ATI RN
ATI Medical Surgical 2 Final 2024 Assessment Questions
Extract:
Question 1 of 5
A nurse is caring for a client who reports low back pain and asks the nurse for specific exercise recommendations. Which of the following activities should the nurse suggest?
Correct Answer: D
Rationale: Swimming is a low-impact exercise that does not put additional stress on the spine. The buoyancy of the water supports the body, reducing the load on the back while allowing for a full range of motion, making it suitable for managing low back pain.
Question 2 of 5
A nurse is assessing a client who has Paget's disease of the bone. Which of the following findings should the nurse expect? (Select all that apply.)
Correct Answer: B,C,D,E
Rationale:
Choice A: Cold extremities are not a typical symptom associated with Paget's disease of the bone. This condition usually does not affect the temperature of the limbs directly.
Choice B: Skeletal pain is a common symptom in Paget's disease due to the abnormal bone remodeling process. The affected bones may become painful, especially in the pelvis, spine, skull, and long bones.
Choice C: Visual loss can occur if Paget's disease affects the skull, leading to increased pressure on the nerves associated with vision. This pressure can result in visual impairment or loss.
Choice D: Cranial enlargement is a possible finding in Paget's disease when the skull is involved. The abnormal bone growth can cause the skull to increase in size.
Choice E: An abnormal gait may develop if Paget's disease affects the legs, causing the bones to bow and leading to difficulty walking.
Question 3 of 5
A nurse in a provider's office is assessing a client who reports shoulder pain. Which of the following findings by the nurse indicates a rotator cuff injury?
Correct Answer: A
Rationale: The inability to abduct the arm at the shoulder is a classic sign of a rotator cuff injury. The rotator cuff is responsible for stabilizing the shoulder joint and aiding in various movements, including abduction. When there is a tear or significant weakness in the rotator cuff muscles, especially the supraspinatus muscle, the patient may be unable to lift the arm away from the body or may experience pain while doing so. A negative drop arm test would actually indicate that there is no rotator cuff injury. The drop arm test is performed by asking the patient to fully abduct the arm to 90 degrees and then slowly lower it. If the patient can control the motion and lower the arm smoothly, the test is negative. A positive drop arm test, where the patient cannot control the descent of the arm, would suggest a rotator cuff tear. While an alteration in the contour of the joint may indicate some form of shoulder pathology, it is not specific to a rotator cuff injury. Changes in the contour could be due to various conditions, including dislocation, arthritis, or other musculoskeletal disorders. A positive Tinel's sign is used to diagnose nerve compression or nerve damage, not rotator cuff injuries. It is performed by tapping over the course of a nerve to elicit a tingling sensation or pain in the distribution of the nerve. This sign is commonly associated with conditions like carpal tunnel syndrome.
Question 4 of 5
A nurse is caring for a female client who has rheumatoid arthritis and a new prescription for methotrexate. The client tells the nurse she is planning a pregnancy. Which of the following instructions should the nurse give the client?
Correct Answer: D
Rationale: Methotrexate should be discontinued at least 3 months prior to a planned pregnancy to ensure it is cleared from the body, as it can cause serious birth defects. Reducing the dosage is not safe, as methotrexate is contraindicated in pregnancy. Dietary modifications are not the primary concern, and breastfeeding is not recommended due to potential harm to the infant.
Question 5 of 5
A nurse is caring for an older adult client who has rheumatoid arthritis (RA) and is taking aspirin 650 mg every 4 hours. Which of the following diagnostic tests should the nurse monitor to evaluate the effectiveness of this medication?
Correct Answer: B
Rationale: Erythrocyte sedimentation rate (ESR) measures inflammation and is used to assess RA severity. A decrease in ESR indicates aspirin's effectiveness in reducing inflammation. ANA and RF are diagnostic, not monitoring, tests, and WBC count is not specific to aspirin's effects.