ATI RN
ATI RN Adult Medical Surgical 2023 Questions Correct Answers Questions
Extract:
Question 1 of 5
A nurse is caring for a client who has tuberculosis. Which of the following precautions should the nurse implement for this client?
Correct Answer: B
Rationale: The correct answer is B: Airborne precautions. Tuberculosis is transmitted through the air via droplet nuclei. Implementing airborne precautions includes wearing an N95 respirator, placing the client in a negative pressure room, and ensuring proper ventilation. Standard precautions (
A) are for all clients, contact precautions (
C) are for direct contact with the client or their environment, and droplet precautions (
D) are for pathogens transmitted through respiratory droplets.
Therefore, implementing airborne precautions is crucial to prevent the spread of tuberculosis.
Question 2 of 5
A nurse is monitoring a client who has a traumatic brain injury. Which of the following findings should the nurse identify as a manifestation of Cushing's triad?
Correct Answer: A
Rationale: The correct answer is A: Increase in blood pressure from 130/80 mm Hg to 180/100 mm Hg. Cushing's triad is a set of three classic signs indicating increased intracranial pressure (ICP). The triad includes hypertension (widening pulse pressure), bradycardia, and irregular respirations. In this case, an increase in blood pressure is consistent with the hypertension component of Cushing's triad. This occurs due to the body's compensatory mechanism to maintain perfusion to the brain in response to increased ICP.
Choices B, C, D, and E do not align with the classic signs of Cushing's triad. Bradycardia, not a decrease in heart rate, is typically seen in Cushing's triad. Rapid and shallow respirations are not part of the triad. Hypotension is not a characteristic finding in Cushing's triad.
Question 3 of 5
A nurse is providing teaching to a client who has a new prescription for levothyroxine to treat hypothyroidism. Which of the following statements by the client indicates an understanding of the teaching?
Correct Answer: B
Rationale:
Correct Answer: B - If my heart starts racing
Rationale: This statement indicates an understanding of a potential side effect of levothyroxine, which is palpitations or rapid heart rate. It shows that the client is aware of the importance of monitoring for adverse reactions and seeking medical attention if necessary. This is crucial as it can indicate overmedication, which can be harmful.
Incorrect
Choices:
A: Taking levothyroxine with food can interfere with its absorption, reducing its effectiveness.
C: Adjusting the dosage is the healthcare provider's responsibility based on lab results, not the client's decision.
D: Stopping the medication abruptly can lead to a worsening of hypothyroidism symptoms.
E: Taking levothyroxine at night can interfere with sleep patterns and absorption.
Question 4 of 5
A nurse is caring for a client who is postoperative and develops respiratory depression after receiving morphine for pain control. Which of the following medications should the nurse expect the provider to prescribe?
Correct Answer: D
Rationale: The correct answer is D: Naloxone. Naloxone is an opioid antagonist that reverses the effects of opioids, including respiratory depression.
Therefore, the nurse should expect the provider to prescribe naloxone to counteract the respiratory depression caused by morphine. Flumazenil (
A) is a benzodiazepine antagonist and would not be effective in this situation. Calcium gluconate (
B) is used to treat calcium deficiencies and would not address respiratory depression. Diphenhydramine (
C) is an antihistamine and not indicated for reversing opioid-induced respiratory depression.
Question 5 of 5
A nurse is monitoring an older adult client who has an exacerbation of chronic lymphocytic leukemi The nurse notes petechiae on the client's skin. Which of the following actions should the nurse take?
Correct Answer: C
Rationale: The correct answer is C: Institute bleeding precautions. Petechiae are tiny red or purple spots on the skin caused by bleeding under the skin. In chronic lymphocytic leukemia, the client's platelet count may be low, leading to an increased risk of bleeding. By instituting bleeding precautions, the nurse can help prevent injuries that could result in further bleeding. Determining the client's blood type (
A) is not necessary in this situation. Avoiding IV pain medication (
B) is not directly related to managing petechiae. Implementing airborne precautions (
D) is not relevant to the client's presentation with petechiae.