ATI RN
ATI Medical Surgical Proctored Exam 2023 With NGN Questions and Correct Answers Questions
Extract:
Question 1 of 5
A nurse is caring for a client who has an arteriovenous graft. Which of the following findings indicates adequate circulation of the graft?
Correct Answer: A
Rationale: The correct answer is A: Palpable thrill. A palpable thrill indicates that there is adequate circulation of the arteriovenous graft. A thrill is a vibration felt over the graft site, which suggests that blood is flowing through the graft properly. A palpable thrill is a positive sign of good circulation.
The other choices are incorrect because:
B: Membranous blood pressure does not provide information about the circulation of the graft.
C: Absence of a bruit could indicate decreased or absent blood flow through the graft.
D: Dilated appearance of the graft does not necessarily indicate adequate circulation; it could be due to other reasons such as infection or inflammation.
Question 2 of 5
A nurse is caring for a client who has COPD. Which of the following findings require immediate follow-up?
Correct Answer: D
Rationale: The correct answer is D because tachypnea, productive cough with yellow mucus in a client with COPD can indicate an exacerbation or infection, requiring immediate intervention. A: Orientation is not an urgent concern. B: Restlessness can be due to various reasons and doesn't necessarily indicate an emergency. C: Pupillary reactivity is not relevant to COPD management.
Question 3 of 5
A nurse is assessing a client who has skeletal traction for a femoral fracture. The nurse notes that the weights are resting on the floor. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct action for the nurse to take is to reapply the weights to ensure proper traction. This is crucial to maintain the intended pulling force required for the skeletal traction to be effective in realigning the fractured bone. If the weights are resting on the floor, it means that the traction is not being applied as intended, which can lead to ineffective treatment and potential complications. Removing a weight (choice
A) would decrease the traction force, tying knots in the ropes (choice
B) would alter the mechanics of the system, and increasing the elevation of the extremity (choice
C) would not address the issue of weights resting on the floor.
Therefore, the best course of action is to reapply the weights to ensure proper traction and alignment of the fractured bone.
Question 4 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 5 of 5
A nurse is caring for a client who has cervical cancer and is receiving internal radiation therapy. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct action for the nurse to take is to check if the radioactive device is in the correct position. This is crucial to ensure that the radiation therapy is being delivered accurately and effectively. By verifying the position of the radioactive device, the nurse can prevent potential harm to the client and ensure the success of the treatment.
Choice B is incorrect because limiting visitors' time does not directly relate to the safety and effectiveness of the radiation therapy.
Choice C is incorrect as asking visitors to remain 3 feet away does not address the primary concern of verifying the device's position.
Choice D is also incorrect as lead-lined aprons are typically used by healthcare providers during procedures, not by the client.