ATI RN Adult Medical Surgical 2023
Seizure precautions - (correct Answer) - Ensure client has IV access for seizure medication
administration.
Postoperative lab values - (correct Answer) - Report Hgb level of 8 g/dL to provider as an indicator of
postoperative hemorrhage or anemia.
ESWL procedure - (correct Answer) - Expect stone fragments in the urine after extracorporeal shock
wave lithotripsy.
Airborne precautions - (correct Answer) - Initiate airborne precautions for a client with anorexia, low-
grade fever, night sweats, and productive cough, as these are manifestations of tuberculosis.
TPN administration - (correct Answer) - Administer dextrose 10% in water until new TPN bag arrives to
avoid drop in blood glucose level.
Levothyroxine interaction - (correct Answer) - Instruct client to avoid taking calcium within 4 hr of
levothyroxine administration, as calcium can interfere with the effectiveness of the medication.
Mechanical ventilation anxiety - (correct Answer) - Instruct client to allow the machine to breathe for
them to reduce anxiety and restlessness associated with fighting the ventilator.
Adverse effect of enalapril - (correct Answer) - Identify orthostatic hypotension as an adverse effect of
enalapril.
Delayed wound healing - (correct Answer) - Identify urine output of 25 mL/hr as a finding that
contributes to delayed wound healing.
Hypothyroidism and opioid analgesic - (correct Answer) - Instruct client to void every 4 hours to decrease
the risk of urinary retention, which is an adverse effect of opioid analgesics.
Portal hypertension - (correct Answer) - Obtain vital signs first when caring for a client who is vomiting
blood mixed with food after a meal, as this indicates a potential rupture of esophageal varices.
Gastrectomy postoperative instructions - (correct Answer) - Instruct client to avoid drinking fluids with
meals, eat several small meals per day, consume high-protein snacks, and avoid highly seasoned foods.
Cushing's triad - (correct Answer) - Identify bradycardia as a component of Cushing's triad in a client with
increased intracranial pressure from a traumatic brain injury.
Client coping with diabetes diagnosis - (correct Answer) - Recognize the client's change in behavior of
inspecting feet daily as an indication of successful coping with the diagnosis.
Inguinal hernia assessment - (correct Answer) - Palpate location C to verify the presence of an inguinal
hernia.
Rattlesnake bite treatment - (correct Answer) - Expect a prescription for an opioid analgesic to promote
comfort following a rattlesnake bite.
, Hemodialysis treatment - (correct Answer) - Perform a 12-lead ECG, place the client in Trendelenburg
position, administer a 0.9% sodium chloride 200 mL IV bolus, apply oxygen at 2 L/min via nasal cannula,
and notify the provider immediately.
Client rights - (correct Answer) - Ensure a client signs informed consent before receiving a placebo during
a research trial.
Omeprazole action - (correct Answer) - Instruct the client that omeprazole provides relief by suppressing
gastric acid production.
Physical therapy referral - (correct Answer) - Refer a client who is receiving preoperative teaching for a
right knee arthroplasty to physical therapy to begin understanding postoperative exercises and physical
restrictions.
Droplet precautions - (correct Answer) - Instruct an assistive personnel (AP) to wear a mask when
coming within 3 ft of a client who has bacterial meningitis.
Stress incontinence and weight loss - (correct Answer) - Recommend weight loss to reduce excess
abdominal pressure and mitigate the risk of stress incontinence.
Hypokalemia and bowel sounds - (correct Answer) - Expect hypoactive bowel sounds in a client with
hypokalemia.
Diagnostic results follow-up - (correct Answer) - Follow up on PCO2 level, WBC count, chest X-ray, and
oxygen saturation level.
Neurological event follow-up - (correct Answer) - Follow up on visual disturbances, tingling of the lips,
hand grasps, and expressive aphasia.
Testicular self-examination - (correct Answer) - Instruct the client to roll each testicle between the thumb
and fingers to feel for any lumps deep in the center of the testicle.
Hyperthyroidism assessment - (correct Answer) - Report blood pressure of 170/80 mm Hg to the
provider as a priority finding.
Muscle cramps and tingling sensation - (correct Answer) - Administer calcium carbonate to a client
experiencing muscle cramps and tingling sensation in the hands.
Seizure intervention - (correct Answer) - Turn the client to the side during a seizure to prevent aspiration.
Medication to withhold prior to cardioversion - (correct Answer) - Instruct the client to withhold digoxin
for 48 hr prior to cardioversion.
Sildenafil and nitroglycerin - (correct Answer) - Inform the client that they cannot use sildenafil if they
are taking nitroglycerin due to the risk of significant hypotension.
Magnesium sulfate adverse effects - (correct Answer) - Monitor for respiratory paralysis as an adverse
effect of magnesium sulfate.
Erythropoietin therapy - (correct Answer) - Explain that the medication is taken to increase energy levels
by increasing hematocrit and reducing fatigue.
