Exam (elaborations)

ATI Med Surg Retake Nursing Questions with Simplified Solutions All Revised and Graded Pass

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Course
Nursing

Institution
Nursing

1. A nurse is preparing to administer thrombolytic therapy to a client who had an ischemic stroke. Which of the following is an appropriate nursing action? - CORRECT ANSWER -- Elevate the head of the bed between 25 and 30 degrees 2. A nurse is teaching a client about the use of an incentive spi...

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Uploaded on August 8, 2024
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nursing

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Course Nursing

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ATI Med Surg Retake Nursing Questions with

Simplified Solutions All Revised and Graded Pass

1. A nurse is preparing to administer thrombolytic therapy to a client who had an ischemic

stroke. Which of the following is an appropriate nursing action? - CORRECT ANSWER ✔✔ --

Elevate the head of the bed between 25 and 30 degrees

2. A nurse is teaching a client about the use of an incentive spirometer. Which of the following

instructions should the nurse include in the teaching? - CORRECT ANSWER ✔✔ --Hold breath

about 3 to 5 seconds before exhaling.

3. A nurse is assessing a client who is 12 hr. postoperative following a colon resection. Which of

the following findings should the nurse report to the surgeon? - CORRECT ANSWER ✔✔ -Hgb

8.2 g/dl

A home care nurse is planning to use nonpharmacological pain relief measures for

an older adult client who has severe chronic back pain. Which of the following

guidelines should the nurse use - CORRECT ANSWER ✔✔ -Distraction changes the client's

perception of pain, but does not affect the cause

A nurse at a long-term care facility is assessing an older adult client. Which of the

following findings should the nurse identify as an indication that the client has a recall

,memory impairment? - CORRECT ANSWER ✔✔ -Inability to state what he had for dinner last

nigh

A nurse caring for a client at risk for increased intracranial pressure is monitoring the client for

manifestations that indicate that the pressure is increasing. To do this, the nurse should check the

function of the third cranial nerve by performing which of the following data-collection

activities? - CORRECT ANSWER ✔✔ -Checking pupillary responses to light

A nurse in a clinic is providing preventive teaching to an older adult client during

a well visit. The nurse should instruct the client that which of the following

immunizations are recommended for healthy adults after age 60? - CORRECT ANSWER ✔✔ --

Herpes zoster

- Pneumococcal polysaccharide

- influenza

A nurse in a orovider's ortice is collectina dad for a 45-ver-old client wno is having

manifestations associated with perimenopause. Which of the following findings should the nurse

expect - CORRECT ANSWER ✔✔ -Report of dryness with vaginal bleeding

A nurse in a provider's office is reinforcing teaching with a client who has anemia and has been

taking

ferrous gluconate for several weeks. Which of the following instructions should the nurse

include? - CORRECT ANSWER ✔✔ -Take this medication between meals.

,A nurse in an emergency department is assessing a client who has cirrhosis of

the liver. Which of the following is a priority finding? - CORRECT ANSWER ✔✔ -Mental

confusion

A nurse in an emergency department is caring for a client who has sinus

bradycardia. Which of the following actions should the nurse take first? - CORRECT ANSWER

✔✔ -Measure the client's blood pressure.

A nurse in an emergency department Is caring for a client who is receiving treatment

for excessive ingestion of antacids. The nurse should Identify that this client Is at risk for

which of the following acid-base imbalances? - CORRECT ANSWER ✔✔ -Metabolic alkalosis

A nurse in an emergency department is reviewing a client's ECG reading. Which of

the following findings should the nurse identify as an indication that the client has

first-degree heart block? - CORRECT ANSWER ✔✔ -Prolonged PR intervals

A nurse in the emergency department is assessing a client. Which of the following actions

should the nurse take first?

Reports productive cough with yellow sputum for the past 2 weeks. Reports nausea,

vomiting, night sweats and 3.2 kg (7lb) weight loss in the past month. - CORRECT ANSWER

✔✔ --Initiate airborne precautions

A nurse in the emergency department is caring for a client who has deep partial thickness

, burns over 30% of his body, including his upper chest and abdomen. Which of the following

actions is the nurse priority? - CORRECT ANSWER ✔✔ -Check the clients mouth for black

particles.

A nurse is admitting a client to the emergency department after a gunshot

wound to the abdomen. Which of the following actions should the nurse take to

help prevent the onset of acute kidney failure? - CORRECT ANSWER ✔✔ -Administer IV

fluids to the client

A nurse is admitting a client who reports chest pain and has been placed on a telemetry

monitor. Which of the following should the nurse analyze to determine whether the client is

experiencing a myocardial infarction? - CORRECT ANSWER ✔✔ -ST segment

A nurse is assessing a client 15 min after the start of a transfusion of 1 unit of

packed RBCs. Which of the following findings is an indication of a hemolytic

transfusion reaction? - CORRECT ANSWER ✔✔ -Hypotension

A nurse is assessing a client for a positive Chvostek's sign following a

thyroidectomy. Which of the following areas on the client's head should the nurse tap to

assess the client for tetany? - CORRECT ANSWER ✔✔ -Cheek area

A nurse is assessing a client who has acute kidney failure. Which of the following

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