ATI RN
ATI Nur285 Med Surg Fall Exam Questions
Extract:
Question 1 of 5
A nurse is caring for a client in the primary care office who has a recent diagnosis of a hiatal hernia. Which of the following new information will be beneficial for the nurse to relay to the client?
Correct Answer: A
Rationale: A hiatal hernia can increase the risk of GERD by causing the lower esophageal sphincter to malfunction, leading to acid reflux into the esophagus.
Question 2 of 5
A patient with anorexia nervosa shows signs of malnutrition and is prescribed parenteral nutrition. If the client develops refeeding syndrome, what laboratory tests does the nurse expect the healthcare provider to order? (Select all that apply.)
Correct Answer: A,C,D,E
Rationale: Monitoring serum phosphorus, calcium, potassium, and magnesium is crucial to detect electrolyte imbalances associated with refeeding syndrome.
Question 3 of 5
A nurse is creating a plan of care to maintain the skin integrity of a client who experiences frequent diarrhea due to ulcerative colitis. Which of the following interventions should the nurse include in the plan?
Correct Answer: C
Rationale: Wiping the perianal area with warm water and applying a barrier cream is an appropriate and effective intervention to protect the skin. The warm water is gentle, and the barrier cream provides a protective layer that helps prevent skin breakdown from frequent contact with stool.
Question 4 of 5
A nurse is providing teaching to a client who has a new colostomy. Which of the following information should the nurse include in the teaching?
Correct Answer: B
Rationale: A small amount of bleeding around the stoma is normal during early healing, but excessive bleeding requires attention.
Question 5 of 5
The nurse is caring for a client who has had an upper G.I. endoscopy. The client's vital signs must be taken every 30 minutes for two hours after the procedure. The nurse assigns an unlicensed assistant to take the vital signs. Two hours later, the assistant reports to client who was previously afebrile has now developed a temperature of 101.8°F. What should the nurse do in response to this reported data by the unlicensed assistant?
Correct Answer: A
Rationale: A fever following an upper gastrointestinal endoscopy can be a sign of a serious complication, such as perforation, which could cause peritonitis. The nurse should promptly assess the client for other signs of perforation, such as abdominal pain, rigidity, or changes in vital signs.