ATI PN ADULT MEDICAL SURGICAL 2023
1. A nurse is reinforcing teaching with a client about breast self-examinations.
Which of the following statements by the client indicates an understanding of the
teaching?
A. "I will perform breast exams the day my period begins."
B. "I will perform breast exams every other month."
C. "It is common for the skin on my breasts to dimple."
D. "It is common for one breast to be larger than the other."
The correct answer is choice D
Explanation
Choice A Reason:
"I will perform breast exams the day my period begins." This statement is incorrect because
performing breast exams just before or during your period might not be ideal. Breasts can be
more tender or swollen during this time, which could make it harder to detect any
abnormalities.
Choice B Reason:
"I will perform breast exams every other month." This statement is incorrect. Regular breast
self-exams are important, but doing them every other month might not be frequent enough.
It's generally recommended to perform breast self-exams once a month, ideally around the
same time each month, to detect any changes or abnormalities early.
Choice C Reason:
"It is common for the skin on my breasts to dimple." This statement is incorrect. Dimpling or
puckering of the skin on the breasts can sometimes be a sign of an underlying issue, such as
breast cancer. It's not considered a normal or common occurrence, so this statement doesn't
indicate an understanding of what to look for during a breast self-exam. If a person notices
skin changes like dimpling, it's recommended to seek medical advice.
Choice D Reason:
"It is common for one breast to be larger than the other." This statement reflects an
understanding that breast asymmetry, where one breast is slightly larger than the other, is a
common and normal occurrence.
2.A nurse is caring for a client who has a prescription for propranolol for the treatment
of atrial fibrillation. Which of the following actions should the nurse take?
A. Request a dosage increase if the apical heart rate is less than 60/min.
B. Withhold the medication if the systolic blood pressure is less than 90 mm Hg.
C. Administer the medication with an antacid.
D. Instruct the client to expect increased hair growth.
The correct answer is choice B
,Explanation
Choice A Reason:
Requesting a dosage increase if the apical heart rate is less than 60/min is not necessary.
Propranolol is used to lower heart rate in conditions like atrial fibrillation, so a heart rate
below 60/min might be the desired effect of the medication.
Choice B Reason:
Withholding the medication if the systolic blood pressure is less than 90 mm Hg is
necessary. Propranolol is a beta-blocker that can lower blood pressure. If the systolic blood
pressure drops below 90 mm Hg, withholding the medication is necessary to prevent further
lowering of blood pressure, which could lead to adverse effects like dizziness, fainting, or
inadequate blood perfusion to vital organs.
Choice C Reason:
Administering the medication with an antacid might interfere with the absorption of
propranolol, so they shouldn't be taken together unless instructed by the healthcare provider.
Choice D Reason:
Expecting increased hair growth is not an anticipated effect of propranolol. Hair growth is not
a usual side effect associated with this medication.
3 . A nurse is assisting with the plan of care for an older adult client who has a new
prescription for transdermal clonidine. Which of the following information should the
nurse include in the plan of care?
A. Inform the client of the adverse effect of diarrhea.
B. Monitor the client for weight loss.
C. Advise the client about increased dry mouth.
D. Check the client for increased hypopigmentation under the patch.
The correct answer is choice C
Explanation
Choice A Reason:
, Informing the client of the adverse effect of diarrhea is less common with clonidine use,
especially in comparison to other side effects like dry mouth or skin irritation.
Choice B Reason:
Monitoring for weight loss isn't a primary concern specifically associated with transdermal
clonidine use.
Choice C Reason:
Advising the client about increased dry mouth is appropriate. Dry mouth is a common side
effect of clonidine, especially when it's administered transdermally (via a patch). Informing
the client about this potential side effect helps them anticipate and manage it. Other side
effects might include skin irritation or redness at the patch application site, but increased
hypopigmentation under the patch is not a recognized or typical side effect of transdermal
clonidine.
Choice D Reason:
Checking for increased hypopigmentation under the patch is not a recognized effect of
transdermal clonidine.
4. A nurse is reviewing the laboratory data of a client who is scheduled for a liver
biopsy. Which of the following values should the nurse report to the provider?
