RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED

Downloaded by: kiaritalaboy | Distribution of this document is illegal RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal  RNVATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 90 loade drati onals p r o v id e d Question: 90 of 90 CORRECT FLAG  Time Remaining: 00:38:42  Pause Remaining: 00:05:00 PAUSE A nurse is caring for a client who has atopic dermatitis and a prescription for triamcinoloneointment. The nurse should assess the client to monitor for which of the following adverse effects? Increased pigmentation Topical glucocorticoid therapy can cause the adverse effect of hypopigmentation. Localized hair loss Long-term glucocorticoid therapy can cause hypertrichosis, or excessive hair growth,especially on the facial area. Thinning of the skin MY ANSWER Thinning of the skin and delayed healing are adverse effects of topical glucocorticoid preparations. The client should only apply the ointment to dry patches of the skin becausetopical steroids can cause atrophy of the dermis and epidermis, which can result in thinning of the skin. Increased sensitivityto the sun The nurse should instruct the client to avoid excessive sun exposure when taking topicalfluticasone; however, triamcinolone ointment does not cause photosensitivity.  RN VATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 89 loade drati onals p r o v id e d Question: 89 of 90 CORRECT  Time Remaining: 00:37:45 RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal Frothysputum FLAG  Pause Remaining: 00:05:00 PAUSE A nurse is assessing a client who hasleft-sided heart failure. Which of the following findingsishould the nurse identify as a manifestation of left-sided heart failure? Dependent edema The nurse should identify that dependent edema is a manifestation of right-sided heart failure due to right ventricular failure and fluid retention from pressure building up in thevenous system. Jugulardistention The nurse should identify that jugular vein distention is a manifestation of right-sided heartfailure due to right ventricular failure and fluid retention from pressure building up in the venous system. Weight gain The nurse should identify that weight gain is a manifestation of right-sided heart failure due to right ventricular failure and fluid retention from pressure building up in the venoussystem. MY ANSWER The nurse should identify that frothy sputum, dyspnea, and wheezing are manifestations ofleft-sided heart failure. Treatment includes fluid restriction and diuretics to decrease preload and reduce pulmonary congestion. Pink-tinged frothy sputum can be an early indication of pulmonary edema and can be life-threatening. Therefore, the nurse should notify the provider immediately.  RNVATI Adult Medical Surgical 2019 Q u e Cst i on i8 8 Lilo a d e iOd ra t i o n a l s ip r o vSid e id E Question: 88 of 90 CORRECT RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal Respiratoryialkalosis FLAG  Time Remaining: 00:37:30  Pause Remaining: 00:05:00 PAUSE A nurse is caring for a client who is experiencing anxiety as well as numbness and tingling of thelips and fingers. The client's ABGs are: pH7.48, PCO2 30 mm Hg, HCO3 - 24 mEq/L, PaO2 85 mm Hg. Which of the following acid-base imbalances should the nurse identify that the client is experiencing? MY ANSWER This pH is alkaline (increased) and the PCO2 is decreased, representingalveolar hyperventilation and resultant respiratory alkalosis. Respiratory acidosis This pH is alkaline (increased) and the PCO2 is decreased. A decreased pH and an increased PCO2 indicate respiratory acidosis. Metabolicalkalosis This HCO3 - 24 mEq/L is within the expected range of 21 to 28 mEq/L and the pH is alkaline (increased). An increased pH andHCO3 - indicate metabolic alkalosis. Metabolicacidosis This HCO3 - 24 mEq/L is within the expected range of 21 to 28 mEq/L and the pH is alkaline (increased). A decreased pH andHCO3 - indicate metabolic acidosis.  RNVATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 87 loade drati onals p r o v id e d Question: 87 of 90 CORRECT FLAG  Time Remaining: 00:37:22  Pause Remaining: 00:05:00 PAUSE A nurse is assessing a client who has Cushing'ssyndrome. Which of the following findingsishould the nurse expect? Vitiligo RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal Osteoporosis Vitiligo is the loss of pigment from areas of a client's skin, causing irregular, white patches.Vitiligo is a manifestation of adrenal-gland hypofunction. MY ANSWER Osteoporosis is a common finding with Cushing's syndrome. Bones become thinner as aresult of mineral loss and nitrogen depletion, and the risk for fractures increases. Myxedema A client who has hypothyroidism can develop myxedema that causes mucinous cellularedema around the eyes, across the upper back, and in the hands and feet. Heat intolerance A client who has hyperthyroidism can develop heat intolerance, along with an increase insweating.  RNVATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 86 loade drati onals p r o v id e d Question: 86 of 90 CORRECT FLAG  Time Remaining: 00:37:13  Pause Remaining: 00:05:00 PAUSE A nurse is inspecting the skin of a client who has basal cell carcinoma. The nurse should identifywhich of the following lesion characteristics on the client's skin? MY ANSWER A client who has basal cell carcinoma has a nodular lesion with well-defined borders and a pearly or waxy appearance, resulting from overexposure to the sun, especially on the face,head, and neck. An irregular border on a variegated-colored lesion Aipearly,iwaxyinodule RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal A client who has melanoma has a lesion with irregular borders and variegated colors ofred, white, and blue, most often on the upper back or lower legs. A firm,nodular, crusty, or ulcerated lesion A client who has squamous cell carcinoma has a firm, nodular, and crusty lesion with anulcerated center, resulting from sun exposure, chronic irritation, burns, or irradiation tothe skin. A weeping vesicle Aclient who has herpes zoster has weeping, blister-type lesions.  RNVATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 85 loade drati onals p r o v id e d Question: 85 of 90 CORRECT FLAG  Time Remaining: 00:37:02  Pause Remaining: 00:05:00 PAUSE A nurse is assessing a client who has hypocalcemia. In which of the following areasshould the nurse tap on the client's face to detect the presence of Chvostek's sign? (You will find hot spotsto select in the artworkbelow. Select only the hotspot that correspondsto your answer.) RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal A is correct. The nurse should tap the client's cheek just in front of the ear and below the zygomatic arch. The client who has hypocalcemia will display a Chvostek's sign, which is atwitching ofthe facial muscle. B is incorrect. The nurse should apply upward pressure at the supraorbital ridge, belowthe eyebrow, to assess for tenderness and inflammation of the frontal sinuses. C is incorrect. The nurse should palpate the jaw and mastoid muscle of a client who has temporomandibular joint dysfunction. This can be caused by misaligned teeth, arthritis, orgrinding of the teeth. With palpation, the nurse might feel a click, pop, or grating sensationiwhen the client opens or closes the jaw. RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal Lowiurineispecificigravity  RNVATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 84 loade drati onals p r o v id e d Question: 84 of 90 CORRECT FLAG  Time Remaining: 00:36:55  Pause Remaining: 00:05:00 PAUSE A nurse in an emergency department is assessing a client who is overusing prescribed diureticsand has a sodium level of 127 mEq/L. Which of the following laboratory findingsshould the nurse expect? High lipase A high lipase level is associated with pancreatic dysfunction or renal failure and is not anexpected finding with hyponatremia or dehydration. MY ANSWER A client who has hyponatremia as a result of diuretic overuse has a low urine specific gravity. The increased excretion of water alters the ratio of particulate matter, whichaffects the specific gravity. Low hemoglobin A client who is dehydrated as a result of diuretic overuse can have an elevated hemoglobinlevel because ofthe difference in ratio between intravascular fluid and blood cells. High creatine kinase-MB(CK-MB) An elevated CK-MB level indicates a myocardial infarction and is not an expected findingiwith hyponatremia.  RNVATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 83 loade drati onals p r o v id e d Question: 83 of 90 RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal Reviewitheidailyischeduleiwithitheiclientieveryimorning. INCORRECT FLAG  Time Remaining: 00:36:47  Pause Remaining: 00:05:00 PAUSE A home healthnurse is assisting a client with planning care for afamilymember who hasAlzheimer's disease.Which ofthe following instructionsshould the nurse include? Remove clutterfrom rooms and hallways. The nurse should instruct the family member to remove clutter from rooms and hallwaysso the client is able to walk without the risk of falling or tripping over objects. Later in thedisease, the client can experience seizures, so cluttered areas could be a risk to the client. Place amonthly calendarin the client'sroom. MY ANSWER The nurse should instruct the family member to place a single-date calendar in the client'sroom. A monthly calendar can be overwhelming and confusing to a client who has Alzheimer's disease. Use confrontation tomanage the client'sbehavior. The nurse should instruct the family member to redirect the client by starting another activity when the client begins to act out or becomes overstimulated. Redirecting the clientmight help them gain focus. The nurse should instruct the family member to use short, simple sentences when explaining an activity to the client. The explanation should be done immediately before theactivity to aid the client's memory and ability to followdirections.  RNVATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 82 loade drati onals p r o v id e d Question: 82 of 90 CORRECT  Time Remaining: 00:36:39 RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal Refractoryihypoxemia FLAG  Pause Remaining: 00:05:00 PAUSE A nurse is caring for a client who has developed acute respiratory distresssyndrome (ARDS). Which ofthefollowingfindingsshould thenurse identify as amanifestation ofthissyndrome? An audible pleuralfriction rub A client who has a pulmonary embolism can have a pleural friction rub along with tachypnea, tachycardia, dyspnea, and sudden, sharp chest pain. However, a pleural frictionrub is not a manifestation of ARDS. Trachealdeviation fromthe midline A client who has a tension pneumothorax can have tracheal deviation with dyspnea, tachycardia, and tachypnea. On auscultation, breath sounds over the area of the pneumothorax are decreased or absent. However, tracheal deviation is not a manifestationofARDS. MY ANSWER ARDS is a systemic inflammatory response to trauma, sepsis, burns, pancreatitis, and blooditransfusions, when excess lung fluid dilutes surfactant activity in the lungs. A client who has ARDS has refractory hypoxemia, which is hypoxemia that does not improve with oxygen therapy. Extensive pulmonary edema evident on a chest x-ray is a manifestation of ARDS. Bloodyexpectorant when coughing A client who has lung cancer or laryngeal trauma can have hemoptysis. However, bloodyexpectorant is not a manifestation of ARDS.  RNVATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 81 loade drati onals p r o v id e d Question: 81 of 90 CORRECT RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal Flatineckiveins FLAG  Time Remaining: 00:36:33  Pause Remaining: 00:05:00 PAUSE An emergency room nurse is assessing a client who has asthma and difficulty breathing. Whichof the following findingsshould indicate to the nurse that the client is experiencing status asthmaticus? Coughing Status asthmaticus causes labored breathing and wheezing. Coughing indicates that theclientis exchanging air and is a manifestation ofpneumonia, not status asthmaticus. A client who has status asthmaticus has distended neck veins while trying to facilitatebreathing due to increased pulmonary pressure. Use of accessorymuscles MY ANSWER A client who has status asthmaticus uses accessory muscles to help facilitate breathing, which is a manifestation of a severe airflow obstruction. The situation is lifethreateningand the nurse should intervene immediately with strong systemic bronchodilators, epinephrine, corticosteroids, and oxygen. Presenceof coarse crackles The presence of coarse crackles indicates air movement through fluid-filled airways and isa manifestation of pneumonia, not status asthmaticus.  RNVATI Adult Medical Surgical 2019 Q u e Cst i on i8 0 Lilo a d e Od ra t io n a l s ip r o vSid e id E Question: 80 of 90 CORRECT  Time Remaining: 00:36:27  Pause Remaining: 00:05:00 PAUSE RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal Skinirash FLAG A nurse isteaching a client who has a new prescription for phenytoin to treat a seizure disorder. Which of the following adverse effects should the nurse instruct the client to reportimmediately to the provider? Tender, bleeding gums Gingival hyperplasia is an overgrowth of gum tissue that causes the gums to bleed, swell, and become tender. Gingival hyperplasia is nonurgent adverse effect when a client is takingpi henytoin; therefore, there is another finding that is the priority. The nurse should advise the client to maintain good oral hygiene with a soft toothbrush and to follow up with an oral health professional. Increased facial hair Hirsutism, an increased growth of hair in unexpected places on the client's body, isnonurgent because itis an expected finding for a client who is taking phenytoin. Constipation Constipation is nonurgent because it is an expected finding for a client who is takingpi henytoin. MY ANSWER When using the urgent vs. nonurgent approach to client care, the nurse should determine that the priority finding is a rash, which can have a measles-like appearance and progress to exfoliative dermatitis or Stevens-Johnson syndrome. The client should report this findingito the provider immediately.  RNVATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 79 loade drati onals p r o v id e d Question: 79 of 90 INCORRECT  Time Remaining: 00:36:21  Pause Remaining: 00:05:00 RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal Clearidrainageionitheidressings PAUSE FLAG A nurse ismonitoring a clientfollowing a lumbarlaminectomy. The client has adrain and indwellingurinary catheter. Thenurse should identifywhich ofthe following findings as anindication of a complication of the surgery? Oraltemperature of 37.2° C (99° F) The nurse should expect a slight elevation of the client's temperature postoperatively.However, an increased temperature elevation or a spike can indicate an infection. The nurse should identify clear drainage on or around the dressing as an indication of acerebral spinal leak and should report this finding to the provider immediately. Drain output 75mL in 4hr The nurse shouldexpect the clientto have no more than 125mL of drain output in 4 hr. Decreasedbowelsoundsin allquadrants oftheabdomen MY ANSWER The nurse should expect decreased bowel sounds when caring for a client following a laminectomy due to anesthesia and pain medication. The nurse should continue to monitorthe client to assess for a paralytic ileus.  