ATI RN
ATI Medsurg Proctored Final Exam Questions
Extract:
Question 1 of 5
A nurse is caring for four hospitalized clients. Which of the following clients should the nurse identify as being at risk for fluid volume deficit?
Correct Answer: B
Rationale: The correct answer is B. The client with gastroenteritis and fever is at risk for fluid volume deficit due to increased fluid loss from vomiting and diarrhea. Fever also increases fluid loss through perspiration. The other choices do not directly indicate increased fluid loss. A: Antibiotics for wound infection may not directly lead to fluid volume deficit. C: IV fluids would help maintain hydration status, so this client is not at risk for deficit. D: Hypokalemia may be related to electrolyte imbalance, but not necessarily fluid volume deficit.
Question 2 of 5
A nurse is admitting a client who has a serum calcium level of 12.3 mg/dL and initiates cardiac monitoring. Which of the following findings should the nurse expect during the initial assessment?
Correct Answer: A
Rationale: The correct answer is A: Lethargy. A serum calcium level of 12.3 mg/dL indicates hypercalcemia. In hypercalcemia, calcium affects the central nervous system, leading to lethargy, weakness, and confusion. Lethargy is a common early symptom of hypercalcemia. Hypertension is not typically associated with hypercalcemia. Muscle spasms are more common in hypocalcemia. Severe agitation is not a typical manifestation of hypercalcemia.
Question 3 of 5
A nurse is preparing to initiate a transfusion of packed RBC for a client who has anemia. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct answer is A: Check the client's vital signs every 15 min during the transfusion. This is crucial to monitor for any signs of transfusion reaction, such as fever, chills, or hypotension. Vital signs should be closely monitored initially and then at regular intervals to ensure the client's safety. Checking every 15 minutes allows for early detection and prompt intervention if any adverse reactions occur.
Choice B is incorrect because obtaining a blood pressure reading every 30 minutes is not as frequent as checking vital signs every 15 minutes, which is necessary for early detection of adverse reactions.
Choice C is incorrect as starting the transfusion at a rapid rate can lead to adverse reactions like fluid overload or hemolysis. Transfusions should be started at a slow rate to minimize these risks.
Choice D is incorrect because checking vital signs every hour is not frequent enough to detect early signs of transfusion reactions. Regular monitoring every 15 minutes is recommended for safety.
Question 4 of 5
A nurse is assessing a client who reports numbness and pain in his right palm, index finger, and middle finger. The client reports working with a keyboard most of the time while at work. The nurse suspects carpal tunnel syndrome. Which of the following tests should the nurse request that the client perform?
Correct Answer: B
Rationale: The correct answer is B: Phalen's test. Phalen's test is used to assess for carpal tunnel syndrome by having the client flex the wrists and press the backs of the hands together for 1 minute to compress the median nerve. This test reproduces symptoms in individuals with carpal tunnel syndrome due to increased pressure on the median nerve. Tinel's sign (
A) is used to assess for nerve compression, but it is not specific to carpal tunnel syndrome. Rinne's test (
C) is used to assess for hearing loss. Romberg test (
D) is used to assess for balance and proprioception issues.
Choices E, F, and G are not relevant to assessing carpal tunnel syndrome.
Question 5 of 5
A nurse cares for a client on ethambutol therapy for tuberculosis. What should be monitored?
Correct Answer: B
Rationale: The correct answer is B: Visual acuity. Ethambutol can cause optic neuritis, leading to visual disturbances. Monitoring visual acuity is crucial to detect any changes early.
Incorrect choices:
A: Hearing loss is associated with other medications for TB, not ethambutol.
C: Liver function is not typically affected by ethambutol.
D: Blood glucose is not directly impacted by ethambutol therapy.
In summary, monitoring visual acuity is essential due to the potential optic nerve toxicity of ethambutol, making it the most relevant parameter to monitor in this case.