ATI Med Surg Practice A 2022

ATI Med Surg Practice A 2022 A home health nurse is assigned to a client who was recently discharged from rehabilitation center after experiencing a RIGHT-hemispheric cerebrovascular accident (CVA). Which of the following neurological deficits should the nurse expect to find when assess? Visual spatial deficits (loss of depth perception occur secondary) Left hemianopsia (blindness in the left half of the visual field, occurs secondary) One-sided neglect (unawareness of the affected side, occurs secondary) Expressive aphasia is incorrect. Expressive aphasia, or an inability to express what one wants to convey, occurs secondary to a left-hemispheric stroke. Right hemiplegia is incorrect. Right hemiplegia occurs secondary to a left-hemispheric stroke. A nurse is reviewing the health record of a client who is scheduled for allergy skin testing. The nurse should postpone the testing and report to the provider which of the following findings? A. Current medications R. The nurse should review the client's medication record and identify medications, including ACE inhibitors, beta blockers, theophylline, nifedipine, and glucocorticoids, such as prednisone, that can alter the allergy skin test results. These medications can diminish the client's reaction to the allergens. The nurse should notify the provider and instruct the client to discontinue prednisone for 2 weeks before allergy skin testing. A nurse is caring for a client who has pancreatitis. Which of the labs should be expected? A. Calcium R. A client who has pancreatitis is expected to have decreased calcium and magnesium levels due to fat necrosis. A nurse is caring for a client who has DKA. Which of the following lab finding should be expected? A. BUN 32 R. DKA results in osmotic diuresis and subsequent dehydration. The nurse should expect a client who has DKA to have elevated BUN, creatinine, and specific gravity levels resulting from the excess glucose present in the urine. A nurse is providing discharge instructions to a client who has partial thickness burn on the hand. Which of the following should the nurse include? A. Wrap fingers with individual dressing R. The nurse should instruct the client to wrap the fingers individually to allow for functional use of the hand while healing occurs. The nurse should also instruct the client to perform range-of-motion exercises to each finger every hour while awake to promote function of the injured hand. A nurse is planning care for a client who has burns and is immunocompromised. Which precautions should the nurse include in the plan of care to rpevent pseudomonas aeruginosa? A. Avoid placing plants in the room R. Live plants can harbor P. aeruginosa, and this bacterium can infect burn wounds and cause life-threatening complications. The nurse should ensure no one brings live plants or flowers into the client's room. A nurse in an emergency department is caring for a client who reports vomiting and diarrhea for the past 3 days. Which of the following findings should indicate to the nurse that the client is experiencing fluid volume deficit? A. HR of 110/min R. A client who has a 3-day history of vomiting and diarrhea is likely to have fluid volume deficit and an elevated heart rate. A nurse in an emergency department is reviewing the providers prescriptions for a client who sustained a rattlesnake bite to the lower leg. Which should the nurse expect? A. Administer and opioid analgesic to the client R. The nurse should expect a prescription for an opioid analgesic to promote comfort following a rattlesnake bite. A nurse is providing teaching to a client who has chronic kidney disease and a new prescription for erythropoietin. Which of the following statements by the client indicates an understanding of the teaching? A. "I am taking this medication to increase my energy level." R. The goal of erythropoietin therapy is to increase the level of hematocrit in clients who have anemia. When the medication is effective, the client should have a decrease in fatigue and an improvement in activity tolerance. A nurse is reviewing the laboratory results of a client who has cirrhosis. Which of the following lboratory values should the nurse expect? A. Elevated bilirubin level R. Bilirubin levels reflect the liver's ability to conjugate and excrete bilirubin, a byproduct of the hemolysis of red blood cells. Bilirubin levels rise with liver disease and clinically reflect the client's degree of jaundice. A nurse in community clinic is caring for a client who reports an increase in frequency of migraine headaches. To reduce the risk for headaches, which food should he avoid? A. Aged cheese R. Foods that contain tyramine, such as aged cheese and sausage, can trigger migraine headaches. A nurse is planning to provide discharge teaching or the family of an older adult client who has hemianopsia and is at risk for falls. Which of the following instructions should the nurse