A. Bilirubin 1.0 mg/dL (0.3 to 1.0 mg/dL)
B. Aspartate aminotransferase 34 units/L (0 to 34 units/L)
C. Ammonia 55 mcg/dl. (10 to 80 mcg/dL)
D. Platelets 60,000/mm3 (150,000 to 400,000/mm3)
The correct answer is choice D
Explanation
Choice A Reason:
Bilirubin 1.0 mg/dL (0.3 to 1.0 mg/dL) is incorrect. Bilirubin levels within the normal range
typically indicate normal liver function. The value of 1.0 mg/dL falls within the expected
range, so it doesn't raise immediate concerns regarding the need for a liver biopsy.
, Choice B Reason:
Aspartate aminotransferase 34 units/L (0 to 34 units/L) is incorrect. Aspartate
aminotransferase (AST) is an enzyme found in various tissues, including the liver, heart,
muscles, and red blood cells. While a value of 34 units/L is at the upper limit of the normal
range, it's still within the expected range and doesn't typically prompt immediate concern for
the need for a biopsy.
Choice C Reason:
Ammonia 55 mcg/dL (10 to 80 mcg/dL ) is incorrect. Ammonia levels can rise in cases of
liver dysfunction. The level of 55 mcg/dL falls within the reference range, indicating normal
or near-normal ammonia levels, which doesn't usually necessitate an urgent liver biopsy.
Choice D Reason:
Platelets 60,000/mm3 (150,000 to 400,000/mm3) is correct. Platelets are crucial for blood
clotting. A significantly low platelet count, such as 60,000/mm3, termed thrombocytopenia,
can indicate compromised clotting ability, which might pose a risk of bleeding during or after
a liver biopsy. In the context of a liver biopsy, a low platelet count warrants attention and
consideration before proceeding with the procedure to prevent excessive bleeding or
complications.
5 .A nurse is caring for a client who is postoperative following a right radical
mastectomy. Which of the following actions should the nurse take to prevent the
development of lymphedema?
A. Keep both arms below the level of the client's heart.
B. Limit range-of-motion exercises with the affected arm.
C. Use the client's left arm to obtain blood samples.
D. Obtain blood pressure readings using the client's right arm.
The correct answer is choice C
Explanation
Choice A Reason:
Keeping both arms below the level of the client's heart doesn't specifically address the
prevention of lymphedema and might not be necessary for this purpose.
Choice B Reason:
1. A nurse is reinforcing teaching with a client about breast self-examinations.
Which of the following statements by the client indicates an understanding of the
teaching?
A. "I will perform breast exams the day my period begins."
B. "I will perform breast exams every other month."
C. "It is common for the skin on my breasts to dimple."
D. "It is common for one breast to be larger than the other."
The correct answer is choice D
Explanation
Choice A Reason:
"I will perform breast exams the day my period begins." This statement is incorrect because
performing breast exams just before or during your period might not be ideal. Breasts can be
more tender or swollen during this time, which could make it harder to detect any
abnormalities.
Choice B Reason:
"I will perform breast exams every other month." This statement is incorrect. Regular breast
self-exams are important, but doing them every other month might not be frequent enough.
It's generally recommended to perform breast self-exams once a month, ideally around the
same time each month, to detect any changes or abnormalities early.
Choice C Reason:
"It is common for the skin on my breasts to dimple." This statement is incorrect. Dimpling or
puckering of the skin on the breasts can sometimes be a sign of an underlying issue, such as
breast cancer. It's not considered a normal or common occurrence, so this statement doesn't
indicate an understanding of what to look for during a breast self-exam. If a person notices
skin changes like dimpling, it's recommended to seek medical advice.
Choice D Reason:
"It is common for one breast to be larger than the other." This statement reflects an
understanding that breast asymmetry, where one breast is slightly larger than the other, is a
common and normal occurrence.
2.A nurse is caring for a client who has a prescription for propranolol for the treatment
of atrial fibrillation. Which of the following actions should the nurse take?
A. Request a dosage increase if the apical heart rate is less than 60/min.
B. Withhold the medication if the systolic blood pressure is less than 90 mm Hg.
C. Administer the medication with an antacid.
D. Instruct the client to expect increased hair growth.
The correct answer is choice B
,Explanation
Choice A Reason:
Requesting a dosage increase if the apical heart rate is less than 60/min is not necessary.
Propranolol is used to lower heart rate in conditions like atrial fibrillation, so a heart rate
below 60/min might be the desired effect of the medication.
