ATI RN ADULT MEDICAL SURGICAL PRACTICE WITH NGN ALREADY GRADED A+

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 A nurse is preparing a client who has supraventricular tachycardia for elective cardioversion. Which of the following prescribed medications should the nurse instruct the client to withhold for 48 hr prior to cardioversion? Enoxaparin Metformin Diazepam Digoxin Digoxin A nurse is caring for a client who has anorexia, low-grade fever, night sweats, and a productive cough. Which of the following actions should the nurse take first? Obtain a sputum sample. Administer antipyretics. Provide hand hygiene education. Initiate airborne precautions. Initiate airborne precautions. -exhibiting manifestations of tuberculosis. The greatest risk in this client situation is for other people in the facility to acquire an airborne disease from this client. Therefore, the first action the nurse should take is to initiate airborne precautions. A nurse is caring for a client who has a stage 111 pressure injury. Which of the following findings contributes to delayed wound healing? WBC count 6,000/mm3 BMI 24 Urine output 25 mL/hr Albumin 4 g/dL Urine output 25 mL/hr -Urinary output reflects fluid status. Inadequate urine output can indicate dehydration, which can delay wound healing. Rationale -well-managed pain level enhances a client’s willingness to increase mobility. -BMI less than 18.5 are considered at risk for complications, such as poor wound healing. (24 is within normal limits) A nurse is caring for a client who has emphysema and is receiving mechanical ventilation. The client appears anxious and restless, and the high-pressure alarm is sounding. Which of the following actions should the nurse take first? -Obtain ABGs -Administer Propofol to the client. -Instruct the client to allow the machine to breathe for them. -Disconnect the machine and manually ventilate the client. Instruct the client to allow the machine to breathe for them. -should first use the least restrictive intervention. Therefore, the first action the nurse should take is to provide verbal instructions and emotional support to help the client relax and allow the ventilator to work. A nurse is caring for a client who has hepatic encephalopathy that is being treated withy lactulose. The client is experiencing excessive stools. Which of the following findings is an adverse effect of this medication? Hypokalemia Hypercalcemia Gastrointestinal bleeding Confusion Hypokalemia 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? Heart rate 110/min Blood pressure 138/90 mm Hg Urine specific gravity 1.020 BUN 15 mg/dL Heart rate 110/min -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 is caring for a client who has pancreatitis. The nurse should expect which of the following laboratory results to be below the expected reference range? Amylase Alkaline phosphatase Bilirubin Calcium Calcium A nurse is assessing a client who has Graces' disease. Which of the following images should indicate to the nurse that the client has exophthalmos? Identify an outward protrusion of the eyes as exophthalmos, a common finding of Graves' disease. An overproduction of the thyroid hormone causes edema of the extraocular muscle and increases fatty tissue behind the eye, which results in the eyes protruding outward. Exophthalmos can cause the client to experience problems with vision, including focusing on objects, as well as pressure on the optic nerve. A nurse is caring for a client who was just admitted from the emergency department (ED). 0945: Client is experiencing a sickle cell crisis. 1200: Client is sitting up in high-Fowler's position and appears anxious. Client reports shortness of breath and severe chest pain as 9 on a scale of 0 to 10. Client states that they have started coughing and are expectorating pink-tinged mucus. Lung sounds with increased wheezing in left lung and clear on the right side. Equal chest expansion noted. Neck veins flat. No peripheral edema observed. The client is most likely experiencing _____ and _____. Fluid volume overload Right-sided heart failure. Acute chest syndrome Pneumonia Pneumothorax The client is most likely experiencing Acute chest syndrome and pneumonia. rationale Acute chest syndrome is correct. which can be caused by respiratory infections and debris from sickled cells. The client is displaying manifestations of acute chest syndrome, which include cough, shortness of breath, wheezing, tachypnea, fever, and chest pain. Pneumonia is correct. as evidenced by the manifestations of cough, shortness of breath, fever, tachypnea, blood-tinged sputum, and chest pain. A nurse 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? Place a padded tongue blade at the client's bedside. Keep the side rails lowered on the client's bed. Maintain the client's bed at hip level and above. Ensure the client has a patent IV. Ensure the client has a patent IV. -The nurse should ensure