ATI RN
ATI RN Adult Medical Surgical 2023 I Questions
Extract:
Question 1 of 5
A nurse is reinforcing discharge teaching with a client on how to care for a newly created ileal conduit. Which of the following instructions should the nurse include in the teaching?
Correct Answer: B
Rationale: Emptying the pouch when 2/3 full prevents leakage and maintains skin integrity.
Question 2 of 5
A nurse is caring for a client who has a peripherally inserted central catheter (PICC) for the administration of total parenteral nutrition (TPN). The transparent dressing over the insertion site requires replacement. Which of the following actions should the nurse take?
Correct Answer: B
Rationale: Sterile technique is required for PICC dressing changes to prevent infection.
Question 3 of 5
The nurse is instructing the client on the correct way to take nitroglycerin as needed for chest pain:
Correct Answer: D
Rationale: Sublingual nitroglycerin every 5 minutes up to 3 doses is the standard protocol for acute chest pain relief.
Question 4 of 5
A client with a spinal cord injury is at risk for experiencing autonomic dysreflexia. The nurse would carefully monitor the client for which of the following manifestations?
Correct Answer: A
Rationale: Severe headache is a primary sign of autonomic dysreflexia due to sudden hypertension from unopposed sympathetic response.
Question 5 of 5
A patient is exhibiting an altered level of consciousness and is unresponsive to verbal stimuli. To elicit a response from a painful stimulus, the nurse would:
Correct Answer: B
Rationale: Pinching the trapezius muscle is a safe, effective method to assess response to pain in an unresponsive patient.