ATI PN ADULT MEDICAL SURGICAL PROCTORED EXAM WITH
NGN 170 – QUESTIONS AND ANSWERS | VERIFIED AND WELL
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1. A licensed practical nurse (LPN) is reinforcing discharge instructions with a client who
has a new prescription for warfarin. Which of the following statements by the client
indicates an understanding of the teaching?
A. "I will increase my intake of dark leafy green vegetables daily."
B. "I should use a soft-bristled toothbrush and an electric razor."
C. "I can take aspirin for occasional headaches while on this medication."
D. "I will discontinue the medication immediately if I notice minor bruising."
Clients taking warfarin, an anticoagulant, are at an increased risk for bleeding. Using a soft-
bristled toothbrush and an electric razor minimizes the risk of gum trauma and skin cuts.
Dark leafy green vegetables are high in vitamin K, which antagonizes warfarin, and intake
should remain consistent rather than increased. Aspirin increases bleeding risk and should be
avoided unless explicitly prescribed. The client should never discontinue warfarin without
consulting the primary healthcare provider.
2. A nurse is caring for a client who is 4 hr postoperative following a total knee
arthroplasty. Which of the following findings should the nurse report immediately to the
provider?
A. Temperature of 37.8°C (100.0°F)
B. Serosanguineous drainage on the dressing measuring 4 cm
C. Absence of pedal pulses in the operative extremity
D. Report of mild pain controlled adequately by oral medication
The absence of distal pulses indicates compromised arterial blood flow to the extremity, which
is a medical emergency that can lead to tissue ischemia and loss of the limb. A low-grade
temperature of 37.8°C is common immediately postoperatively. A small amount of
serosanguineous drainage is expected. Mild, controlled pain is an expected postoperative
finding.
,3. A nurse is collecting data from a client who has a diagnosis of left-sided heart failure.
Which of the following findings should the nurse expect?
A. Jugular vein distention
B. Dependent peripheral edema
C. Exertional dyspnea
D. Hepatomegaly
Left-sided heart failure results in the inability of the left ventricle to pump effectively, leading
to pulmonary congestion and increased pulmonary pressure, which manifests as exertional
dyspnea, orthopnea, and crackles in the lungs. Jugular vein distention, dependent peripheral
edema, and hepatomegaly are classic clinical manifestations of right-sided heart failure.
4. A nurse is caring for a client who has chronic kidney disease and a serum potassium
level of 6.8 mEq/L. Which of the following medications should the nurse expect to
administer first?
A. Oral sodium polystyrene sulfonate
B. Intravenous regular insulin in dextrose 10% water
C. Oral potassium chloride
D. Furosemide tablets
A serum potassium level of 6.8 mEq/L indicates severe hyperkalemia, which places the client
at high risk for fatal cardiac arrhythmias. Administering regular insulin intravenously along
with dextrose shifts potassium rapidly into the cells, lowering serum levels within minutes.
Sodium polystyrene sulfonate works too slowly for acute severe hyperkalemia. Potassium
chloride would worsen the condition. Furosemide is too slow for acute emergency correction
of this level.
5. A nurse is reinforcing teaching with a client who has a newly created colostomy. Which
of the following instructions should the nurse include?
A. "Change the pouching system every day without fail."
B. "Cut the skin barrier opening 1/8 inch larger than the stoma."
C. "Expect the stoma to appear pale pink and dry."
D. "Empty the ostomy pouch when it is completely full."
, The skin barrier opening should be cut approximately 1/8 inch larger than the stoma to
prevent excoriation and trauma to the stoma tissue while protecting the surrounding skin from
effluent. The pouching system is typically changed every 3 to 5 days, not daily. A healthy
stoma should appear moist, shiny, and red or pink. The pouch should be emptied when it is
one-third to one-half full to prevent pulling and leaks.
6. A nurse is caring for a client who has a diagnosis of type 1 diabetes mellitus and is found
unresponsive. The client's blood glucose reading is 38 mg/dL. Which of the following
actions should the nurse take?
A. Administer regular insulin subcutaneously.
B. Administer 50% dextrose intravenous push.
C. Provide 4 oz of orange juice orally.
D. Instruct the client to consume carbohydrate tablets.
Because the client is unresponsive, oral administration of glucose is contraindicated due to
the high risk of aspiration. Intravenous administration of 50% dextrose rapidly restores blood
glucose levels in an emergency. Insulin would lower blood glucose further. Orange juice and
carbohydrate tablets require a conscious client who can safely swallow.
7. A nurse is reviewing the laboratory results of a client who is receiving chemotherapy and
has a white blood cell (WBC) count of 2,000/mm3. Which of the following precautions
should the nurse implement?
A. Bleeding precautions
B. Neutropenic precautions
C. Contact precautions
D. Airborne precautions
A WBC count of 2,000/mm3 indicates leukopenia, specifically neutropenia, placing the client
at severe risk for opportunistic infections. Neutropenic precautions include strict hand
hygiene, avoiding raw fruits and vegetables, restricting live plants, and limiting visitors.
Bleeding precautions are for low platelets. Contact and airborne precautions are for infectious
transmission control, not primary immunosuppression.
8. A nurse is caring for a client who is scheduled for an open cholecystectomy. Which of the
following interventions is the priority in the immediate postoperative period?