the client has IV access in the event that the client requires medication to stop seizure activity. A nurse is ass4ess9ing a client who has had a plaster cast applied to their left leg 2 hr ago. Which of the following actions should the nurse take? Inspect the cast for drainage once every 24 hr Check that one finger fits between the cast and the leg. Perform neurovascular checks every 2 to 3 hr. Make sure the client has a warm blanket covering the cast. Check that one finger fits between the cast and the leg. -make sure the cast is not too tight, the nurse should be able to slide one finger under the cast. It is not uncommon for casts to loosen as swelling subsides, but that should not be an issue 2 hr after application. Rationale -inspect the cast for drainage and alignment at least once every 8 to 12 hr. -For the first 24 hr after cast application, the nurse should check the neurovascular status of the client's leg every hour. -cast is uncovered to allow for thorough air drying of the plaster. Also, the heat that is generated by the drying process has to escape. A nurse is caring for a client 1 hr following a cardiac catheterization. The nurse notes the formation of a hematoma at the insertion site and a decreased pulse rate in the affected extremity. Which of the following interventions is the nurse's priority? Initiate oxygen at 2 L/min via nasal cannula Apply firm pressure to the insertion site Take the client's vital signs. Obtain a stat order for an aPTT Apply firm pressure to the insertion site -greatest risk to the client is bleeding. Therefore, the priority intervention is for the nurse to apply firm pressure to the hematoma to stop the bleeding. A nurse is assessing a male client for an inguinal hernia. Which of the following areas should the nurse palpate to verify that the client has an inguinal hernia? Belly button Upper groin Lower groin Upper groin A nurse is teaching a class about client rights. Which of the following instructions should the nurse include? A client should sign an informed consent before receiving a placebo during a research trial. A client cannot refuse to sign a consent form for a life-saving treatment. A client who has a mental illness is unable to give informed consent. An unemancipated minor needs guardian consent for substance use disorder treatment. A client should sign an informed consent before receiving a placebo during a research trial. -ensure a client has provided informed consent before administering a placebo. Placebos should not be used outside of approved clinical research in which the client has consented to participate. Rationale -unemancipated minor has the right to consent to treatment for substance use disorder. A nurse in a provider's office is caring for a client who requests sildenafil to treat erectile dysfunction. Which of the following statements should the nurse make? "You might need to take a stool softener while taking this medication." "You will not be abled to use sildenafil if you have diabetes." "You will need to limit your caffeine intake if you start taking sildenafil." "You will not be able to use sildenafil if you are taking nitroglycerin." "You will not be able to use sildenafil if you are taking nitroglycerin." A nurse is caring for a client has who has chronic glomerulonephritis with oliguria. Which of the following findings should the nurse identify as a manifestation of chronic glomerulonephritis? Metabolic alkalosis Hyperkalemia Increased hemoglobin Hypophosphatemia Hyperkalemia -chronic glomerulonephritis can experience hyperkalemia as a result of kidney failure. Kidney failure results in decreased excretion of potassium. Rationale -hyperphosphatemia as a result of decreased excretion of phosphorus through the kidneys. -can experience anemia as a result of decreased RBC production. A nurse is assessing a patient for suspected stroke. The nurse should place the priority on which of the following findings? Dysphagia Aphasia Ataxia Hemianopsia Dysphagia -Dysphagia indicates that this client is at greatest risk for aspiration due to impaired sensation and function within the oral cavity. Therefore, the nurse should place priority on this finding. A nurse is caring for a client who has a prescription for enalapril. The nurse should identify which of the following findings as an adverse effect of the medication? Bradycardia Tremors Orthostatic hypotension Drowsiness Orthostatic hypotension A nurse is assessing a client who had extracorporeal shock wave lithotripsy (ESWL) 6 hr ago. Which of the following findings should the nurse expect? Stone fragments in the urine Fever Deceased urine output Bruising on the lower abdomen Stone fragments in the urine -ESWL is an effort to break the calculi so that the fragments pass down the ureter, into the bladder, and through the urethra during voiding. Following the procedure, the nurse should strain the client's urine to confirm the passage of stones.