ATI RN
ATI Nur258 Med Surg 2 Final Exam Questions
Extract:
Question 1 of 5
A nurse is caring for a client with a history of rheumatoid arthritis who takes corticosteroids on a regular basis. The client asks the nurse about the potential complications of taking corticosteroids. What is the nurse's best response?
Correct Answer: C
Rationale: Corticosteroids cause immunosuppression by inhibiting the function of various immune cells and reducing the production of inflammatory cytokines. This increases the risk of infections.
Question 2 of 5
A nurse is providing discharge planning for a client who has just been diagnosed as being in the early stage of rheumatoid arthritis and starting methotrexate. What should the nurse include in the client's teaching?
Correct Answer: A
Rationale: Monitoring for symptoms of anemia is essential as methotrexate can cause bone marrow suppression, leading to anemia. The nurse should instruct the client to report symptoms like fatigue, pallor, and shortness of breath.
Question 3 of 5
A nurse is preparing to administer cefazolin 1 g by intermittent intravenous (IV) bolus over 30 minutes. Available is cefazolin 1 g in 100 mL dextrose 5% in water (D5W). The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero. Only enter numbers and decimals. Do not enter any letters in your answer.)
Correct Answer: 33
Rationale: Infusion rate = 3.33 mL/min x 10 gtt/mL = 33.3 gtt/min, rounded to 33 gtt/min.
Extract:
Medical History
Client admitted with report of polyuria and polydipsia.
Notable muscle twitching of upper extremities.
Past medical history: Varicella as a child. No other health issues.
Current medications: Occasional ibuprofen for pain.
Family history: Father had history of nephrogenic diabetes insipidus.
Physical Examination
Alert and oriented to person, place, and time.
Client states that they have had difficulty concentrating lately and are irritable.
Client reports occasional dizziness.
Skin is warm, dry, and scaly.
Mucous membranes dry and pink.
Lungs clear to auscultation bilaterally.
Abdomen soft, nondistended with active bowel sounds x 4.
Denies nausea, vomiting, or diarrhea.
Peripheral pulses 1+
Twitching noted in upper extremities, client states they have had twitching "for some time."
Nurses' Notes
0845:
Needed assistance to the bathroom, reports dizziness.
Urine output 1,500 mL.
Assisted client to bed.
Vitals taken.
Vital Signs
0800:
Temperature 37.4° C (99.4° F)
Heart rate 100/min
Respiratory rate 22/min
Blood pressure 108/78 mm Hg
SpO2 98% on room air
0900:
Temperature 37.4° C (99.4° F)
Heart rate 104/min
Respiratory rate 22/min
Blood pressure 96/70 mm Hg
Diagnostic Results
Basic metabolic profile
Sodium 157 mEq/L (nl. 136-145 mEq/L)
Potassium 3.49 mEq/L (nl. 3.5-5 mEq/L)
Chloride 102 mEq/L (nl. 98-106 mEq/L)
Magnesium 1.8 mEq/L (nl. 1.8-2.6 mEq/L)
Total calcium 9.7 mg/dL (nl. 8.8-10.4 mg/dL)
Complete blood count (CBC) with differential
Total white blood cell (WBC) count 6,500/mm3 (nl. 5,000-10,000/mm3)
Neutrophils 60% (55% to 70%)
Lymphocytes 30% (20% to 40%)
Monocytes 5% (2% to 8%)
Eosinophils 2.5% (1% to 4%)
Basophils 0.7% (0.5% to 1%)
Hemoglobin 21 g/dL (Male: 14 to 18 g/dL; Female: 12 to 16 g/dL)
Hematocrit 55% (Male: 42% to 52%; Female: 37% to 47%)
RBCs 5.7 x 106µL (Male: 4.7 to 6.1 x 106µL; Female: 4.2 to 5.4 x 106µL
Question 4 of 5
Complete the following sentence by using the lists of options. The nurse should first address the client's..... followed by the client's.....
Correct Answer: A,B
Rationale: Elevated sodium level (157 mEq/L) indicates hypernatremia, requiring urgent correction. Blood pressure should be addressed next to ensure stability.
Extract:
History and Physical
Day 1
Client works as a firearms instructor at a shooting range.
Hypertension
Heart failure
Osteoarthritis
Medication Administration Record
Day 1:
Gentamycin 500 mg by mouth (PO) daily
Bumetanide 2 mg PO daily
Naproxen 250 mg PO daily
Nurses' Notes
6 months later:
Client reports having trouble hearing in noisy places.
Client states they are hearing sounds as muffled.
Diagnostic Results
6 months later:
Audiometer test with hearing loss at 39 dB
Question 5 of 5
A nurse is reviewing a client's medical record. Select the 4 findings that place the client at risk for hearing impairment.
Correct Answer: B,C,D,E
Rationale: Employment at a shooting range, gentamycin, naproxen, and bumetanide are risk factors for hearing impairment due to noise exposure and ototoxicity.