ATI PN Medical Surgical
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A nurse is reinforcing teaching about the use of an insulin pen with a client who has type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?
- A. "I will shake the pen before injecting the insulin."
- B. "I will apply a disposable needle on the cartridge."
- C. "I will hold the pen upside-down to select the appropriate dose."
- D. "I will aspirate before injecting the insulin."
Explanation
Explanation
Insulin pens require the client to attach a new disposable needle before each injection to maintain sterility and ensure proper insulin delivery. This is a correct and essential step in insulin pen use. Insulin pens should not be shaken, as this can damage the insulin formulation. They do not need to be held upside-down to dial the dose, and aspiration is not recommended when administering insulin subcutaneously.Correct Answer Is:
B. "I will apply a disposable needle on the cartridge."A nurse is reinforcing teaching with a client about heart disease prevention. Which of the following client statements indicates an understanding of the teaching?
- a) "I will increase my dairy intake by drinking whole milk every meal."
- b) "I will exercise by walking twice a week for 25 minutes."
- c) "I will try to maintain my blood pressure around 116/72."
- d) "I will improve my LDL cholesterol by raising it from 100 to 130."
Explanation
Explanation
A blood pressure of 116/72 mm Hg is within the recommended healthy range and reflects effective control of a major modifiable risk factor for heart disease. Keeping blood pressure at this level helps reduce strain on the cardiovascular system and lowers the risk of stroke, heart attack, and heart failure. This statement demonstrates accurate understanding of prevention through optimal blood pressure management.Correct Answer Is:
c) "I will try to maintain my blood pressure around 116/72."A nurse is caring for a client who is in skeletal traction. Which of the following actions should the nurse take?
- A. Unscrew the pins to cleanse the pin sites.
- B. Remove the weights while turning the client in bed.
- C. Loosen the rope knots holding the weights for 30 min if the client reports pain.
- D. Ensure that there is at least 4.5 kg (10 lb) of weight applied to the client's traction.
Explanation
Skeletal traction uses pins inserted into the bone to provide continuous, precise pulling force. For traction to be effective, a minimum amount of weight—generally 4.5 to 9 kg (10–20 lb)—must be applied to maintain proper alignment and reduce muscle spasms. Ensuring that at least 10 lb of weight is in place is essential to keep the traction system functioning correctly. The weights must never be removed or loosened unless prescribed, as this can cause misalignment, increased pain, or injury. Pin sites must be cleaned without manipulating or unscrewing the pins to prevent infection or destabilization.
Correct Answer Is:
D. Ensure that there is at least 4.5 kg (10 lb) of weight applied to the client's traction.
A nurse is reinforcing teaching with a client who has gastroesophageal reflux disease. Which of the following dietary instructions should the nurse include?
- a) Chew food thoroughly.
- b) Use a straw when drinking liquids.
- c) Drink carbonated beverages with meals.
- d) Limit meals to three per day with no snacking in between.
Explanation
Explanation
Chewing food thoroughly helps reduce the workload on the stomach and decreases the risk of reflux by promoting easier, more efficient digestion. Well-chewed food is less likely to contribute to gastric distention, which can worsen GERD symptoms. Additionally, taking time to chew slows down eating, which helps prevent overeating—another trigger for reflux. The other options worsen GERD by increasing swallowed air, gastric pressure, or by encouraging large meals rather than smaller, more frequent ones.Correct Answer Is:
a) Chew food thoroughly.A nurse is caring for a client who is visually impaired. When delivering the client's meal tray, which of the following actions should the nurse take?
- a) Provide the client with a small-handled adaptive utensil.
- b) Arrange for an assistive personnel to feed the client.
- c) Describe the food placement as though the plate were a clock.
- d) Discourage conversations during the client's mealtime.
Explanation
Explanation
Using the "clock method" allows visually impaired clients to locate food on their plate independently and safely. By describing food positions in relation to numbers on a clock (such as "your chicken is at 6 o’clock"), the nurse supports autonomy and dignity during meals. Adaptive utensils may help but are not the priority, and feeding assistance is unnecessary unless the client requests it. Conversation does not hinder eating and can provide comfort.Correct Answer Is:
c) Describe the food placement as though the plate were a clock.A nurse is caring for a client who is in skin traction. Which of the following actions should the nurse take?
- a) Loosen the ropes of the pulleys when repositioning the client in bed.
