ATI Nur258 Med Surg 2 Final Exam | Nurselytic

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ATI Nur258 Med Surg 2 Final Exam Questions

Extract:

Nurses' Notes
Family member brought client to the ED for pain in left arm that began last evening. Client has a history of sickle cell disease diagnosed at age 4 years. Client has prescription for oral morphine sulfate and took one dose last evening at 1800 and this morning at 0900. Client reports no relief from pain, reporting it as 9 on a scale of 0 to 10.
Physical Examination
Client appears in moderate distress, reporting throbbing and stabbing pain to the left arm and hand. Client has full range of motion to arm, wrist, and fingers but resists movement due to pain. Capillary refill is less than 2 seconds, skin warm and dry, no edema, no rashes, no lesions. Client has used oral morphine sulfate in the past to alleviate pain. Reports taking dose of morphine sulfate last night at 1800 with no relief. Took an additional dose of morphine sulfate at 0900 this morning and states, "I am in still in pain, the morphine didn't work." Heart rate regular with no murmur, lungs clear, abdomen soft and nontender.


Vital Signs
Blood pressure 114/68 mm Hg
Heart rate 98/min
Respiratory rate 18/min
Temperature 37.1° C (98.9° F)
SpO2 95% on room air


Question 1 of 5

For each potential healthcare provider's prescription, click to specify if the potential prescription is anticipated, nonessential, or contraindicated for the client.

Options Anticipated NonessentialContraindicated
Intravenous fluid administration
Ice packs to affected area 15 min on/15 min off
Ambulation in hallway with supervision
Hydromorphone intravenously (IV) for pain
Acetaminophen orally (PO) for pain
Oxygen 2 L/min via nasal cannula

Correct Answer: A,D

Rationale: Intravenous fluid administration is anticipated to reduce viscosity of sickled cells. Hydromorphone IV is anticipated for severe pain unresponsive to oral morphine.

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Question 2 of 5

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Question 3 of 5

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Question 4 of 5

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Question 5 of 5

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