ATI RN
ATI Medsurg Exam 5 Questions
Extract:
Question 1 of 5
The nurse recognizes that an important tool in building cultural competence when caring for a client is the:
Correct Answer: A
Rationale: The cultural assessment competency tool guides nurses in collecting culturally relevant information to provide respectful care, unlike tools focused on health risks, ethnic identity, or heritage.
Question 2 of 5
The nurse documents the blood pressure on a client to be 158/94 mm Hg when lying in bed, 13 mm Hg when sitting in a chair, and 98/60 mm Hg when standing. The nurse should recognize which of the following as the evaluation of this?
Correct Answer: A
Rationale: The significant drop in blood pressure upon standing indicates orthostatic hypotension, not hypertension or normal variation.
Question 3 of 5
The nurse is assessing for Jaundice on a client diagnosed with liver disease. Which of the following should the nurse document as an assessment finding for jaundice?
Correct Answer: A
Rationale: Jaundice causes yellowing of the sclera due to bilirubin buildup, visible in normal light, unlike nail deposits or iris involvement.
Question 4 of 5
The nurse is caring for an older adult client in the emergency room diagnosed with dehydration after being found lying on the floor for 2 days. Which of the following assessment findings should the nurse expect on a dehydrated client?
Correct Answer: A
Rationale: Dehydration causes dry mucous membranes and lips due to reduced fluid levels, unlike pale membranes, smooth lips, or white patches, which indicate other conditions.
Question 5 of 5
The nurse is caring for a client with stage 2 pressure ulcer. The nurse should document which of the following as characteristic of a stage II pressure ulcer?
Correct Answer: D
Rationale: Stage II pressure ulcers involve partial-thickness loss with open blisters and a red-pink wound bed, not eschar or subcutaneous involvement.