ATI RN
ATI Medical Surgical 2 Final 2024 Assessment Questions
Extract:
Question 1 of 5
A nurse is providing discharge teaching for a client who is postoperative following a simple mastectomy. The client is to begin outpatient radiation therapy the next day. Which of the following instructions about maintaining skin integrity should the nurse include?
Correct Answer: B
Rationale: Avoiding heat to the irradiated area prevents increased skin irritation and burns.
Question 2 of 5
During a routine physical examination, a nurse observes a 1-cm (0.4-in) lesion on a client's chest. The lesion is raised and flesh-colored with pearly white borders. The nurse should recognize that this finding is suggestive of which of the following types of skin cancer?
Correct Answer: B
Rationale: Malignant melanoma typically presents as a mole that changes in color, size, or feel and has irregular edges. It may also itch, ooze, or bleed. A raised, flesh-colored lesion with pearly white borders is not characteristic of malignant melanoma. Basal cell carcinoma often appears as a raised, pearly bump, sometimes with visible blood vessels, which may have a central depression. The description of the lesion as raised, flesh-colored with pearly white borders aligns with the common presentation of basal cell carcinoma. Squamous cell carcinoma usually presents as a firm, red nodule, or a flat lesion with a scaly, crusted surface. The lesion described does not match the typical appearance of squamous cell carcinoma. Actinic keratosis is characterized by rough, scaly patches on sun-exposed areas of the skin, which may be precancerous. They are not typically described as raised, flesh-colored lesions with pearly borders.
Question 3 of 5
A nurse is caring for a client who is postoperative following an open reduction internal fixation (ORIF) of a femur fracture. Which of the following parameters should the nurse include in the evaluation of the neurovascular status of the client's affected extremity?
Correct Answer: A,C,D
Rationale: Monitoring the temperature of the affected extremity is crucial in evaluating neurovascular status. A cool or cold extremity can indicate decreased perfusion, which may be a sign of neurovascular compromise. Assessing the color of the extremity is essential. Pallor or cyanosis can indicate poor blood flow or oxygenation, which are critical signs of neurovascular impairment. Evaluating sensation helps determine if there is any nerve damage or impairment. Changes in sensation, such as numbness or tingling, can indicate neurovascular compromise.
Question 4 of 5
A nurse is admitting a client to the surgical unit from the Post-Anesthesia Care Unit (PACU) following a cholecystectomy. Which of the following assessments is the nurse's priority?
Correct Answer: B
Rationale: Oxygen saturation is the priority to ensure adequate respiratory function post-anesthesia.
Question 5 of 5
A nurse is caring for an older adult client who had a femoral head fracture 24 hours ago and is in skin traction. The client reports shortness of breath and dyspnea. The nurse should suspect that the client has developed which of the following complications?
Correct Answer: D
Rationale: Fat embolism syndrome is a serious condition that occurs when fat globules enter the bloodstream and lodge within the pulmonary vasculature, leading to respiratory distress. It is a known complication following long bone fractures, such as the femur, and presents with symptoms like shortness of breath, hypoxemia, and neurological manifestations. Given the recent femoral head fracture and the symptoms reported, fat embolism syndrome is the most likely diagnosis.