- b) Inspect the client's skin every 12 hr for signs of breakdown.
- c) Ensure the weights hang freely from the client's bed.
- d) Maintain 6.8 kg (15 lb) of weight for the client's skin traction.
Explanation
Explanation
c) Ensure the weights hang freely from the client's bed.For skin traction to be effective, the weights must hang freely at all times without resting on the floor or bed. This constant, unobstructed pull maintains proper alignment of the affected extremity and reduces muscle spasms. If the weights do not hang freely, traction is interrupted, which can lead to pain, ineffective treatment, or injury. The nurse’s priority is to ensure proper setup and functioning of the traction system.
Correct Answer Is:
c) Ensure the weights hang freely from the client's bed.An occupational health nurse is interpreting the results of a tuberculin skin test for a group of clients who received the test 48 hrs ago. Which of the following clients should the nurse identify as having a positive test result?
- a) A client whose injection site has an elevated area measuring 15 mm (0.6 in)
- b) A client whose injection site is scabbed
- c) A client whose injection site is firm and measures 3 mm (0.1 in)
- d) A client whose injection site is ecchymotic
Explanation
Explanation
a) A client whose injection site has an elevated area measuring 15 mm (0.6 in)A tuberculin skin test is interpreted by measuring the area of induration, not redness, bruising, or scabbing. An induration of 15 mm or greater is considered positive for any client, regardless of risk factors. A positive result indicates exposure to Mycobacterium tuberculosis and requires follow-up testing, such as a chest x-ray. Scabbing and ecchymosis do not represent induration, and an induration of 3 mm is considered negative.
Correct Answer Is:
a) A client whose injection site has an elevated area measuring 15 mm (0.6 in)A nurse is reinforcing teaching with a client who is starting to take metformin extended release. Which of the following instructions should the nurse include in the teaching?
- a) Monitor blood glucose while taking this medication.
- b) Chew the medication before swallowing.
- c) Expect muscle pain while taking this medication.
- d) Take the medication with breakfast.
Explanation
Explanation
Clients taking metformin, including the extended-release form, should regularly monitor their blood glucose levels to evaluate the medication’s effectiveness and detect hypo- or hyperglycemia early. Although metformin does not usually cause hypoglycemia on its own, monitoring allows the client and provider to determine whether glucose levels are improving and whether dosage adjustments are needed. Ongoing monitoring also helps identify patterns related to diet, activity, and illness that may affect glucose control.Correct Answer Is:
a) Monitor blood glucose while taking this medication.A nurse is obtaining a medication history from a client who is to start taking nitroglycerin for chest discomfort with activity. Which of the following medications should the nurse instruct the client to avoid taking within 24 hrs of using nitroglycerin?
- a) Atorvastatin
- b) Metformin
- c) Sildenafil
- d) Omeprazole
Explanation
Explanation
Nitroglycerin causes vasodilation to relieve chest pain, and sildenafil is also a potent vasodilator used for erectile dysfunction. When taken together, these medications can produce a severe and potentially life-threatening drop in blood pressure. This profound hypotension can lead to dizziness, syncope, shock, or even cardiac arrest. Clients must avoid sildenafil and other phosphodiesterase type 5 inhibitors within 24 hours of nitroglycerin use to prevent dangerous cardiovascular collapse.Correct Answer Is:
c) SildenafilA nurse is initiating the use of a continuous passive motion (CPM) device for a client following a total knee arthroplasty. Which of the following actions should the nurse take?
- A. Set the degree of flexion and extension as tolerated by client.
- B. Pad the CPM device with a thick pillow.
- C. Place the client in high-Fowler's position.
- D. Align the client's joints with the joints on the frame.
Explanation
Explanation
Correct alignment is critical when using a CPM device after total knee arthroplasty. The client’s knee joint must be precisely aligned with the mechanical joint of the CPM frame to ensure smooth, controlled movement. Proper alignment prevents strain on the healing tissues, reduces the risk of ligament or prosthetic injury, and ensures the device provides effective passive range of motion. Misalignment can cause pain, improper flexion, pressure injuries, or mechanical damage to the surgical site. The degree of flexion is prescribed, not set by tolerance; thick padding interferes with motion; and high-Fowler’s position is inappropriate because the device requires the leg to be level and supported.Correct Answer Is:
D. Align the client's joints with the joints on the frame.How to Order
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