RNVATI Adult Medical Surgical 2019 Q u e Cst i on i7 8 Lilo a d e iOd ra t i o n a l s ip r o vSid e id E Question: 78 of 90 CORRECT FLAG  Time Remaining: 00:36:15  Pause Remaining: 00:05:00 PAUSE A nurse is assessing a client who hasright-sided heart failure. Which of the following findingsishould the nurse identifyas a manifestation of right-sided heart failure? RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal Increasediabdominaligirth S3 gallop An S3/S4 summation gallop is an expected finding with left-sided heart failure due to pulmonary congestion and increased left ventricular pressure that causes a decrease incardiac output and poor tissue perfusion. Weakperipheral pulses Weak peripheral pulses are an expected finding with left-sided heart failure due todecreased cardiac output. MY ANSWER Increased abdominal girth is an expected finding with right-sided heart failure due to systemic congestion and an enlarged liver and spleen. Systemic congestion can lead to fluidretention and increased pressure in the venous system, which can manifest with edema in the lower extremities. Wheezing Wheezing is an expected finding with left-sided heart failure due to pulmonary congestionand systolic dysfunction.  RNVATI Adult Medical Surgical 2019 Q u e Cst i on i7 7 Lilo a d e iOd ra t i o n a l s ip r o vSid e id E Question: 77 of 90 INCORRECT FLAG  Time Remaining: 00:36:06  Pause Remaining: 00:05:00 PAUSE A nurse is caring for a client who recently assumed the role of caregiver for their aging parents who have chronic illnesses. The nurse should identify that which of the following statements bythe client indicates acceptance ofthe role change? The nurse should identify that the client has accepted the role change of caring for theiraging parents by changing the floor plan of the home to accommodate their father's wheelchair. "I'mso stressed outthatit makesit difficultfor me tomanage everything." "Iichangeditheiflooriplaniofiourihomeitoiaccommodateimyifather'siwheelchair." RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal Theiclient'sibloodipressureiisielevated. This response indicates role overload because the client is feeling overwhelmed withhaving to care for their aging parents. "Attimes, I getso frustrated with howto care formy parents." This response indicates role strain, in which the client feels unsure and frustrated aboutcaring for their aging parents. Feelings of inadequacy can also occur with role strain. "I am learning to take care of my parents asI go." MY ANSWER This response indicates role ambiguity, in which the client feels unsure about how to carefor their aging parents. This might create stress for the client.  RNVATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 76 loade drati onals p r o v id e d Question: 76 of 90 CORRECT FLAG  Time Remaining: 00:36:00  Pause Remaining: 00:05:00 PAUSE A nurse is caring for a client who is receiving vancomycin intermittent IV bolus therapy formethicillin-resistant Staphylococcus aureus (MRSA). Which of the following findings is an indication to the nurse that the client is experiencing an adverse effect of the medication? The client can have an adverse effect called red man syndrome, which causes hypotensionand tachycardia, due to infusing the vancomycin too rapidly. The nurse should infuse the medication over at least 60 min. The clientisbecoming flushed. MY ANSWER Flushing is a manifestation of an infusion reaction to vancomycin that also causes a rash onthe face and upper body, called red man syndrome. Red man syndrome results from RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal BUNi24i M Y iA NS W E R mg/dL infusing vancomycin too rapidly. The nurse should infuse the medication over at least 60min. The clientreportsblurred vision. Blurred vision is not a manifestation of an infusion reaction to vancomycin. Vancomycin can have sensory implications, however. Although rare, it can cause ototoxicity, which isgi enerally reversible. The clientis experiencing polyuria. Polyuria is not a manifestation of an infusion reaction to vancomycin. However,vancomycin can cause renal failure.  RNVATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 75 loade drati onals p r o v id e d Question: 75 of 90 CORRECT FLAG  Time Remaining: 00:35:54  Pause Remaining: 00:05:00 PAUSE A nurse is caring for a male client who has a new prescription for cyclosporine following a kidney transplant. Which of the following findings should the nurse identify as an adverse effectof this therapy? WBC count 8,000/mm3 A WBC count of 8,000/mm<sup3< sup=""> is within the expected reference range of 5,000to 10,000/mm3. If the client develops leukopenia, the nurse should notify the provider because the client is at risk for infection when taking an immunosuppressant such as cyclosporine.</sup3<> RBC count 6 million/mm3 An RBC count of 6 million/mm3 is within the expected reference range of 4.7 to 6.1 million/mm3 for men and 4.2 to 5.4 million/m3 for women. If the client's RBC count decreases, the nurse should notify the provider because the client is at risk for bleedingifollowing an organ transplant. RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal Iron-deficiencyianemia A BUN of 24 mg/dL is above the expected reference range of 10 to 20 mg/dL, indicatingirenal impairment. An adverse effect of cyclosporine is nephrotoxicity. The nurse shouldmonitor the client for increases in BUN and creatinine and report any elevation to the provider. A rise in BUNcould indicate transplant rejection. Potassium 3.5 mEq/L A potassium level of 3.5 mEq/L is within the expected reference range of 3.5 to 5 mEq/L and does not indicate nephrotoxicity. However, the nurse should report a dramatic changein potassium level to the provider.  RNVATI Adult Medical Surgical 2019 Q u e Cst i on i7 4 Lilo a d e iOd ra t i o n a l s ip r o vSid e id E Question: 74 of 90 CORRECT FLAG  Time Remaining: 00:35:49  Pause Remaining: 00:05:00 PAUSE A nurse is caring for a client who has dumping syndrome following a gastric resection. The nurse shouldmonitorthe clientfor whichofthefollowing complications of dumping syndrome? Weight gain Anorexia can result from dumping syndrome because the client can easily become reluctant to eat to avoid the unpleasant manifestations of this syndrome, resulting inweight loss. MY ANSWER The nurse should monitor the client for manifestations of anemia, such as pallor, tachycardia, and fatigue. Rapid emptying of the stomach contents into the intestine can leadto reduced absorption of iron in the duodenum, causing iron-deficiency anemia. Hypercalcemia Hypocalcemia, rather than hypercalcemia, is a manifestation of dumping syndrome due torapid gastric emptying. RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal Theiclient'sidailyipeakiexpiratoryiflowi(PEF)imeasuresi85%iaboveipersonalibest. Reduced heart rate Nausea, abdominal cramping, and tachycardia are manifestations of dumping syndromedue to rapid gastric emptying.  