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ATI NURSING EDUCATION MEDICAL SURGICAL
(NGN) TEST BANK WITH RATIONALES A+
1. A nurse is reviewing the cause of gout with a group of nurses. Which of the following
statements should the nurse make?
A. "Uric acid levels drop and calcium forms precipitate."
Rationale: With gout, clients have hyperuricemia, rather than a reduction in uric acid.
B. "Tophi form in the kidneys and they impair the excretion of uric acid."
Rationale: Tophi, or deposits in tissues near a joint, develop in chronic, late-stage gout. They are
not part of the primary disease process.
C. "The intra-articular deposition of urate crystals causes inflammation."
Rationale: Gout, or gouty arthritis, develops when urate crystals deposit in joints and
tissues and cause inflammation and pain.
D. "Articular cartilage thins, leading to splitting and fragmentation."
Rationale: Gout does not thin and fragment cartilage.
2. A nurse is teaching a group of clients about osteoarthritis. Which of the following
recommendations should the nurse include in the teaching?
A. Use Echinacea to manage joint pain.
Rationale: The nurse may include the use of complementary and alternative therapies in the
teaching.
However, Echinacea is used for the treatment of the common cold, not osteoarthritis. Alternative
therapies that are used for osteoarthritis include glucosamine, chondroitin, and topical capsaicin.
B. Apply ice to the joint before exercising.
Rationale: The nurse should recommend that the clients begin exercising immediately following
the application of heat. This reduces pain and improves mobility, allowing for increased range-
A+ Page 1
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of-motion during exercises. Cold application may be applied following exercise to decrease
discomfort and inflammation.
C. Maintain a recommended body weight.
Rationale: Obesity is a risk factor for the development of osteoarthritis. Maintenance of an
ideal weight is one way a client can prevent added wear and tear on joints and promote
overall joint health.
D. Reduce the amount of purine in the diet.
Rationale: The nurse should recognize that limiting purine in the diet, which is often found in
organ meats, is recommended for clients who have gout.
3. A nurse is caring for a client who has had a myocardial infarction. Upon his first visit to
cardiac rehabilitation, he tells the nurse that he doesn't understand why he needs to be there
because there is nothing more to do, as the damage is done. Which of the following is the correct
nursing response?
A. "Cardiac rehabilitation cannot undo the damage to your heart but it can help you
get back to your previous level of activity safely."
Rationale: With this response, the nurse uses the therapeutic communication technique of
presenting reality by indicating her perception of the situation for the client.
B. "It’s not unusual to feel that way at first, but once you learn the routine, you’ll enjoy it."
Rationale: With this response, the nurse illustrates the nontherapeutic communication technique
of giving reassurance, thus discouraging the client from further communication.
C. "Exercise is good for you and good for your heart."
Rationale: With this response, the nurse illustrates the nontherapeutic communication techniques
of disagreeing and giving advice.
D. "Your doctor is the expert here, and I’m sure he would only recommend what is best for
you."
Rationale: With this response, the nurse illustrates the nontherapeutic communication technique
of defending.
A+ Page 2
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4. A nurse is caring for a client who has heart failure and a potassium level of 2.4 mEq/L.
The nurse should identify which of the following medications as the cause of the client’s low
potassium level?
A. Furosemide
Rationale: Furosemide is a loop (high-ceiling) diuretic that inhibits the reabsorption of
sodium and chloride and results in diuresis, which decreases potassium through excretion
in the distal nephrons.
Hypokalemia is an adverse effect of furosemide.
B. Nitroglycerin
Rationale: A potassium level of 2.4 mEq/L is not an adverse effect of nitroglycerin.
Nitroglycerin is a vasodilator medication to treat angina.
C. Metoprolol
Rationale: A potassium level of 2.4 mEq/L is not an adverse effect of metoprolol. Metoprolol is a
beta-blocker that slows the heart rate and improves contractility of the heart muscle.
D. Spironolactone
Rationale: Spironolactone is a potassium-sparing diuretic medication; therefore, hyperkalemia is
an adverse effect of this medication.
