ATI RN
ATI Nursing 137 Exam 3 Fall 2023 Questions
Extract:
Question 1 of 5
The nurse is taking a health history from a client. The client tells the nurse that. "It feels like the room is spinning." How should the nurse document this finding?
Correct Answer: A
Rationale: The correct answer is A: Vertigo. Vertigo is a specific sensation of spinning or movement when there is no actual movement. The term "feels like the room is spinning" is characteristic of vertigo. Seizure activity (
B) presents with abnormal electrical activity in the brain, not a sensation of spinning. Dizziness (
C) is a vague term that can encompass various sensations, not specific to spinning. Syncope (
D) refers to a temporary loss of consciousness due to decreased blood flow to the brain, not a sensation of spinning.
Question 2 of 5
The nurse is percussing a client's abdomen during a physical assessment. The nurse observes an area of dullness above the right costal margin of approximately 11 cm. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct answer is A: Recognizes this dullness as indicative of an enlarged liver and refers the client to a provider. This answer is correct because dullness above the right costal margin can indicate hepatomegaly (enlarged liver), which may be due to various conditions like liver disease or infection. Referring the client to a healthcare provider is essential for further evaluation and appropriate management.
Choice B is incorrect because simply documenting the presence of hepatomegaly without further action could delay necessary medical intervention.
Choice C is incorrect as asking about alcohol intake alone may not provide a comprehensive assessment of the client's condition.
Choice D is incorrect because dullness above the right costal margin is not a normal finding and should not be overlooked.
Question 3 of 5
The nurse is describing how to perform a testicular self-examination to a client. Which of the following should be the appropriate statement by the nurse?
Correct Answer: B
Rationale:
Correct Answer: B
Rationale:
Choice B is the correct answer because it emphasizes the importance of seeking medical attention if the client notices any abnormalities during the testicular self-examination. This is crucial as early detection of testicular cancer can lead to better treatment outcomes. Calling the health care provider for an enlarged testicle or painless lump ensures prompt evaluation and appropriate management.
Summary of Incorrect
Choices:
A: Incorrect. The timing of the testicular self-examination is not as critical as seeking medical attention for any abnormalities found.
C: Incorrect. Performing a testicular examination once a week may lead to unnecessary anxiety and over-monitoring, as testicular cancer is relatively rare.
D: Incorrect. While the description of the testicle is accurate, this choice does not stress the importance of seeking medical advice for abnormalities found during the examination.
Question 4 of 5
During a community screening event for bone density an elderly client asked the nurse why she is an inch shorter in height. Which of the following responses by the nurse is correct?
Correct Answer: C
Rationale:
Correct Answer: C
Rationale: With aging, the cartilage between the bones in the spine gets worn down, leading to decreased height. This process is known as degenerative disc disease, where the intervertebral discs lose water content and become thinner, causing a reduction in height. As a result, the individual appears shorter. This explanation directly addresses the client's concern about the loss of height and the role of cartilage degeneration in this process.
Summary:
A: Subcutaneous fat loss does not directly contribute to decreased height.
B: Spinal flexibility may decrease with age but does not specifically account for reduced height.
D: Thickening of intervertebral discs and pressure breakdown do not lead to decreased height.
Therefore, option C is the most appropriate response as it accurately explains the mechanism behind the client's height loss.
Question 5 of 5
The nurse is performing a scrotal assessment on a male client. Which of the following findings of the scrotum should the nurse recognize as abnormal?
Correct Answer: D
Rationale: The correct answer is D: Presence of small, firm, non-tender, yellowish nodules. This finding is abnormal as it could indicate the presence of testicular cancer or other concerning conditions. Small, firm, non-tender nodules should raise suspicion and prompt further evaluation.
A: Asymmetry is normal in most males.
B: Marked tenderness could indicate inflammation or infection but is not necessarily abnormal.
C: Easy sliding of scrotal contents is a normal finding.
In summary, choice D is the correct answer due to the concerning nature of the nodules, while the other choices are either normal findings or not indicative of a serious issue.