RNVATI Adult Medical Surgical 2019 Q u e Cst i on i7 3 Lilo a d e iOd ra t i o n a l s ip r o vSid e id E Question: 73 of 90 INCORRECT FLAG  Time Remaining: 00:35:43  Pause Remaining: 00:05:00 PAUSE A nurse is assessing a client who takes salmeterol to treat moderate asthma. Which of thefollowingfindingsshould indicate to the nursethat the medication hasbeen effective? A client who has asthma should use a peak flow meter twice daily to monitor asthma control. A PEF in the green zone, or 80% or above personal best, indicates the effectivenessof medication therapy. The client'sABGsshows a pHlevel of 7.32. A pH level of 7.32 indicates the client is in an acidotic state. Acidosis occurs withbronchoconstriction and indicates the medication has not been effective. The client'sforced expiratory volume isdecreased aftertreatment with medication. MY ANSWER Forced expiratory volume measures the amount of air the client exhales during 1 second and is part of pulmonary function testing. Effective use of a bronchodilator should increasethe client's forced expiratory volume. The client'swheezing islimited to expiratory. RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal "Iiwillicheckimyibloodisugarilevelibeforeiexercising." Salmeterol is a long-acting bronchodilator that helps prevent asthma attacks. Wheezing is anarrowing ofthe airways and indicates that the medication has not been effective.  RNVATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 72 loade drati onals p r o v id e d Question: 72 of 90 CORRECT FLAG  Time Remaining: 00:35:38  Pause Remaining: 00:05:00 PAUSE A nurse is providing teaching about health promotion activitiesfor a client who has a new diagnosis of type 1 diabetes mellitus. Which of the following statements by the client indicatesan understanding of the teaching? "If I can keep myhemoglobin A1C lessthan 6.5%, Iwill be cured of diabetes." Tight control of blood glucose levels can minimize complications associated with diabetesmellitus such as cardiovascular disease, nephropathy, neuropathy, and retinopathy. The nurse should instruct the client that type 1 diabetes mellitus is a chronic condition that causes the body to fail to manufacture insulin and cannot currently be cured. MY ANSWER Clients who have diabetes mellitus should not exercise if their blood glucose level is less than 80 mg/dL or greater than 250 mg/dL. A client who has type 1 diabetes mellitus and ishyperglycemic can experience even higher blood glucose levels. Hypoglycemia can also occur during exercise and up to 24 hr following exercise. The nurse should instruct the clientto monitor blood glucose levels before, during, and following exercise. "Ishould havemy eyes checked every2 years." Microvascular changes to the vessels in the eyes occurs with elevated blood glucose levels,which can lead to retinopathy. To monitor for changes to the eyes, the client should have eye examinations every year. RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal Aspirin Naproxen "Ishould soakmyfeet daily in warm,soapywater." Health promotion activities for a client who has diabetes mellitus includes foot care. Clientsshould inspect their feet and wash them daily with warm water and soap. However, clients should not soak their feet because this can lead to maceration of the skin and skin breakdown.  RNVATI Adult Medical Surgical 2019 Q u e Cst i on i7 1 Lilo a d e iOd ra t i o n a l s ip r o vSid e id E Question: 71 of 90 CORRECT FLAG  Time Remaining: 00:35:31  Pause Remaining: 00:05:00 PAUSE A nurse is providing teaching to a client who has a new prescription for warfarin. Which of thefollowingmedicationsshould the nurse instructthe clientto avoid? (Select allthat apply.) Ferrous sulfateEchinac ea Dextromethorphan MY ANSWER Ferrous sulfate is incorrect. Ferrous sulfate is an iron supplement and has no knowninteraction with warfarin. Echinacea is incorrect. Echinacea is a supplement that a client might take to improve theimmune system and has no known interaction with warfarin. Aspirin is correct. Aspirin is an antiplatelet medication. It can increase the risk of bleedingiwhen taken with warfarin. RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal Placeitheiclientileaningiforwardioveritheibedsideitableiforitheiprocedure. Dextromethorphan is incorrect. Dextromethorphan is a cough suppressant and has noknown interaction with warfarin. Naproxen is correct. Naproxen is an NSAID that relieves mild to moderate pain. It canincrease the risk ofbleeding if taken with warfarin.  RNVATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 70 loade drati onals p r o v id e d Question: 70 of 90 CORRECT FLAG  Time Remaining: 00:35:25  Pause Remaining: 00:05:00 PAUSE A nurse is assisting with the care of a client who isscheduled for a thoracentesis. Which of thefollowing interventions should thenurse plan to take? Informthe clientthattheymust emptytheir bladder before the procedure. A client who is undergoing a paracentesis should empty their bladder before the procedureto prevent injury to the bladder. This action is not necessary before a thoracentesis. Weigh the client before and afterthe procedure. The nurse should weigh a client who is scheduled for a paracentesis before and after the procedure to identify how much fluid the procedure removes from the client's abdomen.This action is not necessary before and after a thoracentesis. MY ANSWER The nurse should place the client leaning forward over the bedside table for a thoracentesis. This allows the provider complete access to the client's chest and back. Thispi osition also expands the spaces between the ribs where the pleural fluid accumulates. Keep the client on bed rest afterthe procedure. RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal A client who undergoes a paracentesis remains on bed rest following the procedure. Thenurse should monitor the client for shortness of breath and listen to the client's lung sounds following the procedure. Bed rest is not necessary following a thoracentesis.  RNVATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 69 loade drati onals p r o v id e d Question: 69 of 90 CORRECT FLAG  Time Remaining: 00:35:19  Pause Remaining: 00:05:00 PAUSE A nurse is providing discharge teaching about infection control at home for a client who has tuberculosis. Which of the following statements by the client indicates an understanding of theteaching? "I will haveto move out of my family'shome until I am no longer contagious." Individuals living in the same household as the client have already been exposed to the tuberculosis bacteria, so it is not necessary for the client to be isolated from others in the household. Instead, the nurse should instruct the client that all members living in the household should be tested for tuberculosis. Clients who have tuberculosis are no longer considered contagious when three consecutive sputum samples test negative for Mycobacterium tuberculosis, which often occurs 2 to 3 weeks after starting the medicationregimen. "M Y I will place myused tissues in a plastic bag." The sputum of a client who has tuberculosis is considered infectious until there are three consecutive sputum samples that test negative for Mycobacterium tuberculosis. Tissues thatare soiled with the client's sputum should be placed in a plastic bag and sealed to avoid spreading the infection. The tuberculosis bacteria is easily spread through microscopic droplets, which can be spread when coughing, sneezing, talking, laughing, or singing. Placing hands over the mouth to cover the cough can result in the bacteria being present on the hands and transferredtoanother individual, spreadingthe infection. The nurse shouldinstructthe "IiwillicoverimyimouthiwithimyihandsiwheniIihaveitoicough." RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal Use disposableutensilsfor meals. client to use a tissue to cover the nose and mouth when coughing or sneezing and then todispose of the tissue by placing it in a plastic bag and sealing it. "I willnot go in public areas until I amcured." The medication regimen for treatment of tuberculosis can last as long as 2 years. The nurseshould instruct the client that the infection is contagious only until there are three consecutive sputum samples that test negative for Mycobacterium tuberculosis. In the interim, the client shouldwear a mask when in public to prevent the spread of infection.  