the nurse should perform the following actions.

Correct Answer: C,A,E,B,D

Rationale: Here's the correct order of actions for managing an IV infiltration: C. Stop the infusion. (This is the priority action to prevent further infiltration.) A. Remove the IV catheter. (Once the infusion is stopped, the source of the infiltration needs to be removed.) E. Elevate the extremity. (This helps reduce swelling.) B. Apply warm or cold compresses. (This helps reduce discomfort and swelling. Warm compresses are generally used for non-vesicant solutions, while cold compresses are used for vesicant solutions, or as ordered. The type of fluid infiltrated is important to know.) D. Apply a sterile dressing. (This protects the insertion site and prevents infection.)

Question 2 of 5

A nurse is reviewing discharge instructions with a client following a right cataract extraction. Which of the following instructions should the nurse include?

Correct Answer: A

Rationale: Lifting heavy objects can increase intraocular pressure, which should be avoided after cataract surgery.

Question 3 of 5

A nurse is caring for a client who has an indwelling urinary catheter. Which of the following actions should the nurse take to prevent infection?

Correct Answer: C

Rationale: Checking the catheter tubing for kinks or twisting ensures urine flow and prevents infection.

Question 4 of 5

A nurse in a clinic is interviewing a client who has a possible diagnosis of endometriosis. Which of the following findings in the client's history should the nurse recognize as consistent with a diagnosis of endometriosis?

Correct Answer: D

Rationale: Dysmenorrhea (painful menstrual periods) that is unresponsive to NSAIDs is a common symptom of endometriosis.

Question 5 of 5

A nurse is providing nail care for a client. Which of the following actions should the nurse take?

Correct Answer: C

Rationale: Filing the nails in a rounded shape can prevent injury and is the recommended method for nail care.

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