Questions 47

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ATI RN Test Bank

ATI Nur211 Capstone Questions

Extract:


Question 1 of 5

A nurse is caring for a client who returns to the nursing unit from the recovery room after a sigmoid colon resection for adenocarcinoma. The client had an episode of intraoperative bleeding. Which finding indicates to the nurse that the client may be developing hypovolemic shock?

Correct Answer: C

Rationale: Increased heart rate (88 to 110/min) is a compensatory sign of hypovolemic shock. Temperature rise, reduced respiratory rate, and lower urine output are less specific or later signs.

Question 2 of 5

A nurse is teaching a client who has septic shock about the development of disseminated intravascular coagulation (DIC). Which of the following statements should the nurse make?

Correct Answer: D

Rationale: DIC results from abnormal coagulation, depleting fibrinogen and causing clotting and bleeding. Heparin is not lifelong, platelets decrease, and it’s not genetic.

Question 3 of 5

A nurse is assessing the reflexes of a client who has an unrepaired femur fracture and has suddenly become stuporous. For which of the following findings should the nurse identify that the client exhibits Babinski's sign?

Correct Answer: D

Rationale: Babinski’s sign is dorsiflexion of the great toe, indicating upper motor neuron damage. Jerking, pinpoint pupils, and arm pronation are unrelated.

Question 4 of 5

A nurse is doing rounds and notes a patient in the following position: How would the nurse document this finding?

Correct Answer: D

Rationale: Decerebrate posturing involves extended arms and legs with plantar flexion, indicating severe brain injury. Decorticate involves flexion, and others are unrelated.

Question 5 of 5

A nurse is caring for a client who has heart failure and a prescription for digoxin 125 mcg PO daily. Available is digoxin PO 0.25 mg/tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer: 0.5

Rationale: Convert 125 mcg to 0.125 mg. Dose = 0.125 mg / 0.25 mg/tablet = 0.5 tablets.

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