ATI - ADULT MEDICAL SURGICAL NGN B EXAM FULLY SOLVED & UPDATED 2024.

A nurse is providing teaching to a client who is perimenopausal and has a prescription for hormone replacement therapy. For which of the following adverse effects should the nurse instruct the client to notify the provider? Calf pain Numbness in the arms Intense headache A nurse is planning care for a client who is postoperative following a laparotomy and has a closed-suction drain. Which of the following actions should the nurse take to manage the drain? Compress the drain reservoir after emptying. A nurse is caring for a client who has DKA. Which of the following findings should indicate to the nurse that the client's condition is improving? Glucose 272 mg/dL A nurse is reviewing the laboratory findings of a client who developed chest pain 6 hr ago. The nurse should identify which of the following findings as an indication of a myocardial infarction (MI)? Troponin I 8 ng/mL A nurse is planning a health promotional presentation for a group of African American clients at a community center. Which of the following disorders presents the greatest risk to this group of clients? hypertension A nurse is providing education to a client who is at risk for osteoporosis. Which of the following instructions should the nurse include? Walk for 30 min four times per week. A nurse is caring for a client who has an arterial line. Which of the following actions should the nurse take? Place a pressure bag around the flush solution. A nurse is reviewing the ABG results of a client who has advanced COPD. Which of the following results should the nurse expect? PaCO2 56 A nurse is providing postoperative teaching for a client who had a total knee arthroplasty. Which of the following instructions should the nurse include? Flex the foot every hour when awake. A nurse is planning care for a client who is postoperative following a parathyroidectomy. Which of the following actions should the nurse identify as the priority? Place a tracheostomy tray at the bedside. A nurse is evaluating the plan of care for four clients after 2 days of hospitalization. The nurse should identify the need to revise the plan for which of the following clients? A client who is postoperative following abdominal surgery and reports feeling that something "popped" when they coughed A nurse is checking the ECG rhythm strip for a client who has a temporary pacemaker. The nurse notes a pacemaker artifact followed by a QRS complex. Which of the following actions should the nurse take? Document that depolarization has occurred. A nurse is providing discharge instructions to a client who has active tuberculosis (TB). Which of the following information should the nurse include in the instructions? Sputum specimens are necessary every 2 to 4 weeks until there are three negative cultures. A nurse is caring for a client who is receiving a blood transfusion. The client becomes restless, dyspneic, and has crackles noted to the lung bases. Which of the following actions should the nurse anticipate taking? Slow the infusion rate A nurse is assessing a client who is postoperative following a thyroidectomy. Which of the following findings is the nurse's priority? Temperature 38.9° C (102° F) A nurse is caring for a client who has homonymous hemianopsia as a result of a stroke. To reduce the risk of falls when ambulating, the nurse should provide which of the following instructions to the client? Scan the environment by turning your head from side to side. A PACU nurse is assessing a client who is postoperative following a right nephrectomy. The client's initial vital signs were heart rate 80/min, blood pressure 130/70 mm Hg, respiratory rate 16/min, and temperature 36° C (96.80 F). Which of the following vital sign changes should alert the nurse that the client might be hemorrhaging? Heart rate 110/min A nurse is caring for a client who is 8 hr postoperative following a total hip arthroplasty. The client is unable to void on the bedpan. Which of the following actions should the nurse take first? Scan the bladder with a portable ultrasound. A nurse is assessing a client who has advanced lung cancer and is receiving palliative care. The client has just undergone thoracentesis. The nurse should expect a reduction in which of the following common manifestations of advanced cancer? Dyspnea A nurse is caring for a client who is postoperative. Nurses' Notes Client admitted to medical-surgical unit from PACU. Client reports incisional pain as 2 on a scale of 0 to 10. Client appears restless and frequently asks for water. Bilateral lower extremities cool with +1 pedal pulses. Urine output is 40 mL for the past 2 hr. Moderate amount of bright red drainage noted on surgical incision dressing. Vital Signs Temperature 37.6° C (99.7° F) Heart rate 114/min Respiratory rate 22/min Blood pressure 88/54 mm Hg Oxygen saturation 93% on room air Diagnostic Results Hgb 18 g/dL (12 to 16 g/dL) Hct 54% (37% to 47 %) Total WBC count 11,000/mm3 (5,000 to 10,000/mm3) Troponin T 0.04 ng/mL (less than 0.1 ng/mL) Medical History. History of hypertension. Acute myocardial infarction 1 year ago. Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress. The nurse should insert a large-gauge IV and initiate a fluid challenge because the client is most likely experiencing hypovolemia as evidenced by the client's restlessness, tachycardia, hypotension, decreased pulses, cool extremities, and decreased urine output. The nurse should monitor the client's urine output and blood pressure to evaluate the effectiveness of treatment. A home health nurse is providing teaching to a client who has a stage 1 pressure injury on the greater trochanter of his left hip. Which of the following instructions should the nurse include in the teaching? Change position every hour A nurse is performing a preoperative assessment for a client. The nurse should identify that an allergy to which of the following foods can indicate a latex allergy? avocados Vital Signs Blood pressure 155/98 mm Hg Heart rate 98/min Respiratory rate 14/min Temperature 38.4° C (101.1 ° F) Medication Administration Record Gentamicin 60 mg intermittent IV bolus Q8H Ceftriaxone 1 g intermittent IV bolus BID Morphine 2.5 mg IV bolus Q3H PRN for pain Acetaminophen 650 mg PO Q6H PRN for fever greater than 38°C (100.4° F) Laboratory Results WBC count 13,700/mm3 Serum creatinine 2.1 mg/dL Hemoglobin 10 g/dL A nurse is reviewing the medical record of a client who has osteomyelitis and a prescription for gentamicin. Which of the following findings from the client's medical record should indicate to the nurse the need to withhold the medication and notify the provider? Serum creatinine A nurse is obtaining a medication history from a client who is scheduled to undergo cataract surgery. The nurse should recognize that which of the following client medications is a contraindication for the surgery and notify the provider? Warfarin A nurse is providing teaching to a client who has hypertension and a new prescription for verapamil. Which of the following information should the nurse include in the teaching? "Increase fiber intake to avoid constipation." A nurse is reviewing the medical record of a client who is taking warfarin for chronic atrial fibrillation. Which of the following values should the nurse identify as a desired outcome for this therapy? INR 2.5 A nurse is caring for a client who has breast cancer and tells the nurse that they would like to have acupuncture because it provides greater relief than pain medication. Which of the following statements should the nurse make? "I can speak with the provider about incorporating acupuncture into your treatment plan." A nurse is caring for a client who has increased intracranial pressure (ICP) and is receiving mannitol via continuous IV infusion. Which of the following findings should the nurse report to the provider as an adverse effect of this medication? Crackles heard on auscultation A nurse is reviewing the laboratory results of a client who has AIDS and is taking amphotericin B for a fungal infection. The nurse should identify that which of the following values is an indication of an adverse effect of the medication? BUN 34 mg/dL A nurse is teaching a client about osteoporosis prevention. The nurse should instruct the client that which of the following medications can increase their risk for developing osteoporosis? Prednisone A nurse has received report on a client who is being admitted to the emergency department. Nurses' Notes 2330: Report received from ambulance crew: Client has a penetrating wound to the anterior upper right chest. Client is alert and oriented with a Glasgow Coma Scale (GCS) score of 15. Client's shirt covered with bright red blood. Client reports pain as 6 on a scale of 0 to 10. Shortness of breath noted. 2345: Client is alert and oriented with a GCS score of 15. Client has a penetrating wound to the anterior right upper chest measuring 2.5 cm (1 in). No other wounds or injuries found. Bilateral radial and pedal pulses are +1. Left lung sounds are clear, right upper lung sounds diminished. Client still reports pain as 6 on a scale of 0 to 10 over anterior chest. Bowel sounds are present in all 4 quadrants. Graphic Record 2330: Current vital signs from ambulance crew: Heart rate 125/min Respiratory rate 28/min Temperature 36° C (96.8° F) Blood pressure 145/90 mm Hg Sa0, 90% on oxygen 2 L/min via nasal cannula 2345: Temperature 35.9° C (96.6° F) A Heart rate 135/min Respiratory rate 34/min Blood pressure 96/45 mm Hg Sa0, 92% on 40% face mask Diagnostic Results Hematocrit 26% (Male 42% to 52%) Hemoglobin 8.7 g/dL (Male 14 to 18 g/dL) WBC count 9,000/mm? (5,000 to 10,000/mm3) Platelet count 148,000/mm (150,000 to 400,000/mm3) Lactate (arterial) 5 mg/dL (3 to 7 mg/dL) Provider Prescriptions Transfuse 2 units of packed RBCs. Prepare the client for chest tube insertion. Initiate NPO status. Select the 3 findings that require follow-up by the nurse. Oxygen saturation is correct. The client has an oxygen saturation that is less than the expected reference level, indicating hypoxia. The nurse should plan to increase the client's supplemental oxygen. Pain level is correct. The nurse should follow up on the client's pain level. Wound drainage is correct. The nurse should apply a pressure dressing to control bleeding. Complete the following sentence by using the lists of options. The client is most likely experiencing a hemothorax as evidenced by the client's respiratory findings The nurse should first address the client's blood pressure followed by the client's oxygenation Oxygenation and blood pressure are correct. Using the airway, breathing, circulation priority framework, the nurse should first address the client's oxygenation, followed by the client's blood pressure. The client's oxygenation is below the expected reference range and is the priority. The nurse should then address the client's circulation because the client's blood pressure is below the expected reference range. For each potential provider's prescription, click to specify if the potential prescription is anticipated or contraindicated for the client. Transfuse packed RBs is anticipated. The client's increased heart rate and decreased blood pressure indicate decreased circulating blood volume due to trauma. Therefore, the nurse should anticipate transfusing packed RBCs. Place the client in Trendelenburg position is contraindicated. Due to clinical manifestations of hypovolemia, the nurse should position the client flat or place their head of bed no more than 30° to promote venous return to the heart. Prepare the client for chest tube insertion is anticipated. The client has manifestations of a hemothorax. Therefore, a chest tube is indicated. Cover the client with a cooling blanket is contraindicated. The client's temperature is below the expected reference range, which is a manifestation of hypothermia. Therefore, covering the client with a cooling blanket is contraindicated. Initiate NO status is anticipated. The client might require a surgical procedure. Therefore, the nurse should anticipate initiating NPO status. The nurse is caring for the client following the placement of a chest tube for a hemothorax. Which of the following actions should the nurse take? Place the client in high-Fowler's position is correct. The nurse should place the client in high-Fowler's position to promote drainage of the hemothorax. Ensure there is continuous bubbling in the wate