ATI RN
ATI n200 Med Surg Exam Questions
Extract:
Question 1 of 5
An 18-year-old first year college student is admitted to a medical telemetry unit due to a near syncopal episode at the residence hall. The patient has a history of anxiety, obsessive-compulsive disorder & anorexia nervosa. Their body mass index is 16.7 today. Based on lab data, a right subclavian triple lumen catheter is placed to give total parenteral nutrition (TPN). Ninety minutes after the infusion started, the patient reports muscle cramping, headache & visual changes. Based on these findings, the nurse & healthcare team's highest priority is possible
Correct Answer: A
Rationale: Refeeding syndrome occurs when a malnourished patient is given nutrition (such as TPN), leading to electrolyte imbalances (particularly low phosphorus, potassium, and magnesium) that can cause symptoms like muscle cramping, headache, and visual changes. This condition requires immediate correction of electrolyte imbalances and careful monitoring. Sudden hyperglycemia can occur with TPN, but the symptoms described (muscle cramping, headache, and visual changes) are more consistent with refeeding syndrome. An air embolus is a serious complication but is less likely to be the cause of these symptoms. Acute panic attacks could cause some of the symptoms, but the patient's low BMI and history of anorexia nervosa make refeeding syndrome the more likely cause.
Question 2 of 5
Post total joint replacement, the patient needs for the joint to heal prior to sexual activity. What position is best for the patient after a total joint replacement of the hip?
Correct Answer: A
Rationale: Side-lying on the unaffected side is the safest position for hip replacement patients to avoid dislocating the affected hip. Lateral Sims position is not appropriate for this scenario. Reverse Trendelenburg position is not related to hip replacement precautions. The patient being on the bottom is not recommended for a hip replacement as it could cause stress on the joint.
Question 3 of 5
The client has been diagnosed with rheumatoid arthritis and asks, 'What impact will this have on my activities of daily living in the years to come?' What is the best response by the nurse?
Correct Answer: B
Rationale: Suggesting remedies prematurely without fully understanding the client's concerns might not address their specific needs. The best response is to encourage open communication by acknowledging the client's concerns and fostering a discussion. This approach helps the nurse understand the client's worries and provide tailored information about rheumatoid arthritis and its potential impact on daily life. The progression of rheumatoid arthritis is variable and can affect activities of daily living more noticeably over time; it's not always subtle. While predicting disease outcomes can be difficult, giving a more open response like option B will foster better communication and support.
Question 4 of 5
The nurse recognizes that the goals of teaching about the transmission of tuberculosis have been met when the client with tuberculosis:
Correct Answer: A
Rationale: Covering the mouth (
A) prevents TB spread. Reporting (
B), N95 mask (
C), and washing items (
D) are less critical for transmission.
Question 5 of 5
A client with arthritis is prescribed ibuprofen 800 mg PO TID for pain reduction in the knee. The nurse should instruct the client to report which of the following side effects to the physician? (SELECT ALL THAT APPLY)
Correct Answer: A,B,C
Rationale: Blood in stools: This could indicate gastrointestinal bleeding, a serious side effect of NSAIDs like ibuprofen. Peripheral edema: NSAIDs can cause fluid retention and lead to peripheral edema. Heartburn: Heartburn is a common side effect of NSAIDs due to their gastrointestinal irritation. A cold: This is not related to NSAID use and is not a side effect. Thickened fingernails: This is unrelated to ibuprofen use.