ATI RN
ATI n269 Med Surg Comprehensive Exam Questions
Extract:
Question 1 of 5
A nurse is caring for a client who has pneumonia. Which of the following actions should the nurse take to promote thinning of respiratory secretions?
Correct Answer: C
Rationale: Increasing fluid intake is the most effective way to thin respiratory secretions. Fluids help to hydrate the mucous membranes, making the mucus less thick and easier to clear.
Question 2 of 5
A nurse is providing instruction to a new nurse about caring for clients who are receiving diuretic therapy to treat heart failure. The nurse should explain that which of the following medications puts clients at risk for both hyperkalemia and hyponatremia?
Correct Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic. It helps retain - retain potassium while excreting sodium and water, which increases the risk for hyperkalemia (high potassium) and hyponatremia (low sodium) when used in combination with other medications that affect electrolyte balance.
Question 3 of 5
A nurse is performing a home safety assessment for a client who has experienced a stroke. Which of the following findings are a safety hazard for the client?
Correct Answer: A,B,E
Rationale: Dim lighting, a hot water heater set at 54°C (130°F), and area rugs are safety hazards for a stroke client. Dim lighting increases fall risk, high water temperature can cause burns, and area rugs are tripping hazards. Medications in a clear bag and grab bars are not hazards.
Question 4 of 5
A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first?
Correct Answer: C
Rationale: The first action should be to check the client's vital signs. Nausea and weakness are common symptoms of digoxin toxicity, which can cause bradycardia, arrhythmias, and other life-threatening complications. Checking the vital signs, particularly the heart rate, is critical to assess if the client is experiencing digoxin toxicity.
Question 5 of 5
A nurse is caring for a client who has an acute ankle sprain. Which of the following actions should the nurse take? (Select all that apply.)
Correct Answer: B,C,E
Rationale: Elevating the ankle, applying a compression bandage, and encouraging rest are appropriate actions for an acute ankle sprain to reduce swelling, support the injury, and promote healing. Passive range-of-motion exercises and applying heat can exacerbate the injury in the acute phase.