ATI RN
ATI Medical Surgical 2 Final 2024 Assessment Questions
Extract:
Question 1 of 5
A nurse is caring for a client immediately following a hemodialysis treatment. For which of the following manifestations will the nurse administer a PRN dose of phenytoin?
Correct Answer: A
Rationale: Phenytoin is an antiepileptic drug used to treat and prevent seizures. Headache and restlessness could be signs of neurological irritation or an impending seizure, which phenytoin can help manage.
Question 2 of 5
A charge nurse is teaching a group of healthcare workers about hand hygiene to prevent infection. Which of the following information should the charge nurse include in the teaching?
Correct Answer: C
Rationale: Chlorhexidine is recommended for hand hygiene in immunocompromised patients due to its broad-spectrum antimicrobial activity. Artificial nails should be avoided, not just trimmed. Soap and water are required for C. difficile, as alcohol-based rubs are ineffective. Hand hygiene before eye drops should ensure clean hands, with no specific preference for alcohol-based rubs.
Question 3 of 5
A nurse in a provider's office is assessing a client who reports shoulder pain. Which of the following findings by the nurse indicates a rotator cuff injury?
Correct Answer: A
Rationale: The inability to abduct the arm at the shoulder is a classic sign of a rotator cuff injury. The rotator cuff is responsible for stabilizing the shoulder joint and aiding in various movements, including abduction. When there is a tear or significant weakness in the rotator cuff muscles, especially the supraspinatus muscle, the patient may be unable to lift the arm away from the body or may experience pain while doing so. A negative drop arm test would actually indicate that there is no rotator cuff injury. The drop arm test is performed by asking the patient to fully abduct the arm to 90 degrees and then slowly lower it. If the patient can control the motion and lower the arm smoothly, the test is negative. A positive drop arm test, where the patient cannot control the descent of the arm, would suggest a rotator cuff tear. While an alteration in the contour of the joint may indicate some form of shoulder pathology, it is not specific to a rotator cuff injury. Changes in the contour could be due to various conditions, including dislocation, arthritis, or other musculoskeletal disorders. A positive Tinel's sign is used to diagnose nerve compression or nerve damage, not rotator cuff injuries. It is performed by tapping over the course of a nerve to elicit a tingling sensation or pain in the distribution of the nerve. This sign is commonly associated with conditions like carpal tunnel syndrome.
Question 4 of 5
A nurse is caring for a client who has a history of exposure to TB and symptoms of night sweats and hemoptysis. Which of the following tests should the nurse realize is the most reliable to confirm the diagnosis of active pulmonary TB?
Correct Answer: B
Rationale: A sputum culture for acid-fast bacillus is the gold standard for confirming active pulmonary TB, providing definitive diagnosis.
Question 5 of 5
A nurse in a long-term care facility is caring for an older adult client who had a stroke 4 weeks ago and is unable to move independently. The nurse should monitor for which of the following complications of immobility?
Correct Answer: A
Rationale: A reddened area over the sacrum indicates potential pressure ulcer development, a common complication of immobility. Hearing difficulties are unrelated, stiffness is a longer-term issue, and upper extremity movement issues are likely due to the stroke itself.