ATI RN
ATI RN Adult Medical Surgical Online Practice 2023 A
1. A client had an evacuation of a subdural hematoma. Which of the following actions should the nurse take first?
- A. Observe for cerebrospinal fluid (CSF) leaks from the evacuation site.
- B. Assess for an increase in temperature.
- C. Check the oximeter.
- D. Monitor for manifestations of increased intracranial pressure.
Correct answer: C
Rationale: When caring for a client who had an evacuation of a subdural hematoma, the nurse's priority is to check the oximeter. Monitoring oxygen saturation is crucial to ensure adequate tissue oxygenation, especially after such a procedure. This assessment helps in early detection of hypoxemia, which can be detrimental to the client's recovery. While observing for CSF leaks, assessing for temperature changes, and monitoring for signs of increased intracranial pressure are important, checking the oximeter takes precedence to address immediate oxygenation needs.
2. During an assessment, a client with a long history of smoking and suspected laryngeal cancer will most likely report which early manifestation?
- A. Dysphagia
- B. Hoarseness
- C. Dyspnea
- D. Weight loss
Correct answer: B
Rationale: In clients with laryngeal cancer, hoarseness is often one of the earliest manifestations due to vocal cord involvement. The irritation and inflammation caused by the tumor affect the vocal cords, leading to changes in voice quality. Dysphagia (choice A) typically occurs later as the tumor grows and interferes with swallowing. Dyspnea (choice C) and weight loss (choice D) may occur as the cancer progresses, but hoarseness is usually among the first signs to manifest in laryngeal cancer.
3. A client has a chest tube in place connected to wall suction due to a right-sided pneumothorax. The client complains of chest burning. Which of the following actions should be taken?
- A. Increase the wall suction.
- B. Strip the chest tube.
- C. Clamp the chest tube.
- D. Reposition the client.
Correct answer: D
Rationale: When a client with a chest tube connected to wall suction complains of chest burning, it may indicate that the tube is irritating or compressing nearby tissues. Repositioning the client can help relieve this irritation by ensuring the tube is not kinked or pulling on the tissues. Increasing suction, stripping the tube, or clamping it are not appropriate actions and could potentially worsen the situation or cause harm.
4. A client with chronic obstructive pulmonary disease (COPD) is receiving nutrition education. Which nutrition information should the nurse include in this client's teaching? (Select ONE that does not apply)
- A. Avoid drinking fluids just before and during meals.
- B. Rest before meals if you have dyspnea.
- C. Have about six small meals a day.
- D. Eat high-fiber foods to promote gastric emptying.
Correct answer: D
Rationale: The correct answer is D. Avoiding drinking fluids just before and during meals helps prevent bloating in clients with COPD. Resting before meals if experiencing dyspnea can aid in improving breathing during meals. Having approximately six small meals a day can reduce bloating and help with easier digestion. However, consuming high-fiber foods to promote gastric emptying is not advisable for clients with COPD, as fibrous foods can lead to gas production, abdominal bloating, and increased shortness of breath. Clients with COPD should focus on increasing calorie and protein intake to prevent malnourishment. Increasing carbohydrate intake should also be avoided, as it can raise carbon dioxide production and worsen dyspnea.
5. A client with Parkinson's disease is prescribed carbidopa-levodopa (Sinemet). What should the nurse include in the teaching about this medication?
- A. Take the medication without a high-protein meal.
- B. Expect the medication to take several weeks to reach full effectiveness.
- C. The medication may cause urine to turn light.
- D. You may experience a rapid heartbeat as a common side effect.
Correct answer: B
Rationale: Patients prescribed carbidopa-levodopa should be informed that it may take several weeks for the medication to reach its full therapeutic effectiveness in managing Parkinson's disease symptoms. This delayed onset of action is important for patients to be aware of to prevent premature discontinuation of the medication due to perceived lack of efficacy.
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