A. Encouraging early ambulation
NGN 170 – QUESTIONS AND ANSWERS | VERIFIED AND WELL
DETAILED ANSWERS PLUS RATIONALES | GUARANTEED PASS |
LATEST EXAM UPDATE | EXAM PREP | STUDY GUIDE |
PRACTICE TEST| DOWNLOAD INSTANT PDF
1. A licensed practical nurse (LPN) is reinforcing discharge instructions with a client who
has a new prescription for warfarin. Which of the following statements by the client
indicates an understanding of the teaching?
A. "I will increase my intake of dark leafy green vegetables daily."
B. "I should use a soft-bristled toothbrush and an electric razor."
C. "I can take aspirin for occasional headaches while on this medication."
D. "I will discontinue the medication immediately if I notice minor bruising."
Clients taking warfarin, an anticoagulant, are at an increased risk for bleeding. Using a soft-
bristled toothbrush and an electric razor minimizes the risk of gum trauma and skin cuts.
Dark leafy green vegetables are high in vitamin K, which antagonizes warfarin, and intake
should remain consistent rather than increased. Aspirin increases bleeding risk and should be
avoided unless explicitly prescribed. The client should never discontinue warfarin without
consulting the primary healthcare provider.
2. A nurse is caring for a client who is 4 hr postoperative following a total knee
arthroplasty. Which of the following findings should the nurse report immediately to the
provider?
A. Temperature of 37.8°C (100.0°F)
B. Serosanguineous drainage on the dressing measuring 4 cm
C. Absence of pedal pulses in the operative extremity
D. Report of mild pain controlled adequately by oral medication
The absence of distal pulses indicates compromised arterial blood flow to the extremity, which
is a medical emergency that can lead to tissue ischemia and loss of the limb. A low-grade
temperature of 37.8°C is common immediately postoperatively. A small amount of
serosanguineous drainage is expected. Mild, controlled pain is an expected postoperative
finding.
,3. A nurse is collecting data from a client who has a diagnosis of left-sided heart failure.
Which of the following findings should the nurse expect?
A. Jugular vein distention
B. Dependent peripheral edema
C. Exertional dyspnea
D. Hepatomegaly
Left-sided heart failure results in the inability of the left ventricle to pump effectively, leading
to pulmonary congestion and increased pulmonary pressure, which manifests as exertional
dyspnea, orthopnea, and crackles in the lungs. Jugular vein distention, dependent peripheral
edema, and hepatomegaly are classic clinical manifestations of right-sided heart failure.
4. A nurse is caring for a client who has chronic kidney disease and a serum potassium
level of 6.8 mEq/L. Which of the following medications should the nurse expect to
administer first?
A. Oral sodium polystyrene sulfonate
B. Intravenous regular insulin in dextrose 10% water
C. Oral potassium chloride
D. Furosemide tablets
A serum potassium level of 6.8 mEq/L indicates severe hyperkalemia, which places the client
at high risk for fatal cardiac arrhythmias. Administering regular insulin intravenously along
with dextrose shifts potassium rapidly into the cells, lowering serum levels within minutes.
Sodium polystyrene sulfonate works too slowly for acute severe hyperkalemia. Potassium
chloride would worsen the condition. Furosemide is too slow for acute emergency correction
of this level.
5. A nurse is reinforcing teaching with a client who has a newly created colostomy. Which
of the following instructions should the nurse include?
A. "Change the pouching system every day without fail."
B. "Cut the skin barrier opening 1/8 inch larger than the stoma."
C. "Expect the stoma to appear pale pink and dry."
D. "Empty the ostomy pouch when it is completely full."
, The skin barrier opening should be cut approximately 1/8 inch larger than the stoma to
prevent excoriation and trauma to the stoma tissue while protecting the surrounding skin from
effluent. The pouching system is typically changed every 3 to 5 days, not daily. A healthy
stoma should appear moist, shiny, and red or pink. The pouch should be emptied when it is
one-third to one-half full to prevent pulling and leaks.
6. A nurse is caring for a client who has a diagnosis of type 1 diabetes mellitus and is found
unresponsive. The client's blood glucose reading is 38 mg/dL. Which of the following
actions should the nurse take?
A. Administer regular insulin subcutaneously.
B. Administer 50% dextrose intravenous push.
C. Provide 4 oz of orange juice orally.
D. Instruct the client to consume carbohydrate tablets.
Because the client is unresponsive, oral administration of glucose is contraindicated due to
the high risk of aspiration. Intravenous administration of 50% dextrose rapidly restores blood
glucose levels in an emergency. Insulin would lower blood glucose further. Orange juice and
carbohydrate tablets require a conscious client who can safely swallow.
7. A nurse is reviewing the laboratory results of a client who is receiving chemotherapy and
has a white blood cell (WBC) count of 2,000/mm3. Which of the following precautions
should the nurse implement?
A. Bleeding precautions
B. Neutropenic precautions
C. Contact precautions
D. Airborne precautions
A WBC count of 2,000/mm3 indicates leukopenia, specifically neutropenia, placing the client
at severe risk for opportunistic infections. Neutropenic precautions include strict hand
hygiene, avoiding raw fruits and vegetables, restricting live plants, and limiting visitors.
Bleeding precautions are for low platelets. Contact and airborne precautions are for infectious
transmission control, not primary immunosuppression.
8. A nurse is caring for a client who is scheduled for an open cholecystectomy. Which of the
following interventions is the priority in the immediate postoperative period?
A. Encouraging early ambulation
