ATI RN Adult Medical Surgical Practice
2019 -2023 with NGN
A nurse is assessing a client who has acute cholecystitis. Which of the following findings is the
nurse's priority?
Anorexia
Abdominal pain radiating to the right shoulder
Tachycardia
Rebound abdominal tenderness
Tachycardia
-Tachycardia is a manifestation of biliary colic, which can lead to shock. The nurse should
position the head of the client's bed flat and report this finding immediately
A nurse is caring for a client who is undergoing hemodialysis to treat end-stage kidney disease
(ESKD). The client reports muscle cramps and tingling sensation in their hands. Which of the
following medications should the nurse plan to administer?
Epoetin alfa
Furosemide
Captopril
Calcium carbonate
Calcium carbonate
A nurse is providing teaching to a client who is receiving chemotherapy and has a new
prescription for epoetin alfa. Which of the following client statements indicates an understanding
of the teaching?
"I will monitor my blood pressure while taking this medication"
"I should take a vitamin D supplement to increase the effectiveness of the medication."
,"I should inform the provider if I experience an increased appetite while taking this medication"
"I will decrease the amount of protein in my diet while taking this medication."
"I will monitor my blood pressure while taking this medication"
-monitor their blood pressure while taking this medication because hypertension is a common
adverse effect and can lead to hypertensive encephalopathy.
Rationale
-client requires an adequate intake of iron, folic acid, and vitamin B12 while taking this
medication because they are essential to the production of erythrocytes.
-increase the amount of protein in their diet while receiving chemotherapy to decrease the risk
for infection.
The nurse is caring for a group of clients. The nurse should plan to make a referral to physical
therapy for which of the following clients?
-A client who is receiving preoperative teaching for a right knee arthroplasty.
-A client who states they will have difficulty obtaining a walker for home use.
-A client who reports an increase in pain following a left hip arthroplasty.
-A client who is having emotional difficulty accepting that they have a prosthetic leg.
A client who is receiving preoperative teaching for a right knee arthroplasty.
-should make a referral to physical therapy for a client who is receiving preoperative teaching for
a knee arthroplasty so the client can begin understanding postoperative exercises and physical
restrictions.
Rationale
-should make a referral to a social worker for walker
-should contact the provider for a client who is experiencing increased pain following a left hip
arthroplasty.
-should refer the client to a counselor to assist with coping with the adjustment to the need of a
prosthetic leg.
,A nurse is providing teaching to a female client who has a history of urinary tract infections
(UTIs). Which of the following information should the nurse include in the teaching?
Avoid foods that are high in ascorbic acid.
Add oatmeal to the water when taking a tub bath.
Urinate every 6 hr.
Take daily cranberry supplements.
Take daily cranberry supplements
-.take cranberry supplements or drink low-fructose cranberry juice because it contains
compounds that adhere to the urinary tract wall, decreasing the risk for developing a UTI
Rationale
-risk for developing UTIs should urinate every 2 to 4 hr.
-take showers rather than tub baths because bacteria in the bath water can enter the urethra.
-increase intake of ascorbic acid to acidify the urine.
A nurse is providing instructions to a client who has type 2 diabetes mellitus and a new
prescription for metformin. Which of the following statements by the client indicates an
understanding of the teaching?
"I will monitor my blood sugar carefully because the medication increases the secretion of
insulin."
"I should take this medication with a meal."
"I can expect to gain weight while taking this medication."
"While taking this medication, I will experience flushing of my skin."
"I should take this medication with a meal."
-take metformin with or immediately following meals to improve absorption and to minimize
gastrointestinal distress.
, Rationale
-Metformin decreases the amount of glucose produced in the liver and increases tissue
sensitivity to insulin
-Typically, clients lose weight when beginning to take metformin due to nausea and vomiting.
A nurse is caring for a client who is receiving total parenteral nutrition (TPN). A new bag is not
available when the current infusion is nearly completed. Which of the following actions should
the nurse take?
Keep the line open with 0.9% sodium chloride until the new bag arrives.
Administer dextrose 10% in water until the new bag arrives.
Flush the line and cap the port until the new bag arrives.
Decrease the infusion rate until the new bag arrives.
Administer dextrose 10% in water until the new bag arrives.
-TPN solutions have a high concentration of dextrose. Therefore, if a TPN solution is temporarily
unavailable, the nurse should administer dextrose 10% or 20% in water to avoid a precipitous
drop in the client's blood glucose level.
A nurse in a community clinic is caring for a client who reports an increase in the frequency of
migraine headaches. To help reduce the risk for migraine headaches, which of the following
foods should the nurse recommend the client avoid?
