ATI RN
ATI Med Surg Pharm Comprehensive Exam 1 Questions
Extract:
Nurses' Notes
0800: Client reports abdominal pain that began the previous evening. Client is two weeks postoperative from a right knee replacement. Reports taking 3 to 4 hydrocodone tablets daily for postoperative pain. Has not had bowel movement in 4 days. Reports not drinking many fluids to avoid having "to get up and go to the bathroom so often because it hurts to walk."
0830: Client taken for abdominal x-ray. Partner reports that client has not been following physical therapist's exercise regimen of walking several times daily.
0915: Fecal mass of hard, dry stool removed digitally from client per provider's order.
1015: Provided teaching to client and partner about constipation and methods to avoid further impaction.
Diagnostic Results
0900:
Abdominal x-ray: Large amount of fecal material throughout the colon with rectal impaction. No evidence of small bowel obstruction.
Question 1 of 5
A nurse is providing teaching to a client who has constipation. Which of the following information should the nurse include?(Select all that apply.)
Correct Answer: C,D,E
Rationale: Including probiotic foods in the diet can help maintain a healthy gut flora, which is beneficial for digestion and preventing constipation. It is crucial to increase fluid intake, aiming for at least 1500 mL daily, to help soften the stool and support regular bowel movements. Increasing daily exercise, especially walking, can stimulate the muscles involved in the digestive process and help prevent constipation.
Extract:
Question 2 of 5
A nurse is caring for a client who has metastatic bone cancer. The client states, 'I want to go home to die.' The family is concerned about meeting the client's care needs at home. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: Discussing initiating hospice care is appropriate to address the client's desire to go home for end-of-life care and to provide support and resources for the family.
Question 3 of 5
A nurse is caring for a client who has not voided for 8 hr following the removal of an indwelling urinary catheter. Which of the following actions should be the nurse take first?
Correct Answer: C
Rationale: Performing a bladder scan is the first action to assess if the client has urine in the bladder and needs further intervention.
Extract:
History and Physical
Diabetes mellitus type 2 for 15 years
Hypertension for 25 years
Hyperlipidemia for 20 years
History of smoking 40 packs per year
Cerebrovascular accident (CVA) 5 days ago
Nurses' Notes
Day 1, Medical-Surgical Unit (5 days post-CVA):
Client transferred from ICU via gurney, hand-off report received. Client asleep, respirations eupneic, heart rate regular. Abdomen soft, nondistended, active bowel sounds x4 quadrants. No edema noted, compression stockings present. Indwelling urinary catheter draining clear yellow urine. 14 French NG tube noted in right nares, clamped.
Day 2, Medical-Surgical Unit (6 days post-CVA):
Assessment completed. Client awakens for short periods of time, unable to speak, occasional moans noted. Client incontinent of stool, cleaned skin and barrier ointment applied. Skin intact without any areas of erythema. Client unable to reposition self. Occasional movement of left arm and leg noted, right side without movement. Physical therapists in to see client for morning exercises. NG tube noted in right nares, clamped.
Provider Prescriptions
Day 1, Medical-Surgical Unit (5 days post-CVA):
Begin clopidogrel 75 mg via NG tube daily
Diagnostic Results
Day 1, Medical-Surgical Unit (5 days post-CVA):
WBC count 6,900/mm3 (5,000 to 10,000/mm3)
Hgb 16 g/dL (12 g/dL to 16 g/dL)
Hct 41% (37% to 47%)
Platelet count 310,000/mm3 (150,000 to 400,000/mm3)
Day 2, Medical-Surgical Unit (6 days post-CVA):
WBC count 7,200/mm3 (5,000 to 10,000/mm3)
Hgb 16.5 g/dL (12 g/dL to 16 g/dL)
Hct 42% (37% to 47%)
Day 1, Medical-Surgical Unit (5 days post-CVA):
WBC count 6,900/mm3 (5,000 to 10,000/mm3)
Hgb 16 g/dL (12 g/dL to 16 g/dL)
Hct 41% (37% to 47%)
Platelet count 310,000/mm3 (150,000 to 400,000/mm3)
Day 2, Medical-Surgical Unit (6 days post-CVA):
WBC count 7,200/mm3 (5,000 to 10,000/mm3)
Hgb 16.5 g/dL (12 g/dL to 16 g/dL)
Hct 42% (37% to 47%)
Question 4 of 5
The client is at risk for developing _ and _
Correct Answer: A,B
Rationale: The client is at risk for developing pressure injury and foot drop. Given the client's history of a recent cerebrovascular accident (CV
A) and the inability to reposition themselves, there is a heightened risk for pressure injuries due to prolonged periods of immobility. Additionally, the observed occasional movement of the left arm and leg with the right side without movement suggests a potential for muscle weakness or paralysis, which can lead to foot drop.
Extract:
Question 5 of 5
A nurse is teaching the partner of a client who had a stroke about dysphagia. Which of the following statements by the client's partner should indicate to the nurse that the teaching was effective?
Correct Answer: B
Rationale: Tilting the head forward when swallowing helps to close the airway and reduce the risk of aspiration, indicating effective teaching.