RNVATI Adult Medical Surgical 2019 Q u e Cst i on i6 8 Lilo a d e Od ra t io n a l s ip r o vSid e id E Question: 68 of 90 CORRECT FLAG  Time Remaining: 00:35:14  Pause Remaining: 00:05:00 PAUSE A nurse is teaching a client who is scheduled to receive radioactive iodine therapy for treatmentof hyperthyroidism. Which of the following instructions should the nurse include in the teaching? Remain 0.3 m (1 ft) away from children. The client who receives radioactive iodine should follow radiation precautions, which include limiting exposure to infants, children, and women who are pregnant. The nurseshouldinstructthe clientto remain at least 1m (3 ft) away from these individuals. Limitthetime spent around women who are pregnantto 10 min daily. The client who receives radioactive iodine has a degree of radioactivity, which can interfereiwith fetal development. The nurse should instruct the client to limit exposure to women who are pregnant to no more than 1 hr each day. MY ANSWER The client who receives radioactive iodine has radioactivity in the body fluids, includingsaliva, for several weeks followingtreatment. The nurse should instruct the client to use RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal disposable utensils, plates, and cups during this time period to decrease the risk foriradiation exposure to other members of the household. Use an absorbentpad ifincontinent. If a client experiences incontinence, specific steps should be taken because body fluids are radioactive for several weeks after therapy. Male clients should use a condom catheter andai drainage bag. Urine from the drainage bag can then be poured into the toilet and flushed.Women who are incontinent should be encouraged to use facial tissues placed within theirclothing to absorb the urine. The tissues can be flushed as they become soiled with urine. The use of an absorbent pad keeps the radiation in close contact with the client, which shouldbe avoided.  RNVATI Adult Medical Surgical 2019 Q u e Cst i on i6 7 Lilo a d e iOd ra t i o n a l s ip r o vSid e id E Question: 67 of 90 CORRECT FLAG  Time Remaining: 00:35:08  Pause Remaining: 00:05:00 PAUSE A nurse is providing preoperative teaching to a client who is scheduled for a radical prostatectomy.Whichofthe following information should the nurse include in theteaching? The client willbe on bedrest while continuous bladderirrigation isin place. It is important to initiate ambulation soon after surgery to prevent complications, such asvenous thromboembolism. A client who has had an open radical prostatectomy should dangle their legs over the side of the bed and then sit in a chair on the day of surgery. Ambulation shouldbegin the next morning. Cold compresses will beused tomanage bladderspasms. The nurse should use oxybutynin, sitz baths, or warm compresses to relieve bladderspasms. The client willhave anNGtube in place for 48 hrpostoperatively. RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal AiPCAipumpiwillibeiusediforipostoperativeipainicontrol. Atrialifibrillation Clients who are undergoing gastrointestinal surgery require an NG tube. However, a client who is postoperative following an open radical prostatectomy does not require an NG tube.Bowel sounds and function should return postoperatively within the first 24 hr. MY ANSWER A PCA pump is a common method of pain management in the first 24 hr following an openradical prostatectomy. The nurse should teach the client how to manage pain during the preoperative period rather than waiting until after surgery when the client is feeling the sedative effects of the anesthesia and pain medication.  RNVATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 66 loade drati onals p r o v id e d Question: 66 of 90 CORRECT FLAG  Time Remaining: 00:35:02  Pause Remaining: 00:05:00 PAUSE A nurse is assessing a client's ECG strip and notes an irregular heart rate of 98/min with no clearP waves. Which of the following cardiac dysrhythmias should the nurse document? First-degreeheart block With a first-degree atrioventricular (AV) block, the atrial impulses reach the ventricles through the AV node at a slower-than-normal rate. The P waves have a regular shape andai ppear consistently in front of the QRS complex. MY ANSWER With atrial fibrillation, multiple rapid impulses from many different foci cause depolarization of the atria in a rapid, disorganized manner. This causes a chaotic rhythm onthe ECG strip that has no clear P waves, no atrial contractions, and an irregular rhythm. Complete heart block RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal Reporticloudyidialysateidrainageitoitheiprovider. Complete heart block has regular rhythm with a low heart rate, and P waves are clear, butithey outnumber the QRS complexes. There are two different impulses: one that stimulatesthe atria, thus generating the P wave, and another that stimulates the ventricles, creating the QRS complex. Ventriculartachycardia Ventricular tachycardia is a rapid, regular rhythm with a heart rate of 140/min or faster. Pwaves are rarely visible with sustained ventricular tachycardia.  RNVATI Adult Medical Surgical 2019 Q u e Cst i on i6 5 Lilo a d e iOd ra t i o n a l s ip r o vSid e id E Question: 65 of 90 CORRECT FLAG  Time Remaining: 00:34:57  Pause Remaining: 00:05:00 PAUSE A nurse is caring for a client who isreceiving peritoneal dialysis. Which of the following actionsshould the nurse take? Use an infusion pump todeliverthe dialysate at asafe rate. The nurse should infuse the dialysate by gravity into the peritoneal cavity, without aninfusion pump. MY ANSWER The most serious complication of peritoneal dialysis is peritonitis, an inflammation of theperitoneum. Assessment findings include cloudy dialysate drainage, rebound abdominal tenderness, and diffuse abdominal pain. The nurse should report these findings immediately to the provider, who can then prescribe a fluid culture, quick exchanges to wash out mediators of infection, and antibiotics. Warmthe dialysate solution using a low powerlevel on amicrowave oven. RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal ElevatediWBCicount Rebounditenderness Anorexia The nurse should not use a microwave oven to warm dialysate solution. This can result in uneven heating of the solution, which can increase the risk for burns to peritoneal tissues. The nurse should warm the solution using a heating pad or place it in the warming sectionofthe automated cycling machine. Allowthe dialysate to drain over 1 to4 hr. The dwell time for each exchange takes 4to 8 hr;drainage usually takes 10 to 20 min.  