Shellfish
Aged cheese
Peppermint candy
Enriched pasta
Aged cheese
2019 -2023 with NGN
A nurse is assessing a client who has acute cholecystitis. Which of the following findings is the
nurse's priority?
Anorexia
Abdominal pain radiating to the right shoulder
Tachycardia
Rebound abdominal tenderness
Tachycardia
-Tachycardia is a manifestation of biliary colic, which can lead to shock. The nurse should
position the head of the client's bed flat and report this finding immediately
A nurse is caring for a client who is undergoing hemodialysis to treat end-stage kidney disease
(ESKD). The client reports muscle cramps and tingling sensation in their hands. Which of the
following medications should the nurse plan to administer?
Epoetin alfa
Furosemide
Captopril
Calcium carbonate
Calcium carbonate
A nurse is providing teaching to a client who is receiving chemotherapy and has a new
prescription for epoetin alfa. Which of the following client statements indicates an understanding
of the teaching?
"I will monitor my blood pressure while taking this medication"
"I should take a vitamin D supplement to increase the effectiveness of the medication."
,"I should inform the provider if I experience an increased appetite while taking this medication"
"I will decrease the amount of protein in my diet while taking this medication."
"I will monitor my blood pressure while taking this medication"
-monitor their blood pressure while taking this medication because hypertension is a common
adverse effect and can lead to hypertensive encephalopathy.
Rationale
-client requires an adequate intake of iron, folic acid, and vitamin B12 while taking this
medication because they are essential to the production of erythrocytes.
-increase the amount of protein in their diet while receiving chemotherapy to decrease the risk
for infection.
The nurse is caring for a group of clients. The nurse should plan to make a referral to physical
therapy for which of the following clients?
-A client who is receiving preoperative teaching for a right knee arthroplasty.
-A client who states they will have difficulty obtaining a walker for home use.
-A client who reports an increase in pain following a left hip arthroplasty.
-A client who is having emotional difficulty accepting that they have a prosthetic leg.
A client who is receiving preoperative teaching for a right knee arthroplasty.
-should make a referral to physical therapy for a client who is receiving preoperative teaching for
a knee arthroplasty so the client can begin understanding postoperative exercises and physical
restrictions.
Rationale
-should make a referral to a social worker for walker
-should contact the provider for a client who is experiencing increased pain following a left hip
arthroplasty.
-should refer the client to a counselor to assist with coping with the adjustment to the need of a
prosthetic leg.
,A nurse is providing teaching to a female client who has a history of urinary tract infections
(UTIs). Which of the following information should the nurse include in the teaching?
Avoid foods that are high in ascorbic acid.
Add oatmeal to the water when taking a tub bath.
Urinate every 6 hr.
Take daily cranberry supplements.
Take daily cranberry supplements
-.take cranberry supplements or drink low-fructose cranberry juice because it contains
compounds that adhere to the urinary tract wall, decreasing the risk for developing a UTI
Rationale
-risk for developing UTIs should urinate every 2 to 4 hr.
-take showers rather than tub baths because bacteria in the bath water can enter the urethra.
-increase intake of ascorbic acid to acidify the urine.
A nurse is providing instructions to a client who has type 2 diabetes mellitus and a new
prescription for metformin. Which of the following statements by the client indicates an
understanding of the teaching?
"I will monitor my blood sugar carefully because the medication increases the secretion of
insulin."
"I should take this medication with a meal."
"I can expect to gain weight while taking this medication."
"While taking this medication, I will experience flushing of my skin."
"I should take this medication with a meal."
-take metformin with or immediately following meals to improve absorption and to minimize
gastrointestinal distress.
, Rationale
-Metformin decreases the amount of glucose produced in the liver and increases tissue
sensitivity to insulin
-Typically, clients lose weight when beginning to take metformin due to nausea and vomiting.
A nurse is caring for a client who is receiving total parenteral nutrition (TPN). A new bag is not
available when the current infusion is nearly completed. Which of the following actions should
the nurse take?
Keep the line open with 0.9% sodium chloride until the new bag arrives.
Administer dextrose 10% in water until the new bag arrives.
Flush the line and cap the port until the new bag arrives.
Decrease the infusion rate until the new bag arrives.
Administer dextrose 10% in water until the new bag arrives.
-TPN solutions have a high concentration of dextrose. Therefore, if a TPN solution is temporarily
unavailable, the nurse should administer dextrose 10% or 20% in water to avoid a precipitous
drop in the client's blood glucose level.
A nurse in a community clinic is caring for a client who reports an increase in the frequency of
migraine headaches. To help reduce the risk for migraine headaches, which of the following
foods should the nurse recommend the client avoid?
Shellfish
Aged cheese
Peppermint candy
Enriched pasta
Aged cheese
