ATI RN
ATI Med Surg Nursing 300 Final Exam Questions
Extract:
Question 1 of 5
The nurse notices a yellow stain around fluid dripping from a patient's ear who sustained a traumatic brain injury. The nurse's priority intervention will be as follows:
Correct Answer: C
Rationale: Yellow-stained fluid suggests cerebrospinal fluid leak, a TBI complication. Allowing drainage prevents pressure buildup, and notifying the provider ensures further evaluation. Pressure dressings or antibiotics are premature, and IV fluids are unrelated.
Question 2 of 5
The nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which assessment finding indicates a complication of TPN therapy?
Correct Answer: A
Rationale: Blood glucose of 180 mg/dL indicates hyperglycemia, a common TPN complication due to high dextrose content, requiring insulin or rate adjustment.
Question 3 of 5
A client in the gynecology clinic asks the nurse, ''What are the risk factors for developing cervical cancer?'' Which statement by the nurse is the best response?
Correct Answer: C
Rationale: Early sexual activity and multiple partners increase the risk of HPV infection, the primary cause of cervical cancer. Rhinovirus is unrelated, diet and birth control are not primary risks, and Pap smears detect, not prevent, cancer.
Question 4 of 5
The nurse is caring for a client who has a chest tube in place following a pneumothorax. Which assessment finding indicates that the chest tube is functioning properly?
Correct Answer: B
Rationale: Fluctuation (tidaling) in the water seal chamber with respirations indicates the chest tube is patent and functioning, reflecting pleural pressure changes.
Question 5 of 5
Which initial assessment findings would the nurse expect in a client diagnosed with acute lymphocytic leukemia ALL? (SELECT ALL THAT APPLY)
Correct Answer: D,E
Rationale: Petechiae and epistaxis are common due to thrombocytopenia in ALL, causing bleeding tendencies. Ascites, alopecia, and edema are not typical initial findings; alopecia may occur post-chemotherapy.