ATI PN adult Medical Surgical 2020 with NGN Exam 3

Extract:

Question 1 of 5

A nurse is providing care to a client who has sustained deep partial thickness burns to the back of both legs. Which of the following actions should the nurse anticipate taking?

A. Restrict the client's calorie intake to no more than 2,000 calories per day.B. Change sterile gloves between caring for wounds on different areas of the body.C. Administer a diuretic if the client's urine output falls below 30 mL/hr.D. Limit movement or bending of the client's affected extremities.

Correct Answer: B

Rationale: Changing gloves between wound care on different areas prevents cross-contamination, a critical infection control measure.

Question 2 of 5

A nurse is reinforcing teaching with a client who has diabetes mellitus about reducing the risk for a stroke. Which of the following statements by the client indicates an understanding of the teaching?

A. I can decrease my risk for a stroke by losing excess weight.B. My provider might prescribe a glucocorticoid regimen to decrease my risk for a stroke.C. My risk for a stroke increases if my HbA1c level is 6 percent or less.D. Having a total cholesterol level below 200 mg/dL increases my risk for a stroke.

Correct Answer: A

Rationale: Losing excess weight reduces stroke risk, particularly in individuals with diabetes.

Question 3 of 5

A nurse is prioritizing care for four clients. Which of the following clients should the nurse see first?

A. A client who has a spinal cord injury and has a prescription for a condom catheter.B. A client who has immune thrombocytopenic purpura and a platelet count of 150,000/mm.C. A client who reports pain in his left calf and has a respiratory rate of 32/min.D. A client who requires a signed consent form prior to cardiac catheterization.

Correct Answer: C

Rationale: The client reporting pain in the left calf with an elevated respiratory rate could be experiencing a deep vein thrombosis (DVT) leading to a pulmonary embolism, which is a medical emergency.

Question 4 of 5

A charge nurse is observing a newly licensed nurse care for a client who is at risk for falls. Which of the following findings should the nurse identify as a risk factor for falls?

A. Keeps the client's bed in the low positionB. Positions the bedside table close to the clientC. Attaches the call light to the side rail of the client's bedD. Instructs the client to wear their own socks to the bathroom

Correct Answer: D

Rationale: Socks without grips can cause slipping, increasing fall risk.

Question 5 of 5

A nurse is monitoring laboratory values for a client who is receiving hemodialysis and has a serum calcium level of 7.2 mg/dL. For which of the following should the nurse monitor?

A. Hyperactive deep tendon reflexesB. Hypoactive bowel soundsC. LethargyD. Positive Cullen's sign

Correct Answer: C

Rationale: Lethargy is a symptom of hypocalcemia, associated with a low calcium level of 7.2 mg/dL.

ATI PN adult Medical Surgical 2020 with NGN Exam 3 | Nurselytic

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