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 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 2 of 5
A nurse is assessing a client who has increased intracranial pressure. The nurse should recognize that which of the following is the first sign of deteriorating neurological status?
Correct Answer: A
Rationale: The correct answer is A: Altered level of consciousness. This is the first sign of deteriorating neurological status in a client with increased intracranial pressure. Changes in consciousness indicate impairment in brain function, signaling potential brain injury or worsening condition. Altered level of consciousness can progress rapidly if not addressed promptly.
Choice B, Cheyne-Stokes respirations, is associated with abnormal breathing patterns and typically occurs in conditions like heart failure or brain injury, but it is not the first sign of neurological deterioration.
Choice C, Decorticate posturing, is a sign of brain injury but typically occurs after alterations in consciousness.
Choice D, pupillary dilation, can be a sign of increased intracranial pressure, but it usually occurs after alterations in consciousness.
Question 3 of 5
A nurse is providing discharge teaching to a client following a modified left radical mastectomy with breast expander. Which of the following statements by the client indicates an understanding of the teaching?
Correct Answer: B
Rationale: The correct answer is B: "I should expect less than 25 mL of secretions per day in the drainage devices." This demonstrates an understanding of the need to monitor drainage postoperatively. Excessive drainage can indicate complications like infection or bleeding.
A: Performing strength-building exercises with a 15-pound weight is contraindicated postoperatively as it can strain the surgical site.
C: Waiting 2 months before adding saline to the expander is incorrect. Saline can be added gradually postoperatively.
D: Keeping the left arm flexed at the elbow is not recommended as it can lead to stiffness and limited range of motion.
Question 4 of 5
A nurse is caring for a client who is experiencing an exacerbation of heart failure. Thenurse is assessing the client 24 hr later. How should the nurse interpret the findings related to the diagnosis of heart failure? For each finding, click to specify whe ther the finding is unrelated to the diagnosis, a sign of potential improvement, or a sign of potential worsening condition. Diagnostic Results Hgb 8.4 g/dL (12 to 18 g/dL) Hct 42% (37% to 47%) WBC count 9,800/mm3 (5,000 to 10,000/ mm3) Potassium 432 mEq/L (3.5 to 5 mEq/L)
| Findings 24 hr later | unrelated to the diagnosis | Potential improvement | Worsening condition |
|---|---|---|---|
| Lung sounds clean | |||
| Creatinine 1.8 mm/dl | |||
| Weight 113kg(249 lb) | |||
| WBC Count 11,800mm3 | |||
| Temperature: 38.5°C (101.3°F) | |||
| Shortness of breath with exertion |
Correct Answer: A, B,C,D,E
Rationale:
The correct answer is A, B, C, D, E. In heart failure exacerbation, key indicators are related to fluid overload and organ perfusion.
A) Lung sounds clean indicate potential improvement in pulmonary congestion.
B) Creatinine 1.8 mm/dl is important for kidney function monitoring, as worsening kidney function can occur in heart failure.
C) Weight 113kg reflects fluid retention, relevant for heart failure management.
D) WBC count (11,800mm3) can indicate infection, which can worsen heart failure. E) Temperature 38.5°C can suggest infection or systemic inflammatory response, which worsens heart failure.
Question 5 of 5
A nurse is planning care for a client who has dementia and a history of wandering. Which of the following actions should the nurse plan to implement?
Correct Answer: C
Rationale: The correct answer is C: Use a bed alarm. This is the most appropriate action to help prevent the client from wandering and ensure their safety. A bed alarm will alert the nurse when the client tries to get out of bed, allowing for timely intervention. Moving the client to a double room (
A) may not necessarily prevent wandering. Using chemical restraints (
B) is not recommended due to ethical concerns and potential adverse effects. Encouraging excessive stimulation (
D) may increase agitation and wandering behavior.