ATI RN
ATI Med Surg Exam 9 Questions
Extract:
Question 1 of 5
The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis. The client reports a sudden increase in abdominal pain and begins to vomit. On assessment, the nurse notes that the abdomen is distended and bowel sounds are diminished. Which is the best first action the nurse should take?
Correct Answer: C
Rationale: Reason: Requesting the charge nurse put the client on the surgery schedule is not the best first action, as it does not address the urgency of the situation. The client may have a perforated appendix, which is a life-threatening complication that requires immediate intervention. Reason: Documenting the WBC count from the morning labs is not the best first action, as it does not address the client's current condition. The WBC count may be elevated due to inflammation or infection, but it does not indicate the severity of the problem. Reason: This is the correct choice. Notifying the healthcare provider is the best first action, as it alerts them to the possibility of a perforated appendix and allows them to order appropriate tests and treatments. Reason: Providing an antiemetic is not the best first action, as it does not address the underlying cause of the vomiting. The client may have peritonitis, which is inflammation of the abdominal cavity due to leakage of intestinal contents. An antiemetic may mask this symptom and delay diagnosis and treatment.
Question 2 of 5
A client has just had surgery to create an ileostomy. The nurse assesses the client in the immediate postoperative period for which most frequent complication of this type of surgery?
Correct Answer: D
Rationale: Fluid and electrolyte imbalance is a common complication of ileostomy surgery because the colon, which is bypassed, is primarily responsible for absorbing fluids and electrolytes. This leads to increased loss through stool, potentially causing dehydration and imbalances in sodium and potassium.
Question 3 of 5
A nurse is preparing a client with extensive burns for hydrotherapy. What is the priority action by the nurse?
Correct Answer: C
Rationale: Providing analgesics before hydrotherapy begins reduces pain and anxiety, facilitating wound healing (
Choice
C). Educating the client is important but secondary to pain management (
Choice
A). Analgesics after therapy alone are insufficient, as pain occurs during the procedure (
Choice
B). Clean supplies are essential but not the priority over pain relief (
Choice
D).
Question 4 of 5
The client inquires what the positive result from the potassium hydroxide (KOH) test indicates. Which of the following is an accurate response by the nurse?
Correct Answer: B
Rationale: A positive KOH test indicates a fungal infection, as it reveals fungal elements under a microscope.
Question 5 of 5
A nurse is caring for a client who has dementia. Which of the following actions should the nurse take to reduce the client's risk of aspiration pneumonia?
Correct Answer: D
Rationale: Sitting the client upright at 90 degrees during feeding helps gravity direct food away from the lungs, reducing the risk of aspiration pneumonia.