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 is experiencing a seizure. Which of the following actions should the nurse take first?
Correct Answer: D
Rationale: The correct action to take first when caring for a client experiencing a seizure is to clear items from the client's surrounding area (
Choice
D). This is important to prevent injury to the client during the seizure. By removing objects that could cause harm, such as sharp or hard items, the nurse ensures a safe environment for the client. Lowering the client to the floor (
Choice
A) is important but should be done after clearing the surroundings to prevent injury. Obtaining vital signs (
Choice
B) and loosening restrictive clothing (
Choice
C) can be done after ensuring the safety of the environment. Thus, the priority is to clear items from the client's surrounding area to prevent harm during the seizure.
Question 2 of 5
A nurse is preparing a teaching plan for a client who has mucositis related to chemotherapy treatment. Which of the following instructions should the nurse include?
Correct Answer: B
Rationale: The correct answer is B: Wear your dentures only during meals. This instruction is important for a client with mucositis because wearing dentures continuously can exacerbate irritation and discomfort in the mouth. By removing dentures between meals, the client can allow the oral tissues to rest and promote healing.
Choice A is incorrect because vigorous brushing for 60 seconds can further irritate the mucositis.
Choice C is incorrect as flossing can also cause trauma to the inflamed tissues.
Choice D is incorrect as rinsing with hydrogen peroxide can be too harsh and may worsen the condition. It's important to provide gentle care and minimize irritation to the affected areas in mucositis.
Question 3 of 5
A nurse is preparing to administer daily medications to a client who is undergoing a procedure at 1000 that requires IV contrast dye. Which of the following routine medications to give at 0800 should the nurse withhold?
Correct Answer: C
Rationale: The correct answer is C: Metformin. The nurse should withhold metformin before the procedure with IV contrast dye due to the risk of lactic acidosis. IV contrast dye can affect kidney function, leading to an increased risk of lactic acidosis when combined with metformin. Fluticasone (
A), metoprolol (
B), and valproic acid (
D) are not contraindicated before the procedure with IV contrast dye. Fluticasone is an inhaled corticosteroid, metoprolol is a beta-blocker, and valproic acid is an anticonvulsant. These medications are not typically affected by IV contrast dye and can be safely administered.
Question 4 of 5
A nurse in the emergency department is monitoring a client who is receiving dopamine to treat hypovolemic shock. Which of the following findings should the nurse identify as an indication for increasing the client's dopamine dosage?
Correct Answer: A
Rationale: The correct answer is A: Blood pressure 90/50 mm Hg. Dopamine is a vasopressor used to increase blood pressure in hypovolemic shock. A low blood pressure reading of 90/50 mm Hg indicates inadequate perfusion, warranting an increase in dopamine dosage to improve cardiac output. Oxygen saturation (
B) and respiratory rate (
D) are not direct indicators for adjusting dopamine dosage. A heart rate of 60/min (
C) may be within normal limits depending on the client's condition.
Question 5 of 5
A nurse is caring for a client who is receiving a 0.9% sodium chloride via IV infusion. The client has become dyspneic with a blood pressure of 140/100 mm Hg, a fluid intake of 960 mL, and an output of 300 mL in the past 12 hr. Which of the following actions should the nurse take?
Correct Answer: C
Rationale:
Correct Answer: C - Slow infusion rate and contact the provider.
Rationale: The client is showing signs of fluid volume overload with dyspnea, elevated blood pressure, and a significant fluid intake-output discrepancy. Slowing the infusion rate will help reduce fluid intake and potentially prevent worsening of the overload. Contacting the provider is crucial for further assessment and possible adjustment of the treatment plan.
Summary:
A: Lowering the head of the bed may help with respiratory distress but does not address the underlying issue of fluid overload.
B: Administering corticosteroids is not indicated for fluid overload and may worsen the situation.
D: Changing to lactated Ringer's does not address the immediate need to slow down the infusion rate and seek provider guidance.