Exam (elaborations) ATI_MedSurg_Practice_A_Key.

1. A nurse is teaching a client who has a family history of colorectal cancer. To help mitigate this risk, which of the following dietary alterations should the nurse recommend? - Add cabbage to the diet 2. A home health nurse is assigned to a client who was recently discharged from a rehabilitation center after experiencing a right-hemispheric stroke. Which of the following neurologic deficits should the nurse expect to find when assessing the client? - Visual spatial deficits - Left hemianopsia - One-sided neglect 3. A nurse is caring for a client who has viral pneumonia. The client’s pulse oximeter readings have fluctuated between 79% and 88% for the last 30 min. - Nonrebreather mask 4. A nurse is caring for a client who has bilateral pneumonia and an SaO2 of 85%. The client has dyspnea with a productive cough and is using accessory muscles to breathe. - Place the client in high- Fowler’s position 5. A nurse is planning care for a client who has extensive burn injuries and is immunocompromised. Which of the following precautions should the nurse include in the plan of care to prevent a Pseudomonas aeruginosa infection? - Avoid placing plants or flowers in the client’s room 6. An older adult client is brought to an emergency department by a family member. Which of the following assessment findings should cause the nurse to suspect that the client has hypertonic dehydration? - Urine specific gravity 1.045 7. A nurse in an emergency department is reviewing the provider’s prescription for a client who sustained a rattlesnake bite to the lower leg. - Administer an opioid analgesic to the client 8. A nurse is assessing a client who has had a suspected stroke. The nurse should place the priority on which of the following findings? - Dysphagia 9. A nurse is teaching a young adult client how to perform testicular self-examination. Which of the following instructions should the nurse include? - Roll each testicle between the thumb and fingers 10. A nurse is providing instructions to a client who has type 2 diabetes mellitus and a new prescription for metformin. Which of the following statements by the client indicates an understanding of the teaching? - I should take this medication with a meal 11. A nurse is teaching a client who has venous insufficiency about self-care. Which of the following statements should the nurse identify as an indication that the client understands the teaching? - “I will wear clean graduated compression stockings every day.” 12. A nurse is assessing a client who has acute cholecystitis. Which of the following findings is the nurse’s priority? - Tachycardia 13. A nurse is reviewing the health record of a client who is scheduled for allergy skin testing. The nurse should postpone the testing and report to the provider which of the following findings? - Current medications 14. A nurse is caring for a group of clients. The nurse should plan to make a referral to physical therapy for which of the following clients? - A client who is receiving preoperative teaching for a right knee arthroplasty 15. A nurse is caring for a client who has diabetic ketoacidosis (DKA). Which for the following laboratory findings should the nurse expect? - BUN 32 mg/dL 16. A nurse is planning teaching for a client who has bladder cancer and is to undergo a cutaneous diversion procedure to establish a ureterostomy. Which of the following statements should the nurse include in the teaching? - “You should cut the opening of the skin barrier one-eight inch wider than the stoma” 17. A nurse is providing teaching for a female client who has recurrent urinary tract infections. Which of the following information should the nurse include in the teaching? - Void before and after intercourse. 18. A nurse and an assistive personnel (AP) are caring for a client who has bacterial meningitis. The nurse should give the AP which of the following instructions? - Wear a mask 19. A nurse is caring for a client who is 12 hr postoperative following a total hip arthroplasty. Which of the following actions should the nurse take? - Place a pillow between the client’s legs. 20. A nurse in a provider’s office is assessing a client who has migraine headaches and is taking feverfew to prevent headaches. The nurse should identify that which of the following client medications interacts with feverfew? - Naproxen