RNVATI Adult Medical Surgical 2019 Q u e Cst i on i6 4 Lilo a d e iOd ra t i o n a l s ip r o vSid e id E Question: 64 of 90 INCORRECT FLAG  Time Remaining: 00:34:52  Pause Remaining: 00:05:00 PAUSE A nurse is assessing a client who hassuspected appendicitis. Which of the followingmanifestationsshould the nurse expect? (Select all that apply.) Elevated amylase level Ascites MY ANSWER Elevated WBC count is correct. A client who has acute appendicitis will show a moderateelevation ofthe WBC count from 10,000 to 18,000/mm3. If the WBC count is greater than 20,000/mm3, it can indicate a perforated appendix. Elevated amylase level is incorrect. Amylase levels increase with pancreatitis but notiwith acute appendicitis. RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal Applyimoisturizeritoidampiskiniafteribathing. Rebound tenderness is correct. A client who has appendicitis develops localized painover the right lower quadrant of the abdomen. When the area is palpated, pain occurs during release of pressure on the client's abdomen. Ascites is incorrect. Ascites can be a manifestation of cirrhosis; however, it is notassociated with appendicitis. Anorexia is correct. A client who has acute appendicitis experiences nausea, vomiting, andreduced appetite.  RNVATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 63 loade drati onals p r o v id e d Question: 63 of 90 CORRECT FLAG  Time Remaining: 00:34:45  Pause Remaining: 00:05:00 PAUSE A nurse is planning preventative strategiesfor a client who is at risk for pressure injuries. Whichofthe following actionsshould the nurse include in the plan? Maintain the head ofthebed greaterthan 45°. The nurse should keep the head ofthe client’s bed at 30° or lower to avoid shearing actionon the skin. Place adonut-shaped cushion underthe client'ssacrum. A donut-shaped cushion or pillow damages capillary beds in the areas of pressure and canincrease the risks of tissue breakdown and necrosis. Massage bonyprominences three timesdaily. Massaging bony prominences damages capillary beds and can increase the risk of tissueibreakdown and necrosis. RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal Ketonesiinitheiurine MY ANSWER Applying a moisturizer to damp skin after bathing helps prevent dry skin. The drier theskin is, the greater the risk is for skin breakdown.  RNVATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 62 loade drati onals p r o v id e d Question: 62 of 90 CORRECT FLAG  Time Remaining: 00:34:39  Pause Remaining: 00:05:00 PAUSE A nurse is caring for a client who has a new diagnosis of type 1 diabetes mellitus. Which of thefollowing findingsshould the nurse identify as amanifestation oftype 1diabetes? Hypernatremia Clients who have type 1 diabetes mellitus have a decrease in serum sodium levels becauseiof osmotic diuresis by the kidneys. Decreasedserum osmolality Clients who have type 1 diabetes mellitus and have hyperglycemia can develop dehydration, which increases serum osmolality. High osmolality values can lead to stuporand grand mal seizures. MY ANSWER Clients who have type 1 diabetes mellitus can have ketones in the urine, which are a byproduct of the breakdown of fats for energy. Ketones in the urine are an indicator ofinadequate amounts ofinsulin and high blood glucose levels. Hypoglycemia Clients who have type 1 diabetes mellitus have hyperglycemia when they produce too littleinsulin to metabolize glucose for energy. RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal Assessthe surgical incision forsignsof infection.  RNVATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 61 loade drati onals p r o v id e d Question: 61 of 90 CORRECT FLAG  Time Remaining: 00:34:33  Pause Remaining: 00:05:00 PAUSE A nurse is caring for a client who had a surgical repair of an abdominal aortic aneurysm 3 daysago. The client's vital signs are: temperature 38.3° C (100.9° F), heart rate 80/min, respirations16/min, and blood pressure 128/76 mm Hg. Which of the following actionsisthe nurse's priority? Notify the surgeon ofthetemperature elevation. The nurse should notify the surgeon of the client's temperature elevation for further assessment and intervention for possible complications; however, another action is thepriority. Encouragethe clientto drinkmore fluids. The nurse should encourage the client to drink more fluids to replace fluid loss from fever;however, another action is the priority. MY ANSWER A surgical wound infection typically appears 3 to 6 days following the surgery. Fever fromthe third postoperative day onward indicates that this client's greatest risk is either a wound infection or a pulmonary infection; therefore, this is the priority action the nurse shouldtake. Monitor vitalsigns every4 hr. The nurse should continue to monitor vital signs every 4 hr to assess improvement ordeterioration of the client's condition; however, another action is thepriority. RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal "Iimayihaveimildicrampingiforiseveralihours."  RNVATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 60 loade drati onals p r o v id e d Question: 60 of 90 CORRECT FLAG  Time Remaining: 00:34:27  Pause Remaining: 00:05:00 PAUSE A nurse is providing discharge teaching to a client following a loop electrosurgical excision procedure (LEEP)forthetreatment of cervical cancer.Which ofthe following statements by theclient indicates an understanding ofthe teaching? "I can resume sexual intercourse in 48 hours." During the healing period, the client is at an increased risk for infection. Therefore, the client should refrain from sexual intercourse for the time period the provider prescribes,which is usually 3 weeks or until healing is complete. "I can expectsome heavy vaginal bleeding for 24hours." The client should report heavy vaginal bleeding because this can be an indication of complications. The client can expect mild spotting after the LEEP procedure, which cutsaway the affected cervical tissue using a painless electrical current. "I can usetampons whenmy period comesin a week." The client should not use tampons, because they can increase the risk for infection. Following the recovery period, which is usually 3 weeks, the client can resume the use oftampons. MY ANSWER The client should expect very little discomfort from the LEEP procedure, which isperformed in ambulatory care using a painless electrical current.  