5. A nurse is caring for a client who is postoperative following an open reduction internal
fixation (ORIF) of a femur fracture. Which of the following parameters should the nurse include
in the evaluation of the neurovascular status of the client's affected extremity? (Select all that
apply.)
A. Color
B. Temperature
C. Ecchymosis
D. Skin integrity
E. Sensation
A+ Page 3
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Rationale: Color is correct. Clients who have sustained trauma to an extremity, such as a
fracture, are at increased risk for neurovascular compromise. The nurse should check the
color of the client's affected extremity as part of this assessment. The nurse should identify
pallor or cyanosis of the extremity as an indication of peripheral neurovascular dysfunction
and should notify the provider.Temperature is correct. Clients who have sustained trauma
to an extremity, such as a fracture, are at increased risk for neurovascular compromise.
The nurse should monitor the temperature of the extremity as a part of this assessment and
identify skin that is cool or cold to the touch as having decreased perfusion to the tissues of
the extremity, which is an indication of peripheral neurovascular dysfunction. The nurse
should report skin that is cool to the touch to the provider.Ecchymosis is incorrect.
Ecchymosis, or bruising, is an expected finding with leg injuries and is not a component of
a neurovascular check.Skin integrity is incorrect. While the nurse should assess the incision
of a client who is postoperative following an open reduction and internal fixation of the
femur, it is not a component of a neurovascular check.Sensation is correct. Clients who
have sustained trauma to an extremity, such as a fracture, are at increased risk for
neurovascular compromise. The nurse should assess the client's extremity for numbness or
tingling. The nurse should recognize diminished pain or paresthesia as an indication of
damage to the nerves or peripheral neurovascular dysfunction and should report it to the
provider.
6. A nurse is monitoring a client following a thoracentesis. The nurse should identify which
of the following manifestations as a complication and contact the provider immediately?
A. Serosanguineous drainage from the puncture site
Rationale: A small amount of serosanguineous drainage at the puncture site is expected after a
thoracentesis.
B. Discomfort at the puncture site
Rationale: Mild discomfort at the puncture site is expected after a thoracentesis.
C. Increased heart rate
A+ Page 4
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ATI NURSING EDUCATION MEDICAL SURGICAL
(NGN) TEST BANK WITH RATIONALES A+
1. A nurse is reviewing the cause of gout with a group of nurses. Which of the following
statements should the nurse make?
A. "Uric acid levels drop and calcium forms precipitate."
Rationale: With gout, clients have hyperuricemia, rather than a reduction in uric acid.
B. "Tophi form in the kidneys and they impair the excretion of uric acid."
Rationale: Tophi, or deposits in tissues near a joint, develop in chronic, late-stage gout. They are
not part of the primary disease process.
C. "The intra-articular deposition of urate crystals causes inflammation."
Rationale: Gout, or gouty arthritis, develops when urate crystals deposit in joints and
tissues and cause inflammation and pain.
D. "Articular cartilage thins, leading to splitting and fragmentation."
Rationale: Gout does not thin and fragment cartilage.
2. A nurse is teaching a group of clients about osteoarthritis. Which of the following
recommendations should the nurse include in the teaching?
A. Use Echinacea to manage joint pain.
Rationale: The nurse may include the use of complementary and alternative therapies in the
teaching.
However, Echinacea is used for the treatment of the common cold, not osteoarthritis. Alternative
therapies that are used for osteoarthritis include glucosamine, chondroitin, and topical capsaicin.
B. Apply ice to the joint before exercising.
Rationale: The nurse should recommend that the clients begin exercising immediately following
the application of heat. This reduces pain and improves mobility, allowing for increased range-
A+ Page 1
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of-motion during exercises. Cold application may be applied following exercise to decrease
discomfort and inflammation.
C. Maintain a recommended body weight.
Rationale: Obesity is a risk factor for the development of osteoarthritis. Maintenance of an
ideal weight is one way a client can prevent added wear and tear on joints and promote
overall joint health.
D. Reduce the amount of purine in the diet.
Rationale: The nurse should recognize that limiting purine in the diet, which is often found in
organ meats, is recommended for clients who have gout.
