ATI LPN
ATI PN Adult Medical Surgical 2020 with NGN Questions
Extract:
Question 1 of 5
A nurse is monitoring a client who is undergoing a blood transfusion of packed RBCs. The nurse should recognize that which of the following findings indicates fluid overload?
Correct Answer: A
Rationale: Dyspnea indicates fluid overload during a transfusion, as excess volume can lead to pulmonary congestion, requiring immediate action.
Question 2 of 5
A nurse is caring for a client who has a new prescription for enoxaparin. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: Injecting enoxaparin into subcutaneous tissue ensures proper absorption of the anticoagulant, minimizing bruising.
Question 3 of 5
A nurse is preparing a client for a sigmoidoscopy. In which of the following positions should the nurse place the client?
Correct Answer: B
Rationale: The knee-chest position facilitates access to the sigmoid colon during a sigmoidoscopy, optimizing visualization.
Question 4 of 5
A nurse is assisting with care for a client who received a tuberculin skin test 72 hours ago. When collecting data from the test site, which of the following findings indicates a need for further testing?
Correct Answer: A
Rationale: Induration greater than 10 mm indicates a positive tuberculin test, requiring further evaluation for tuberculosis.
Question 5 of 5
A nurse is contributing to the plan of care for a client who has an external fixation device in place to treat an open fracture of the tibia and fibula. Which of the following interventions should the nurse include?
Correct Answer: C
Rationale: Pain medication before pin care reduces discomfort, facilitating effective cleaning and infection prevention.