2023 Med surg- proctored ATI LATEST VERSION 2 EXAM WITH
ACTUAL 100 QUESTION AND CORRECT DETAILED ANSWERS
WITH RATIONALES.
QUESTION
A nurse is teaching a client who has systemic lupus erythematosus who has a new
prescription for prednisone. The nurse should instruct the client to monitor for
which of the following adverse effects of this medication?
CORRECT ANS: Infection.
Expert Rationale
Prednisone is a systemic corticosteroid with potent anti-inflammatory and
immunosuppressive properties. One of the most significant adverse effects of
long-term or high-dose corticosteroid therapy is immunosuppression, which
increases the client's susceptibility to infections. Prednisone suppresses the
immune response by inhibiting inflammatory mediators and reducing the activity
of white blood cells. Additionally, corticosteroids can mask the classic
manifestations of infection, such as fever and inflammation, making early
detection more challenging. The nurse should instruct the client to avoid contact
with individuals who are ill, practice good hand hygiene, and monitor for subtle
signs of infection such as low-grade fever, sore throat, fatigue, or malaise. Any
signs of infection should be reported promptly to the healthcare provider.
DIF: Cognitive Level: Apply (Application) TOP: Immunosuppressive Therapy MSC:
Physiological Integrity – Pharmacological and Parenteral Therapies
QUESTION
A nurse is providing preoperative teaching to a client who will undergo a total
laryngectomy. Which of the following statements indicates that the client
understands the impact of the surgery?
A. "I understand that I will have a permanent tracheostomy after the surgery."
B. "I will be able to speak normally after the surgery."
C. "I will only need the tracheostomy for a few weeks."
D. "I will not be able to eat or drink anything ever again."
,CORRECT ANS: A
Expert Rationale
A total laryngectomy involves the surgical removal of the entire larynx, including
the vocal cords, epiglottis, and surrounding structures. Because the larynx is
completely removed, the airway is permanently separated from the esophagus,
and the client will have a permanent tracheostomy to breathe. This tracheostomy
is a permanent stoma in the neck through which the client will breathe for the
rest of their life. Option B is incorrect because the client will lose their natural
voice and will need to learn alternative methods of communication, such as
esophageal speech, electrolarynx, or tracheoesophageal puncture. Option C is
incorrect because the tracheostomy is permanent, not temporary. Option D is
incorrect; while swallowing may be affected initially, the client will eventually be
able to eat and drink with modifications. Therefore, the statement about having a
permanent tracheostomy indicates understanding.
DIF: Cognitive Level: Apply (Application) TOP: Preoperative Teaching – Total
Laryngectomy MSC: Physiological Integrity – Pharmacological and Parenteral
Therapies
QUESTION
A nurse is assessing a client who has systemic scleroderma. Which of the following
findings should the nurse expect?
A. Finger contractures
B. Facial flushing
C. Hypertension
D. Weight gain
CORRECT ANS: A
Expert Rationale
Systemic scleroderma (systemic sclerosis) is a chronic autoimmune connective
tissue disease characterized by thickening, hardening, and fibrosis of the skin,
blood vessels, and internal organs. In advanced systemic scleroderma, the skin
and subcutaneous tissues become increasingly hard and rigid, leading to joint
contractures, particularly of the fingers and hands. The loss of mobility in the
,extremities occurs due to fibrosis of the skin and underlying tissues. Option B,
facial flushing, is not a typical finding; scleroderma can cause a mask-like facies
due to skin tightening. Option C, hypertension, may occur in scleroderma renal
crisis but is not a universal finding. Option D, weight gain, is not typical; weight
loss may occur due to gastrointestinal involvement. Therefore, finger contractures
are an expected finding in systemic scleroderma.
DIF: Cognitive Level: Understand (Comprehension) TOP: Systemic Scleroderma
MSC: Physiological Integrity – Pharmacological and Parenteral Therapies
QUESTION
A nurse is caring for a client who has a tracheostomy and is receiving mechanical
ventilation. When the low-pressure alarm on the ventilator sounds, it indicates
which of the following to the nurse?