include? A. Remind the client to scan their complete range of vision during ambulation. R. The nurse should instruct the family to remind a client who has hemianopsia, or blindness in half of the visual field, to use visual scanning to look over their complete range of vision during ambulation. This practice can accommodate for the loss of vision and help to reduce the risk for falls. A nurse is providing a teaching to a client who has esophageal cancer and is to undergo radiation therapy. Which statements should the nurse identify as an indication that the client understands the teacing? A. "I will use my hands rather than a washcloth toD clean the radiation area." R. The client should gently wash the radiation area with their hands using warm water and mild soap to protect the skin from further irritation. A nurse is preparing a client who has supraventricular tachycardia for elective cardioversion. Which of the prescribed meds should the nurse instruct the client to withhold for 48 hr prior to cardioversion? A. Digoxin R. Cardiac glycosides, such as digoxin, are withheld prior to cardioversion. These medications can increase ventricular irritability and put the client at risk for ventricular fibrillation after the synchronized countershock of cardioversion. A nurse is in an acute care facility is caring for a client who is at risk for seizures. Which of the following precautions should the nurse implement? A. Ensure that the client has a patent IV. R. The nurse should ensure the client has IV access in the event that the client requires medication to stop seizure activity. A nurse in an emergency department is assessing a client who has a detached retina. Which of the following should the nurse expect the client to report? A. It's like a curtain closed over my eye R. A retinal detachment is the separation of the retina from the epithelium. It can occur because of trauma, cataract surgery, retinopathy, or uveitis. Clients who have retinal detachment typically report the sensation of a curtain being pulled over part of the visual field. A nurse is providing teaching to a client who has gastric ulcer and a new prescription for omeprazole. The nurse should instruct the client that the medication provides relief by which of the following actions? A. Suppressing gastric acid production R. Omeprazole is a proton pump inhibitor. It relieves manifestations of gastric ulcers by suppressing gastric acid production. A nurse is caring for a client who has a new diagnosis of hyperthyroidism. Which of the following is the priority assessment finding that the nurse should report? A. BP 170/80 R. Using the urgent vs. nonurgent approach to client care, the nurse should determine that the priority finding is a systolic blood pressure of 170 mm Hg, which indicates that the client is at risk for thyroid storm. A nurse is providing dietary teaching to a client who is postop following a thyroidectomy with removal of parathyroid glands. The nurse should instruct the client to include which of the following foods that has the greatest amount of calcium? A. 12 almonds R. The nurse should determine that almonds are the best source of calcium to recommend because 12 almonds contain 36 mg of calcium. Removal of the parathyroid glands, which regulate calcium in the body, can result in hypocalcemia. A nurse is preparing to administer a unit of packed RBCs to a client. Which of the following actions should the nurse take? A. Remain with the client for the first 15 min of the infusion. R. The nurse should remain with the client for the first 15 to 30 min of the infusion because hemolytic reactions usually occur during the infusion of the first 50 mL of blood. A nurse is providing teaching to a client who has IBS. Which of the following instructions should the nurse include in the teaching? A. Increase fiber intake to at least 30 g per day. R. DKA results in osmotic diuresis and subsequent dehydration. The nurse should expect a client who has DKA to have elevated BUN, creatinine, and specific gravity levels resulting from the excess glucose present in the urine. A nurse is caring for a client who has chronic glomerulonphritis with oliguria. Which of the findings should the nurse identify as a manifestation? A. Hyperkalemia R. The nurse should identify that a client who has chronic glomerulonephritis can experience hyperkalemia as a result of kidney failure. Kidney failure results in decreased excretion of potassium. A nurse is caring for a client who is postop following a total hip arthroplaty. Which of the following lab values should the nurse report to the provider? A. Hgb 8 g/dL R. The nurse should report an Hgb level of 8 g/dL, which is below the expected reference range and is an indicator of postoperative hemorrhage or anemia. A nurse is planning care fora client who is undergoing brachytherapy via a sealed vaginal implant to treat endometrial cancer. Which cations should be included in plan of care?