RN VATI Adult Medical Surgical 2019 RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal AiclientiwhoseimedicationsitoimanageiParkinson'sidiseaseiareinoilongerieffective CLOSE Q u e sti o n 59 loade drati onals p r o v id e d Question: 59 of 90 CORRECT FLAG  Time Remaining: 00:34:21  Pause Remaining: 00:05:00 PAUSE A nurse is assessing a group of clients. For which of the following clientsshould the nurse makea referral to palliative care? A client who isnewlydiagnosed withtype 1 diabetes mellitus and cannot afford insulin Clients who have type 1 diabetes mellitus require insulin to maintain blood glucose levelswithin the expected reference range. The nurse should refer clients who cannot afford to purchase medications to a social worker who has expertise in identifying resources to assist with purchasing medications at a discounted rate. A client whohasMeniere's disease and cannot safely ambulate due to vertigo Meniere's disease is a sensorineural disorder affecting the auditory system and causes tinnitus, hearing loss, and vertigo, or dizziness. Vertigo can increase the risk for falls. Thenurse should refer this client to a physical or occupational therapist, who will determine the need for assistive devices and evaluate the client's home for safety. A client whohad a stroke and cannot eat or drinkwithout choking A stroke can impact cranial nerve function. Impairment of cranial nerves IX and X results indysphagia. If this occurs, the nurse should make the client NPO and make a referral to a speech-language pathologist. MY ANSWER Parkinson's disease is a neurodegenerative disease marked by alterations in mobility, cognition, mood, and functioning of the sympathetic nervous system. The effectiveness ofmedications used to manage the symptoms can decrease over time. When this occurs, thenurse shouldmake a referralto palliative care. Palliative care is designed to maintain the RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal "Iiwillikeepitheimedicationirefrigerated." client's current quality of life through symptom management, assist with decision makingri egarding care needs, and work with families to identify care outcomes.  RNVATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 58 loade drati onals p r o v id e d Question: 58 of 90 CORRECT FLAG  Time Remaining: 00:34:15  Pause Remaining: 00:05:00 PAUSE A nurse is providing teaching to a client who has a new prescription for cephalexin oral suspension. Which of the following statements by the client indicates an understanding of theteaching? "I will increase my consumption offoods high in potassium." Cephalosporins do not increase the excretion of potassium; therefore, it is not necessary forthe client to increase potassium intake. Thiazide diuretics are an example of a type of medication that depletes potassium, resulting in hypokalemia. "I will apply lotion to myskin if Ifeel any itching." A common adverse effect of cephalosporins is a hypersensitivity reaction. Itching of the skin can indicate a hypersensitivity reaction, and the client should report this finding to theprovider. "I will avoid sun exposure while taking thismedication." Cephalosporins do not cause photosensitivity. However, ciprofloxacin and other fluoroquinolones have an adverse effect of photosensitivity. Photosensitivity can increasethe risk of developing a sunburn when the skin is exposed to direct sunlight. MY ANSWER RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal ShortenediPRiintervals The nurse should instruct the client to refrigerate the oral cephalosporin suspension tomaintain its full strength until the completion ofthe medication regimen.  RNVATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 57 loade drati onals p r o v id e d Question: 57 of 90 INCORRECT FLAG  Time Remaining: 00:34:09  Pause Remaining: 00:05:00 PAUSE A nurse is caring for a client who has acute kidney injury and a potassium level of 6.5 mEq/L.Which of the following ECG changesshould the nurse expect? Prominent P waves MY ANSWER P waves reflect electrical activity in the atria. Flat or absent P waves, rather than prominentP waves, are an expected finding on the ECG of a client who has hyperkalemia. Narrowed QRS complexes The QRS complex reflects ventricular electrical activity. QRS complexes widen when potassium levels reach critical levels and electrical conduction in the ventricles is slowingdown. The PR interval reflects conduction from the sinoatrial node through the atrioventricular node. A potassium level between 6.0 and 6.5 mEq/L slows the impulse conduction betweenti he atria and the ventricles, resulting in a prolonged PR interval. Peaked T waves Elevated potassium levels result in tall, peaked T waves, flat or absent P waves, prolongedPR intervals, wide QRS complexes, and ectopic beats. Hyperkalemia can progress to complete heart block, ventricular fibrillation, and asystole. RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal  Place the clientin a lowFowler's position with the knees bent.  Cover the client's woundwith a sterile saline-soaked dressing.  Prepareitheiclientiforitransferitoisurgery.  Notifyitheisurgeoniaboutitheifinding.  RNVATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 56 loade drati onals p r o v id e d Question: 56 of 90 INCORRECT FLAG  Time Remaining: 00:34:00  Pause Remaining: 00:05:00 PAUSE A nurse is caring for a client who had abdominal surgery. The client tells the nurse that "something gave way." The nurse removes the dressing and sees the wound has eviscerated. Identifythe correctsequence ofstepsthe nurse should follow. (Move the stepsinto thebox onthe right,placing them in the selected order of performance. Use allthe steps.) 3 2 1 4 Based on evidence-based practice, the nurse should immediately contact the surgeon and notify them of the wound evisceration. The nurse should then cover the client’s wound with a sterile saline soaked dressing to protect it from infection. The nurse should then place the client in a low Fowler's position with their knees bent and then prepare the clientto be transferred to surgery.  RNVATI Adult Medical Surgical 2019 Q u e Cst i on i5 5 Lilo a d e iOd ra t i o n a l s ip r o vSid e id E Question: 55 of 90 CORRECT FLAG  Time Remaining: 00:33:54  Pause Remaining: 00:05:00 PAUSE A nurse is caring for a client who is hemorrhaging and hypotensive from esophageal varicealbleeding. Which ofthe following actionsshould the nurse take first? Administer vasopressin to the client. RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal VerifyithatitheiclientihasiadequateiIViaccess. Increasedithirst The nurse should administer a vasoactive medication, such as vasopressin. This medicationincreases blood pressure through vasoconstriction. However, there is another action the nurse should take first. Requestblood fromblood bank. The nurse should request blood from a blood bank in preparation for a blood transfusion. However, there is another action the nurse should take first. Blood should not be requesteduntilthe nurse has verified that the client has adequate IV access. MY ANSWER When using the airway, breathing, and circulation approach to client care, the nurse shouldfirst verify that the client has at least a 20-gauge IV for the administration of blood. Insert an indwellingurinary catheter. The nurse should insert an indwelling urinary catheter to monitor urinary output and theeffectiveness of treatments. However, there is another action the nurse should take first.  RNVATI Adult Medical Surgical 2019 Q u e Cst i on i5 4 Lilo a d e iOd ra t i o n a l s ip r o vSid e id E Question: 54 of 90 CORRECT FLAG  Time Remaining: 00:33:47  Pause Remaining: 00:05:00 PAUSE A nurse is assessing a client who has a new diagnosis of diabetes mellitus. The nurse shouldidentifythat which ofthe following findingsis amanifestation of hyperglycemia? MY ANSWER The nurse should teach the client that increased thirst, or polydipsia, is a manifestation ofhyperglycemia, whichcan lead to dehydration. Other manifestations ofhyperglycemia RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal Diabetesimellitus include an increase in appetite, or polyphagia, an increase in urine production, or polyuria,and fatigue. Decreased urineoutput Thenurse shouldteach the client that polyuria is a manifestation ofhyperglycemia. Dry skin The nurse should teach the client that warm, moist skin is a manifestation ofhyperglycemia. Tremors The nurse should teach the client that tremors and anxiety are manifestations ofhypoglycemia.  RNVATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 53 loade drati onals p r o v id e d Question: 53 of 90 CORRECT FLAG  Time Remaining: 00:33:41  Pause Remaining: 00:05:00 PAUSE A nurse is reviewing the health histories of a group of clients. Which of the following findings should the nurse identify as an indication that a client is at an increased risk for urinary tract infections(UTIs)? Asthma A history of asthma does not increase the risk for UTI development. However, clients whouse corticosteroids to manage their asthma have an increased risk for infections because these medications can reduce the immune response. MY ANSWER RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal Elevateditoiletiseat Diabetes mellitus is a predisposing factor for UTIs. Clients who have underlying diseasesthat compromise their immune response have an increased risk forUTIs. Pernicious anemia Pernicious anemia, or vitamin B12 deficiency, does not increase the risk for UTI development. Pernicious anemia can, however, increase the risk for gastric cancer.Osteoporosis Osteoporosis does not increase the risk for UTI development. Osteoporosis increases therisk for bone fractures and subsequent immobility.  RNVATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 52 loade drati onals p r o v id e d Question: 52 of 90 CORRECT FLAG  Time Remaining: 00:33:35  Pause Remaining: 00:05:00 PAUSE A nurse is preparing to discharge a client who is postoperative following a total hip arthroplasty.Which ofthe following equipmentshould thenurse ensurethatthe client hasai vailable at home prior to discharge? Continuouspassivemotion device Continuous passive motion devices promote range of motion and the prevention of scar tissue of the knee following a total knee arthroplasty. However, they are not used for theclient who is postoperative following a total hip arthroplasty. MY ANSWER A client who is postoperative following a total hip arthroplasty is at risk for dislocation of the hip prosthesis. Limitations on hip flexion and adduction decrease the risk. The client should avoid flexing the hip greater than 90° and should avoid using toilet seats that are low to the ground. An elevated toilet seat should be in place in the client's home prior to theclient's discharge. RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal Retinopathy Trapeze bar A trapeze bar in unnecessary for a client who had a total knee arthroplasty because they receive physical therapy and occupational therapy during their inpatient stay regarding bed mobility and transfers. Compressiongarment Compression garments are specially designed elasticized clothing used in the treatment ofburns. The compression garment places continuous pressure on the burn injury followingigrafting to promote healing and limit the development of scarring, which could inhibit mobility.  RNVATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 51 loade drati onals p r o v id e d Question: 51 of 90 CORRECT FLAG  Time Remaining: 00:33:30  Pause Remaining: 00:05:00 PAUSE A nurse is assessing a client who has a history of type 2 diabetes mellitus. The nurse shouldidentify which of the following findings as an indication of a microvascular complication? Coronary arterydisease Coronary artery disease is a macrovascular complication of diabetes mellitus. Macrovascular complications result from pathologic changes in large or generalized vesselsas a result of hyperglycemia, hyperlipidemia, and an inflammatory process reflected in elevated C-reactive protein levels. The alterations in lipid metabolism that characterize diabetes accelerate the development of atherosclerotic plaque, which is a characteristic of coronary artery disease. MY ANSWER RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal Diabetic retinopathy is a microvascular complication of diabetes mellitus resulting from pathologic changes in small blood vessels, which eventually cause tissue damage, cell deathin the retina, and blindness. Cerebrovascular accident A cerebrovascular accident, or stroke, is a macrovascular complication of diabetes mellitus.Macrovascular complications result from pathologic changes in medium or large vessels asa result of hyperglycemia, hyperlipidemia, and an inflammatory process reflected in elevated C-reactive protein levels. It is essential for a client who has diabetes mellitus to reduce risk factors that can precipitate stroke, such as cigarette smoking. Hypertension Hypertension is a macrovascular complication of diabetes mellitus. Macrovascular complications result from pathologic changes in large or generalized vessels as a result of hyperglycemia, hyperlipidemia, and an inflammatory process reflected in elevated Creactive protein levels. These factors eventually lead to hypertension, other cardiovasculardisorders, or cerebrovascular diseases.  RNVATI Adult Medical Surgical 2019 CLOSE Q u e sti o n 50 loade drati onals p r o v id e d Question: 50 of 90 CORRECT FLAG  Time Remaining: 00:33:24  Pause Remaining: 00:05:00 PAUSE A nurse is caring for a client who is receiving a transfusion of packed RBCs. The nurse notes thatthe client's blood type is AB positive and the blood infusing is labeled type B negative. Which ofthe following actionsshould the nurse take? Stopthebloodtransfusion immediately. Clients who have type AB blood are universal recipients and can receive any ABO bloodtype. Clients who have Rh-positive blood can receive a transfusion from a Rh-negative donor. RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal Monitoritheiclientiforianyiadverseireactions. Turnitheiclientibyilogirollingiwithiaiturningisheet. Prepare to administer antipyretics. Leukocyte incompatibilities are a common cause of febrile transfusion reactions. Unless aclient has a history of febrile reactions to prior transfusions or develops chills or fever, there is no reason to administer antipyretics. MY ANSWER Although the client is a universal recipient and can receive any ABO blood type, the nurse should continue to monitor for any adverse reactions, which is standard procedure for anyblood transfusion. Transfuse the blood over6 hr. The nurse should transfuse the packed RBCs within 4 hr after removing it fromrefrigeration to reduce the risk of bacterial contamination of the blood.  RNVATI Adult Medical Surgical 2019 Q u e Cst i on i4 9 Lilo a d e iOd ra t i o n a l s ip r o vSid e id E Question: 49 of 90 CORRECT FLAG  Time Remaining: 00:33:19  Pause Remaining: 00:05:00 PAUSE A nurse is planning care for a client who had a lumbar laminectomy. Which of the followinginterventionsshould the nurse include in the plan of care? Instructthe clientto lift no more than 6.8 kg (15 lb)when at home. The nurse shouldinstruct the client to lift objects no heavier than 2.3 kg (5 lb)for severalweeks following surgery to prevent reinjuring the lower back. MY ANSWER RN 2023 AdultMedical Surgical ATIProctored Exam ALLFORMS! LATEST UPDATED Downloaded by: kiaritalaboy | Distribution of this document is illegal The nurse should turn the client by log rolling with a turning sheet to keep the client's backistraight and to prevent back spasms from occurring. Informthe clienttoshower on the second postoperative day. The nurse should instruct the client to shower on the third or fourth postoperative day toensure the healing of the incision. Remove sterile adhesive strips