A. A leak within the ventilator's circuitry
B. Increased airway resistance
C. Excessive secretions in the airway
D. The client is breathing over the ventilator
CORRECT ANS: A
Expert Rationale
A low-pressure alarm on a mechanical ventilator indicates that the ventilator is
detecting a pressure lower than the set parameters. This typically occurs when
there is a leak in the ventilator circuitry, such as a disconnected or loose
connection between the ventilator tubing and the endotracheal or tracheostomy
tube, a cuff leak, or a disconnection in the circuit tubing. Option B, increased
airway resistance, would trigger a high-pressure alarm. Option C, excessive
secretions, can cause a high-pressure alarm. Option D, the client breathing over
the ventilator, may also trigger a low-pressure alarm in some cases, but a circuit
leak is the most common cause. Therefore, a low-pressure alarm indicates a leak
within the ventilator's circuitry.
DIF: Cognitive Level: Understand (Comprehension) TOP: Mechanical Ventilation
MSC: Physiological Integrity – Pharmacological and Parenteral Therapies
, QUESTION
A nurse is monitoring a client following a thyroidectomy for the presence of
hypoparathyroidism. Which of the following findings should the nurse expect?
A. Involuntary muscle spasms
B. Bradycardia
C. Weight gain
D. Constipation
CORRECT ANS: A
Expert Rationale
Hypoparathyroidism is a potential complication following a thyroidectomy if the
parathyroid glands are accidentally damaged or removed during the procedure.
The parathyroid glands regulate serum calcium levels through the secretion of
parathyroid hormone (PTH). When PTH levels decrease, serum calcium levels
drop, leading to hypocalcemia. Involuntary muscle spasms, such as carpopedal
spasm, facial twitching (Chvostek's sign), and muscle cramps, are hallmark signs of
hypocalcemia. Option B, bradycardia, is not typical of hypocalcemia; tachycardia
may occur. Option C, weight gain, is associated with hypothyroidism, not
hypoparathyroidism. Option D, constipation, is not a primary sign of
hypocalcemia. Therefore, involuntary muscle spasms are expected findings in
hypoparathyroidism.
DIF: Cognitive Level: Understand (Comprehension) TOP: Postoperative
Complications – Thyroidectomy MSC: Physiological Integrity – Pharmacological
and Parenteral Therapies
QUESTION
A nurse is providing discharge teaching to a client who has osteoarthritis. Which of
the following instructions should the nurse include?
A. "Rest frequently after periods of activity."
B. "Exercise vigorously to strengthen the joints."
C. "Apply heat to painful joints only after exercise."
D. "Avoid all physical activity to prevent joint damage."
CORRECT ANS: A
ACTUAL 100 QUESTION AND CORRECT DETAILED ANSWERS
WITH RATIONALES.
QUESTION
A nurse is teaching a client who has systemic lupus erythematosus who has a new
prescription for prednisone. The nurse should instruct the client to monitor for
which of the following adverse effects of this medication?
CORRECT ANS: Infection.
Expert Rationale
Prednisone is a systemic corticosteroid with potent anti-inflammatory and
immunosuppressive properties. One of the most significant adverse effects of
long-term or high-dose corticosteroid therapy is immunosuppression, which
increases the client's susceptibility to infections. Prednisone suppresses the
immune response by inhibiting inflammatory mediators and reducing the activity
of white blood cells. Additionally, corticosteroids can mask the classic
manifestations of infection, such as fever and inflammation, making early
detection more challenging. The nurse should instruct the client to avoid contact
with individuals who are ill, practice good hand hygiene, and monitor for subtle
signs of infection such as low-grade fever, sore throat, fatigue, or malaise. Any
signs of infection should be reported promptly to the healthcare provider.
DIF: Cognitive Level: Apply (Application) TOP: Immunosuppressive Therapy MSC:
Physiological Integrity – Pharmacological and Parenteral Therapies
QUESTION
A nurse is providing preoperative teaching to a client who will undergo a total
laryngectomy. Which of the following statements indicates that the client
understands the impact of the surgery?
A. "I understand that I will have a permanent tracheostomy after the surgery."
B. "I will be able to speak normally after the surgery."
C. "I will only need the tracheostomy for a few weeks."
D. "I will not be able to eat or drink anything ever again."
,CORRECT ANS: A
Expert Rationale
A total laryngectomy involves the surgical removal of the entire larynx, including
the vocal cords, epiglottis, and surrounding structures. Because the larynx is
completely removed, the airway is permanently separated from the esophagus,
and the client will have a permanent tracheostomy to breathe. This tracheostomy
is a permanent stoma in the neck through which the client will breathe for the
rest of their life. Option B is incorrect because the client will lose their natural
voice and will need to learn alternative methods of communication, such as
esophageal speech, electrolarynx, or tracheoesophageal puncture. Option C is
incorrect because the tracheostomy is permanent, not temporary. Option D is
incorrect; while swallowing may be affected initially, the client will eventually be
able to eat and drink with modifications. Therefore, the statement about having a
permanent tracheostomy indicates understanding.