3. A nurse is caring for a client who has had a myocardial infarction. Upon his first visit to
cardiac rehabilitation, he tells the nurse that he doesn't understand why he needs to be there
because there is nothing more to do, as the damage is done. Which of the following is the correct
nursing response?
A. "Cardiac rehabilitation cannot undo the damage to your heart but it can help you
get back to your previous level of activity safely."
Rationale: With this response, the nurse uses the therapeutic communication technique of
presenting reality by indicating her perception of the situation for the client.
B. "It’s not unusual to feel that way at first, but once you learn the routine, you’ll enjoy it."
Rationale: With this response, the nurse illustrates the nontherapeutic communication technique
of giving reassurance, thus discouraging the client from further communication.
C. "Exercise is good for you and good for your heart."
Rationale: With this response, the nurse illustrates the nontherapeutic communication techniques
of disagreeing and giving advice.
D. "Your doctor is the expert here, and I’m sure he would only recommend what is best for
you."
Rationale: With this response, the nurse illustrates the nontherapeutic communication technique
of defending.
A+ Page 2
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4. A nurse is caring for a client who has heart failure and a potassium level of 2.4 mEq/L.
The nurse should identify which of the following medications as the cause of the client’s low
potassium level?
A. Furosemide
Rationale: Furosemide is a loop (high-ceiling) diuretic that inhibits the reabsorption of
sodium and chloride and results in diuresis, which decreases potassium through excretion
in the distal nephrons.
Hypokalemia is an adverse effect of furosemide.
B. Nitroglycerin
Rationale: A potassium level of 2.4 mEq/L is not an adverse effect of nitroglycerin.
Nitroglycerin is a vasodilator medication to treat angina.
C. Metoprolol
Rationale: A potassium level of 2.4 mEq/L is not an adverse effect of metoprolol. Metoprolol is a
beta-blocker that slows the heart rate and improves contractility of the heart muscle.
D. Spironolactone
Rationale: Spironolactone is a potassium-sparing diuretic medication; therefore, hyperkalemia is
an adverse effect of this medication.
5. A nurse is caring for a client who is postoperative following an open reduction internal
fixation (ORIF) of a femur fracture. Which of the following parameters should the nurse include
in the evaluation of the neurovascular status of the client's affected extremity? (Select all that
apply.)
A. Color
B. Temperature
C. Ecchymosis
D. Skin integrity
E. Sensation
A+ Page 3
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Rationale: Color is correct. Clients who have sustained trauma to an extremity, such as a
fracture, are at increased risk for neurovascular compromise. The nurse should check the
color of the client's affected extremity as part of this assessment. The nurse should identify
pallor or cyanosis of the extremity as an indication of peripheral neurovascular dysfunction
and should notify the provider.Temperature is correct. Clients who have sustained trauma
to an extremity, such as a fracture, are at increased risk for neurovascular compromise.
The nurse should monitor the temperature of the extremity as a part of this assessment and
identify skin that is cool or cold to the touch as having decreased perfusion to the tissues of
the extremity, which is an indication of peripheral neurovascular dysfunction. The nurse
should report skin that is cool to the touch to the provider.Ecchymosis is incorrect.
Ecchymosis, or bruising, is an expected finding with leg injuries and is not a component of
a neurovascular check.Skin integrity is incorrect. While the nurse should assess the incision
of a client who is postoperative following an open reduction and internal fixation of the
femur, it is not a component of a neurovascular check.Sensation is correct. Clients who
have sustained trauma to an extremity, such as a fracture, are at increased risk for
neurovascular compromise. The nurse should assess the client's extremity for numbness or
tingling. The nurse should recognize diminished pain or paresthesia as an indication of
damage to the nerves or peripheral neurovascular dysfunction and should report it to the
provider.
6. A nurse is monitoring a client following a thoracentesis. The nurse should identify which
of the following manifestations as a complication and contact the provider immediately?
A. Serosanguineous drainage from the puncture site
Rationale: A small amount of serosanguineous drainage at the puncture site is expected after a
thoracentesis.
B. Discomfort at the puncture site
Rationale: Mild discomfort at the puncture site is expected after a thoracentesis.
C. Increased heart rate
A+ Page 4
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