Choice B Reason:
Withholding the medication if the systolic blood pressure is less than 90 mm Hg is
necessary. Propranolol is a beta-blocker that can lower blood pressure. If the systolic blood
pressure drops below 90 mm Hg, withholding the medication is necessary to prevent further
lowering of blood pressure, which could lead to adverse effects like dizziness, fainting, or
inadequate blood perfusion to vital organs.
Choice C Reason:
Administering the medication with an antacid might interfere with the absorption of
propranolol, so they shouldn't be taken together unless instructed by the healthcare provider.
Choice D Reason:
Expecting increased hair growth is not an anticipated effect of propranolol. Hair growth is not
a usual side effect associated with this medication.
3 . A nurse is assisting with the plan of care for an older adult client who has a new
prescription for transdermal clonidine. Which of the following information should the
nurse include in the plan of care?
A. Inform the client of the adverse effect of diarrhea.
B. Monitor the client for weight loss.
C. Advise the client about increased dry mouth.
D. Check the client for increased hypopigmentation under the patch.
The correct answer is choice C
Explanation
Choice A Reason:
, Informing the client of the adverse effect of diarrhea is less common with clonidine use,
especially in comparison to other side effects like dry mouth or skin irritation.
Choice B Reason:
Monitoring for weight loss isn't a primary concern specifically associated with transdermal
clonidine use.
Choice C Reason:
Advising the client about increased dry mouth is appropriate. Dry mouth is a common side
effect of clonidine, especially when it's administered transdermally (via a patch). Informing
the client about this potential side effect helps them anticipate and manage it. Other side
effects might include skin irritation or redness at the patch application site, but increased
hypopigmentation under the patch is not a recognized or typical side effect of transdermal
clonidine.
Choice D Reason:
Checking for increased hypopigmentation under the patch is not a recognized effect of
transdermal clonidine.
4. A nurse is reviewing the laboratory data of a client who is scheduled for a liver
biopsy. Which of the following values should the nurse report to the provider?
A. Bilirubin 1.0 mg/dL (0.3 to 1.0 mg/dL)
B. Aspartate aminotransferase 34 units/L (0 to 34 units/L)
C. Ammonia 55 mcg/dl. (10 to 80 mcg/dL)
D. Platelets 60,000/mm3 (150,000 to 400,000/mm3)
The correct answer is choice D
Explanation
Choice A Reason:
Bilirubin 1.0 mg/dL (0.3 to 1.0 mg/dL) is incorrect. Bilirubin levels within the normal range
typically indicate normal liver function. The value of 1.0 mg/dL falls within the expected
range, so it doesn't raise immediate concerns regarding the need for a liver biopsy.
, Choice B Reason:
Aspartate aminotransferase 34 units/L (0 to 34 units/L) is incorrect. Aspartate
aminotransferase (AST) is an enzyme found in various tissues, including the liver, heart,
muscles, and red blood cells. While a value of 34 units/L is at the upper limit of the normal
range, it's still within the expected range and doesn't typically prompt immediate concern for
the need for a biopsy.
Choice C Reason:
Ammonia 55 mcg/dL (10 to 80 mcg/dL ) is incorrect. Ammonia levels can rise in cases of
liver dysfunction. The level of 55 mcg/dL falls within the reference range, indicating normal
or near-normal ammonia levels, which doesn't usually necessitate an urgent liver biopsy.
Choice D Reason:
Platelets 60,000/mm3 (150,000 to 400,000/mm3) is correct. Platelets are crucial for blood
clotting. A significantly low platelet count, such as 60,000/mm3, termed thrombocytopenia,
can indicate compromised clotting ability, which might pose a risk of bleeding during or after
a liver biopsy. In the context of a liver biopsy, a low platelet count warrants attention and
consideration before proceeding with the procedure to prevent excessive bleeding or
complications.
5 .A nurse is caring for a client who is postoperative following a right radical
mastectomy. Which of the following actions should the nurse take to prevent the
development of lymphedema?
A. Keep both arms below the level of the client's heart.
B. Limit range-of-motion exercises with the affected arm.
C. Use the client's left arm to obtain blood samples.
D. Obtain blood pressure readings using the client's right arm.
The correct answer is choice C
Explanation
Choice A Reason:
Keeping both arms below the level of the client's heart doesn't specifically address the
prevention of lymphedema and might not be necessary for this purpose.
Choice B Reason:
