ATI RN Adult Medical Surgical Online Practice 2023
B 100% Verified Correct Solution A+ SCORED
A nurse is caring for a client in the emergency department (ED).Physical Examination Client
presents to the ED with upper abdominal pain that radiates to the right shoulder. Client rates
pain as 7 on a scale of 0 to 10. Client also reports nausea, vomiting, and dyspepsia. Client is awake,
alert, and oriented x3. Lung sounds clear bilaterally, S1 and S2 heart tones noted. All pulses
palpable. Bowel sounds active in all 4 quadrants.
Complete the diagram by dragging from the choices below to specify what condition the client is
most likely experiencing, 2 actions the nurse should take to address that condition, and 2
parameters the nurse should monitor to assess the client's progress. - ANSWER ✔ - The nurse
should plan to administer an opioid analgesic, such as morphine, for acute pain. Since the client
is experiencing nausea and vomiting, the nurse should also ensure they are NPO. The client is
likely experiencing cholecystitis, which typically presents with nausea, vomiting, and upper
abdominal pain that radiates to the right shoulder, fever, and dyspepsia. The client also has
elevated liver enzymes and a WBC count, which is consistent with cholecystitis. Surgical
management for cholecystitis might be indicated. The nurse should monitor the client's stool and
urine color because a biliary obstruction from gallstones may cause clay-colored stools and dark
urine.
A nurse is caring for a client who was just admitted from the emergency department (ED).
Nurses' Notes
0945:
Client is experiencing a sickle cell crisis. Client states that they began experiencing pain in the
lower extremities 3 days ago and is now experiencing pain in the chest, rating it as 4 on scale of
0 to 10.
Oxygen at 3 L/min via nasal cannula in place.
Oral mucosa pink, no cyanosis.
Pulses palpable in all four extremities, no peripheral edema noted.
Respirations even and slightly labored; lung sounds with slight wheezing in left upper lobe.
Abdomen soft and non-tender, bowel sounds active in all four quadrants.
0.45% sodium chloride IV at 200 mL/hr infusing to left hand with no reports of pain or swelling
at the site.
,Drag words from the choices below to fill in each blank in the following sentence. - ANSWER ✔ -
Fluid volume overload is incorrect. While the client is experiencing an increased respiratory rate
and shortness of breath, fluid volume overload typically includes moist crackles on auscultation,
pitting edema in dependent areas, neck vein distension, and hypertension.
Right-sided heart failure is incorrect. While clients who have sickle-cell disease are at risk for
developing heart failure, the client does not have manifestations of right-sided heart failure.
Right-sided heart failure typically presents with signs of fluid volume overload, which includes
jugular vein distention, dependent edema, and blood pressure alterations.
Acute chest syndrome is correct. The client is most likely experiencing acute chest syndrome,
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. The client is most likely experiencing pneumonia as evidenced by the
manifestations of cough, shortness of breath, fever, tachypnea, blood-tinged sputum, and chest
pain.
Pneumothorax is incorrect. While the client is experiencing increased respiratory distress, a
pneumothorax typically presents with reduced or absent breath sounds and unequal chest
expansion.
A nurse is caring for a client.
Nurses' Notes
1200:
Client was admitted to the unit with shortness of breath, a nonproductive cough, chest
discomfort, and myalgia. Prefers orthopneic position. Client reports that manifestations began
about 2 days ago.
For each assessment finding, click to specify if the finding is consistent with emphysema, asthma,
or pneumonia. Each finding may support more than 1 disease process. - ANSWER ✔ -
Temperature is consistent with pneumonia. Fever is a manifestation of pneumonia and is related
to inflammation or infection.
Breath sounds are consistent with emphysema, asthma, and pneumonia. The client's wheezing
is a manifestation of emphysema, asthma, and pneumonia. It is the result of narrowed airways
and alveoli.
ABG results are consistent with emphysema and pneumonia. The client's ABG results indicate
respiratory acidosis, which is a manifestation of emphysema and pneumonia.
Respiratory rate is consistent with emphysema, asthma, and pneumonia. The client's respiratory
rate is a manifestation of emphysema, asthma, and pneumonia.
Heart rate is consistent with emphysema and pneumonia. The client is experiencing tachycardia,
which is a manifestation of emphysema and pneumonia.
, Cough is consistent with emphysema, asthma, and pneumonia. The client's cough is a
manifestation of emphysema, asthma, and pneumonia.
A nurse is caring for a client who is scheduled for a right knee arthroplasty.
Nurses' Notes
0600:
Client is admitted for surgery this a.m. Vital signs recorded. Consents reviewed. Client reports
understanding of surgery and has no further questions for provider.
The nurse provided preoperative teaching to the client. Which of the following statements by the
client indicates an understanding of the teaching?
Select all that apply. - ANSWER ✔ - "Well, I guess there's no changing my mind about having
surgery now" is incorrect. The nurse and the client reviewed the consents; therefore, the nurse
has instructed the client that they have the right to refuse surgery at any time.
"I will need to do the breathing exercises every 1 to 2 hours after the surgery" is correct. The
client should cough and deep breathe and use the incentive spirometer every 1 to 2 hr to reduce
the risk of postoperative complications, such as pneumonia.
"I will be sure to ask for pain medication before my knee starts to hurt too badly" is correct. For
optimal control of postoperative pain, the client should request analgesic medication before the
pain becomes severe.
"My physical therapy will start after I leave the hospital" is incorrect. Early ambulation leads to
improved postoperative outcomes and reduces the risk of complications of immobility, such as
pneumonia and atelectasis. The client should be informed that physical therapy will begin the
day of, or the day following, surgery.
"I will probably be going home with a walker" is correct. It can take 6 weeks for complete recovery
from knee arthroplasty. Clients are often discharged with the use of a walker and will advance to
a cane or crutch 4 to 6 weeks following surgery.
A nurse is providing teaching to a client who has a severe form of stage II Lyme disease. Which of
the following statements made by the client reflects and understanding of the teaching? -
ANSWER ✔ - My joints ache because I have Lyme disease."
Lyme disease is a vector-borne illness transmitted by the deer tick. The disease course occurs in
three stages beginning with joint and muscle pain in stage I. If left untreated, these symptoms
continue throughout stage II and, by stage III, become chronic. Other chronic complications
include memory problems and fatigue.
B 100% Verified Correct Solution A+ SCORED
A nurse is caring for a client in the emergency department (ED).Physical Examination Client
presents to the ED with upper abdominal pain that radiates to the right shoulder. Client rates
pain as 7 on a scale of 0 to 10. Client also reports nausea, vomiting, and dyspepsia. Client is awake,
alert, and oriented x3. Lung sounds clear bilaterally, S1 and S2 heart tones noted. All pulses
palpable. Bowel sounds active in all 4 quadrants.
Complete the diagram by dragging from the choices below to specify what condition the client is
most likely experiencing, 2 actions the nurse should take to address that condition, and 2
parameters the nurse should monitor to assess the client's progress. - ANSWER ✔ - The nurse
should plan to administer an opioid analgesic, such as morphine, for acute pain. Since the client
is experiencing nausea and vomiting, the nurse should also ensure they are NPO. The client is
likely experiencing cholecystitis, which typically presents with nausea, vomiting, and upper
abdominal pain that radiates to the right shoulder, fever, and dyspepsia. The client also has
elevated liver enzymes and a WBC count, which is consistent with cholecystitis. Surgical
management for cholecystitis might be indicated. The nurse should monitor the client's stool and
urine color because a biliary obstruction from gallstones may cause clay-colored stools and dark
urine.
A nurse is caring for a client who was just admitted from the emergency department (ED).
Nurses' Notes
0945:
Client is experiencing a sickle cell crisis. Client states that they began experiencing pain in the
lower extremities 3 days ago and is now experiencing pain in the chest, rating it as 4 on scale of
0 to 10.
Oxygen at 3 L/min via nasal cannula in place.
Oral mucosa pink, no cyanosis.
Pulses palpable in all four extremities, no peripheral edema noted.
Respirations even and slightly labored; lung sounds with slight wheezing in left upper lobe.
Abdomen soft and non-tender, bowel sounds active in all four quadrants.
0.45% sodium chloride IV at 200 mL/hr infusing to left hand with no reports of pain or swelling
at the site.
,Drag words from the choices below to fill in each blank in the following sentence. - ANSWER ✔ -
Fluid volume overload is incorrect. While the client is experiencing an increased respiratory rate
and shortness of breath, fluid volume overload typically includes moist crackles on auscultation,
pitting edema in dependent areas, neck vein distension, and hypertension.
Right-sided heart failure is incorrect. While clients who have sickle-cell disease are at risk for
developing heart failure, the client does not have manifestations of right-sided heart failure.
Right-sided heart failure typically presents with signs of fluid volume overload, which includes
jugular vein distention, dependent edema, and blood pressure alterations.
Acute chest syndrome is correct. The client is most likely experiencing acute chest syndrome,
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. The client is most likely experiencing pneumonia as evidenced by the
manifestations of cough, shortness of breath, fever, tachypnea, blood-tinged sputum, and chest
pain.
Pneumothorax is incorrect. While the client is experiencing increased respiratory distress, a
pneumothorax typically presents with reduced or absent breath sounds and unequal chest
expansion.
A nurse is caring for a client.
Nurses' Notes
1200:
Client was admitted to the unit with shortness of breath, a nonproductive cough, chest
discomfort, and myalgia. Prefers orthopneic position. Client reports that manifestations began
about 2 days ago.
For each assessment finding, click to specify if the finding is consistent with emphysema, asthma,
or pneumonia. Each finding may support more than 1 disease process. - ANSWER ✔ -
Temperature is consistent with pneumonia. Fever is a manifestation of pneumonia and is related
to inflammation or infection.
Breath sounds are consistent with emphysema, asthma, and pneumonia. The client's wheezing
is a manifestation of emphysema, asthma, and pneumonia. It is the result of narrowed airways
and alveoli.
ABG results are consistent with emphysema and pneumonia. The client's ABG results indicate
respiratory acidosis, which is a manifestation of emphysema and pneumonia.
Respiratory rate is consistent with emphysema, asthma, and pneumonia. The client's respiratory
rate is a manifestation of emphysema, asthma, and pneumonia.
Heart rate is consistent with emphysema and pneumonia. The client is experiencing tachycardia,
which is a manifestation of emphysema and pneumonia.
, Cough is consistent with emphysema, asthma, and pneumonia. The client's cough is a
manifestation of emphysema, asthma, and pneumonia.
A nurse is caring for a client who is scheduled for a right knee arthroplasty.
Nurses' Notes
0600:
Client is admitted for surgery this a.m. Vital signs recorded. Consents reviewed. Client reports
understanding of surgery and has no further questions for provider.
The nurse provided preoperative teaching to the client. Which of the following statements by the
client indicates an understanding of the teaching?
Select all that apply. - ANSWER ✔ - "Well, I guess there's no changing my mind about having
surgery now" is incorrect. The nurse and the client reviewed the consents; therefore, the nurse
has instructed the client that they have the right to refuse surgery at any time.
"I will need to do the breathing exercises every 1 to 2 hours after the surgery" is correct. The
client should cough and deep breathe and use the incentive spirometer every 1 to 2 hr to reduce
the risk of postoperative complications, such as pneumonia.
"I will be sure to ask for pain medication before my knee starts to hurt too badly" is correct. For
optimal control of postoperative pain, the client should request analgesic medication before the
pain becomes severe.
"My physical therapy will start after I leave the hospital" is incorrect. Early ambulation leads to
improved postoperative outcomes and reduces the risk of complications of immobility, such as
pneumonia and atelectasis. The client should be informed that physical therapy will begin the
day of, or the day following, surgery.
"I will probably be going home with a walker" is correct. It can take 6 weeks for complete recovery
from knee arthroplasty. Clients are often discharged with the use of a walker and will advance to
a cane or crutch 4 to 6 weeks following surgery.
A nurse is providing teaching to a client who has a severe form of stage II Lyme disease. Which of
the following statements made by the client reflects and understanding of the teaching? -
ANSWER ✔ - My joints ache because I have Lyme disease."
Lyme disease is a vector-borne illness transmitted by the deer tick. The disease course occurs in
three stages beginning with joint and muscle pain in stage I. If left untreated, these symptoms
continue throughout stage II and, by stage III, become chronic. Other chronic complications
include memory problems and fatigue.