Seizure precautions - (correct Answer) - Ensure client has IV access for seizure medication
administration.
Postoperative lab values - (correct Answer) - Report Hgb level of 8 g/dL to provider as an indicator of
postoperative hemorrhage or anemia.
ESWL procedure - (correct Answer) - Expect stone fragments in the urine after extracorporeal shock
wave lithotripsy.
Airborne precautions - (correct Answer) - Initiate airborne precautions for a client with anorexia, low-
grade fever, night sweats, and productive cough, as these are manifestations of tuberculosis.
TPN administration - (correct Answer) - Administer dextrose 10% in water until new TPN bag arrives to
avoid drop in blood glucose level.
Levothyroxine interaction - (correct Answer) - Instruct client to avoid taking calcium within 4 hr of
levothyroxine administration, as calcium can interfere with the effectiveness of the medication.
Mechanical ventilation anxiety - (correct Answer) - Instruct client to allow the machine to breathe for
them to reduce anxiety and restlessness associated with fighting the ventilator.
Adverse effect of enalapril - (correct Answer) - Identify orthostatic hypotension as an adverse effect of
enalapril.
Delayed wound healing - (correct Answer) - Identify urine output of 25 mL/hr as a finding that
contributes to delayed wound healing.
Hypothyroidism and opioid analgesic - (correct Answer) - Instruct client to void every 4 hours to decrease
the risk of urinary retention, which is an adverse effect of opioid analgesics.
Portal hypertension - (correct Answer) - Obtain vital signs first when caring for a client who is vomiting
blood mixed with food after a meal, as this indicates a potential rupture of esophageal varices.
Gastrectomy postoperative instructions - (correct Answer) - Instruct client to avoid drinking fluids with
meals, eat several small meals per day, consume high-protein snacks, and avoid highly seasoned foods.
Cushing's triad - (correct Answer) - Identify bradycardia as a component of Cushing's triad in a client with
increased intracranial pressure from a traumatic brain injury.
Client coping with diabetes diagnosis - (correct Answer) - Recognize the client's change in behavior of
inspecting feet daily as an indication of successful coping with the diagnosis.
Inguinal hernia assessment - (correct Answer) - Palpate location C to verify the presence of an inguinal
hernia.
Rattlesnake bite treatment - (correct Answer) - Expect a prescription for an opioid analgesic to promote
comfort following a rattlesnake bite.
, Hemodialysis treatment - (correct Answer) - Perform a 12-lead ECG, place the client in Trendelenburg
position, administer a 0.9% sodium chloride 200 mL IV bolus, apply oxygen at 2 L/min via nasal cannula,
and notify the provider immediately.
Client rights - (correct Answer) - Ensure a client signs informed consent before receiving a placebo during
a research trial.
Omeprazole action - (correct Answer) - Instruct the client that omeprazole provides relief by suppressing
gastric acid production.
Physical therapy referral - (correct Answer) - Refer a client who is receiving preoperative teaching for a
right knee arthroplasty to physical therapy to begin understanding postoperative exercises and physical
restrictions.
Droplet precautions - (correct Answer) - Instruct an assistive personnel (AP) to wear a mask when
coming within 3 ft of a client who has bacterial meningitis.
Stress incontinence and weight loss - (correct Answer) - Recommend weight loss to reduce excess
abdominal pressure and mitigate the risk of stress incontinence.
Hypokalemia and bowel sounds - (correct Answer) - Expect hypoactive bowel sounds in a client with
hypokalemia.
Diagnostic results follow-up - (correct Answer) - Follow up on PCO2 level, WBC count, chest X-ray, and
oxygen saturation level.
Neurological event follow-up - (correct Answer) - Follow up on visual disturbances, tingling of the lips,
hand grasps, and expressive aphasia.
Testicular self-examination - (correct Answer) - Instruct the client to roll each testicle between the thumb
and fingers to feel for any lumps deep in the center of the testicle.
Hyperthyroidism assessment - (correct Answer) - Report blood pressure of 170/80 mm Hg to the
provider as a priority finding.
Muscle cramps and tingling sensation - (correct Answer) - Administer calcium carbonate to a client
experiencing muscle cramps and tingling sensation in the hands.
Seizure intervention - (correct Answer) - Turn the client to the side during a seizure to prevent aspiration.
Medication to withhold prior to cardioversion - (correct Answer) - Instruct the client to withhold digoxin
for 48 hr prior to cardioversion.
Sildenafil and nitroglycerin - (correct Answer) - Inform the client that they cannot use sildenafil if they
are taking nitroglycerin due to the risk of significant hypotension.
Magnesium sulfate adverse effects - (correct Answer) - Monitor for respiratory paralysis as an adverse
effect of magnesium sulfate.
Erythropoietin therapy - (correct Answer) - Explain that the medication is taken to increase energy levels
by increasing hematocrit and reducing fatigue.