DIF: Cognitive Level: Apply (Application) TOP: Preoperative Teaching – Total
Laryngectomy MSC: Physiological Integrity – Pharmacological and Parenteral
Therapies
QUESTION
A nurse is assessing a client who has systemic scleroderma. Which of the following
findings should the nurse expect?
A. Finger contractures
B. Facial flushing
C. Hypertension
D. Weight gain
CORRECT ANS: A
Expert Rationale
Systemic scleroderma (systemic sclerosis) is a chronic autoimmune connective
tissue disease characterized by thickening, hardening, and fibrosis of the skin,
blood vessels, and internal organs. In advanced systemic scleroderma, the skin
and subcutaneous tissues become increasingly hard and rigid, leading to joint
contractures, particularly of the fingers and hands. The loss of mobility in the
,extremities occurs due to fibrosis of the skin and underlying tissues. Option B,
facial flushing, is not a typical finding; scleroderma can cause a mask-like facies
due to skin tightening. Option C, hypertension, may occur in scleroderma renal
crisis but is not a universal finding. Option D, weight gain, is not typical; weight
loss may occur due to gastrointestinal involvement. Therefore, finger contractures
are an expected finding in systemic scleroderma.
DIF: Cognitive Level: Understand (Comprehension) TOP: Systemic Scleroderma
MSC: Physiological Integrity – Pharmacological and Parenteral Therapies
QUESTION
A nurse is caring for a client who has a tracheostomy and is receiving mechanical
ventilation. When the low-pressure alarm on the ventilator sounds, it indicates
which of the following to the nurse?
A. A leak within the ventilator's circuitry
B. Increased airway resistance
C. Excessive secretions in the airway
D. The client is breathing over the ventilator
CORRECT ANS: A
Expert Rationale
A low-pressure alarm on a mechanical ventilator indicates that the ventilator is
detecting a pressure lower than the set parameters. This typically occurs when
there is a leak in the ventilator circuitry, such as a disconnected or loose
connection between the ventilator tubing and the endotracheal or tracheostomy
tube, a cuff leak, or a disconnection in the circuit tubing. Option B, increased
airway resistance, would trigger a high-pressure alarm. Option C, excessive
secretions, can cause a high-pressure alarm. Option D, the client breathing over
the ventilator, may also trigger a low-pressure alarm in some cases, but a circuit
leak is the most common cause. Therefore, a low-pressure alarm indicates a leak
within the ventilator's circuitry.
DIF: Cognitive Level: Understand (Comprehension) TOP: Mechanical Ventilation
MSC: Physiological Integrity – Pharmacological and Parenteral Therapies
, QUESTION
A nurse is monitoring a client following a thyroidectomy for the presence of
hypoparathyroidism. Which of the following findings should the nurse expect?
A. Involuntary muscle spasms
B. Bradycardia
C. Weight gain
D. Constipation
CORRECT ANS: A
Expert Rationale
Hypoparathyroidism is a potential complication following a thyroidectomy if the
parathyroid glands are accidentally damaged or removed during the procedure.
The parathyroid glands regulate serum calcium levels through the secretion of
parathyroid hormone (PTH). When PTH levels decrease, serum calcium levels
drop, leading to hypocalcemia. Involuntary muscle spasms, such as carpopedal
spasm, facial twitching (Chvostek's sign), and muscle cramps, are hallmark signs of
hypocalcemia. Option B, bradycardia, is not typical of hypocalcemia; tachycardia
may occur. Option C, weight gain, is associated with hypothyroidism, not
hypoparathyroidism. Option D, constipation, is not a primary sign of
hypocalcemia. Therefore, involuntary muscle spasms are expected findings in
hypoparathyroidism.
DIF: Cognitive Level: Understand (Comprehension) TOP: Postoperative
Complications – Thyroidectomy MSC: Physiological Integrity – Pharmacological
and Parenteral Therapies
QUESTION
A nurse is providing discharge teaching to a client who has osteoarthritis. Which of
the following instructions should the nurse include?
A. "Rest frequently after periods of activity."
B. "Exercise vigorously to strengthen the joints."
C. "Apply heat to painful joints only after exercise."
D. "Avoid all physical activity to prevent joint damage."
CORRECT ANS: A
