ATI Med Surge Proctored Exam | Questions and Verified Answers| 2023/ 2024 New Update

ATI Med Surge Proctored Exam | Questions and Verified Answers| 2023/ 2024 New Update QUESTION The nurse obtained a urine specimen from a patient. What result should the nurse recognize as an abnormal finding? Answer: White blood cells (WBCs) 9/hpf *Normal WBC levels in urine are below 5/hpf, with levels exceeding this indicative of inflammation or urinary tract infection. A urine pH of 6.0 is average; amber yellow is normal coloration, and the reference range for specific gravity is 1.003 to 1.030. QUESTION The nurse prepares a patient for discharge after a cystoscopy. It is most important for the nurse to provide additional information in response to which patient statement? Answer: "Bright red bleeding is normal for a few days after the procedure." *Bright red bleeding after a cystoscopy is not normal and should be reported immediately. Other complications include urinary retention, bladder infection, and perforation of the bladder. Patients should drink plenty of fluids and expect burning on urination, pink-tinged urine, and urinary frequency. Warm sitz baths, heat, and mild analgesics may be used to relieve discomfort. QUESTION A patient with a history of recurrent urinary tract infections has been scheduled for a cystoscopy. What teaching point should the nurse emphasize before the procedure? Answer: "You might have pink-tinged urine and burning after your cystoscopy." *Pink-tinged urine, burning, and frequency are common after a cystoscopy. The patient does not need to be NPO before the test, and contrast media is not needed. A cystoscopy does not always necessitate catheterization before or after the procedure. QUESTION The nurse is caring for a patient after a right kidney biopsy. Which position would be the most appropriate for this patient immediately after the procedure? Answer: Right lateral side-lying position *After a renal biopsy, a pressure dressing should be applied. The patient should be kept on the affected side for 30 to 60 minutes to apply additional pressure from the patient's own body weight and then on bed rest for 24 hours. High Fowler's position with arms supported is a position for a patient in respiratory distress. Reverse Trendelenburg position is used to maintain circulation to the legs in peripheral artery insufficiency. Supine with legs elevated puts excessive pressure on the diaphragm and should generally be avoided. QUESTION The nurse is preparing a patient for an intravenous pyelogram (IVP). What is a priority action by the nurse? Answer: Administer a cathartic or enema. *Nursing responsibilities in caring for a patient undergoing an IVP include administration of a cathartic or enema to empty the colon of feces and gas. The nurse will also assess the patient for iodine sensitivity; keep the patient NPO for 8 hours before the procedure; and advise the patient that warmth, a flushed face, and a salty taste during injection of contrast material may occur. QUESTION In addition to urine function, the nurse recognizes that the kidneys perform numerous other functions important to the maintenance of homeostasis. Which physiologic processes are performed by the kidneys (select all that apply.)? Answer: Production of renin Activation of vitamin D Erythropoietin production QUESTION When a patient reports acute, severe, renal colic pain in the lower abdomen, the nurse suspects that the patient is most likely to have an obstruction at which area? Answer: Ureterovesical junction *The ureterovesical junction is the narrowest part of the urethra and easily obstructed by urinary calculi. With a stone in the kidney or at the ureteropelvic junction, the pain may be dull costovertebral flank pain. Stones in the bladder do not cause obstruction or symptoms unless they are staghorn stones. The urethra seldom has obstruction related to stones. QUESTION A patient has sought care because of recent difficulties in establishing and maintaining a urine stream as well as pain that occasionally accompanies urination. How should the nurse document this abnormal assessment finding? Answer: Dysuria QUESTION The nurse is caring for an older adult patient taking bumetanide. What age-related changes does the nurse inform the patient that may be experienced? Answer: Decreased function of the loop of Henle *Bumetanide (Bumex) is a loop diuretic that acts in the loop of Henle to decrease reabsorption of sodium and chloride. Because the loop of Henle loses function with aging, the excretion of drugs becomes less and less efficient. Thus, the circulating levels of drugs are increased and their