ATI PN Medical Surgical
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Free ATI PN Medical Surgical Questions
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?
- Keep both arms below the level of the client's heart.
- Limit range-of-motion exercises with the affected arm.
- Use the client's left arm to obtain blood samples.
- Obtain blood pressure readings using the client's right arm.
Explanation
Explanation
After a radical mastectomy, lymph nodes on the affected side—here, the right arm—have been removed or disrupted, severely impairing lymphatic drainage. Any procedure that increases pressure, trauma, or fluid accumulation in that limb can trigger lymphedema, a chronic and often irreversible swelling caused by lymph fluid buildup. Blood draws, IV insertions, and blood pressure measurements all increase localized pressure or tissue injury, placing the client at high risk for lymphedema on the surgical side. Therefore, the nurse must protect the affected (right) arm by performing all procedures—including blood sampling—on the unaffected left arm. This preserves lymphatic function and reduces long-term complications.Correct Answer Is:
C. Use the client's left arm to obtain blood samples.A nurse is reinforcing teaching with a client who will undergo a colonoscopy the following week. Which of the following instructions should the nurse include?
- Administer enemas 2 days before the procedure.
- Restrict the diet to clear liquids for 1 to 3 days before the procedure.
- Expect the provider to schedule another procedure to remove any polyps.
- Do not eat or drink anything except water for 12 hr before the procedure.
Explanation
Explanation
Before a colonoscopy, the bowel must be completely cleansed so the provider can visualize the colon clearly. A clear liquid diet for 1 to 3 days helps ensure the colon is free of solid residue, improving the accuracy and safety of the procedure. This preparation is standard and essential for adequate bowel visualization during the exam.Correct Answer Is:
B. Restrict the diet to clear liquids for 1 to 3 days before the procedure.A nurse is collecting data from a client about her current pain status. Which of the following questions should the nurse ask to determine the quality of the client's pain?
- "Could you rate your pain on a scale from 0 to 10?"
- "Do you have any pain this morning?"
- "What does your pain feel like?"
- "Is your pain the same as it has been?"
Explanation
Explanation
The quality of pain refers to the client’s description of how the pain feels, such as sharp, dull, burning, throbbing, or stabbing. Asking “What does your pain feel like?” directly elicits this information, helping the nurse understand the characteristics of the pain and guiding appropriate interventionsCorrect Answer Is:
C. "What does your pain feel like?"A nurse is reviewing vital signs obtained by an assistive personnel on a group of clients. The previous vital signs for each of the clients were obtained 4 hr earlier. Which of the following changes should the nurse identify as the priority finding?
- Temperature change from 36.6° C (97.8° F) to 38.8° C (101.9° F)
- Heart rate change from 110/min to 68/min
- Blood pressure change from 118/78 mm Hg to 86/50 mm Hg
- Respiratory rate change from 12/min to 20/min
Explanation
Explanation
A sudden drop in blood pressure indicates potential hemodynamic instability, such as internal bleeding, sepsis, or shock. This change threatens perfusion to vital organs and requires immediate assessment and intervention. A decline of this magnitude is life-threatening and therefore the highest priority among the listed changes, based on the ABCs and the need to ensure adequate circulation.Correct Answer Is:
C. Blood pressure change from 118/78 mm Hg to 86/50 mm Hg.A nurse is caring for a client who is 2 days postoperative following abdominal surgery. The nurse auscultates hypoactive bowel sounds, and the client reports cramping abdominal pain. Which of the following actions should the nurse take first?
- Administer a glycerin suppository.
- Ambulate the client in the hallway.
- Offer an analgesic medication.
- Request the client to be NPO.
Explanation
Explanation
b) Ambulate the client in the hallway.Following abdominal surgery, hypoactive bowel sounds and cramping pain often indicate slowed gastrointestinal motility or early postoperative ileus. The first and safest intervention is to ambulate the client, as movement stimulates peristalsis and helps restore normal bowel function. Early ambulation also improves circulation, reduces gas buildup, and decreases discomfort. More invasive or restrictive interventions, such as suppositories or making the client NPO, are not appropriate as first actions before attempting ambulation.
Correct Answer Is:
b) Ambulate the client in the hallway.A nurse is assisting with the plan of care for a client who requires contact precautions. Which of the following interventions should the nurse include in the plan?
- Keep a stethoscope at the client's bedside for the duration of her hospital stay.
- Wear an N95 mask when entering the room.
- Use an alcohol swab to clean the temperature probe before removing it from the room.
- Remove personal protective equipment immediately after leaving the client's room.
Explanation
Explanation
For clients on contact precautions, dedicating noncritical equipment—such as blood pressure cuffs, thermometers, and stethoscopes—to that client helps prevent the spread of infection to others. This reduces cross-contamination and is a key element of proper contact precaution technique. An N95 mask is not required unless airborne precautions are needed, and PPE must be removed before leaving the room to avoid spreading pathogens. Cleaning equipment before removal is inappropriate for contact precautions.Correct Answer Is:
a) Keep a stethoscope at the client's bedside for the duration of her hospital stay.A nurse is reinforcing teaching with a client who has ovarian cancer and will receive chemotherapy through a peripherally inserted central catheter (PICC) line. Which of the following statements by the client indicates an understanding of the teaching?
- "I will wear an arm immobilizer to prevent dislodgement of this device."
- "I will monitor my temperature for fever while I have this device."
- "It's okay to get the device wet when I shower."
- "I should pull the dressing away from the insertion site when I change it."
Explanation
Explanation
Clients with PICC lines are at risk for central line–associated bloodstream infections (CLABSIs). Monitoring temperature daily allows early detection of infection, which is especially important for immunocompromised clients receiving chemotherapy. This statement shows correct understanding of PICC line care. The device should not get wet, dressings must be removed gently and sterilely, and arm immobilizers are not required and increase clotting risk.Correct Answer Is:
b) "I will monitor my temperature for fever while I have this device."The nurse is reinforcing teaching about a Transcutaneous Electrical Nerve Stimulation (TENS). Which of the following statements by the nurse is accurate?
- "This form of pain management involves tiny needles inserted into the skin and subcutaneous tissues."
- "This form of pain management focuses on a pleasant thought to divert focus."
- "This form of pain management involves meditation, yoga, and progressive muscle relaxation."
- "This form of pain management involves mild electrical stimulus applied to the area of pain."
Explanation
Explanation
A TENS unit works by delivering a mild electrical current through electrodes placed on the skin near the painful area. This electrical stimulation helps block pain signals from reaching the brain and encourages the release of endorphins, the body's natural pain relievers. It is a noninvasive, drug-free method of pain control and is commonly used for musculoskeletal pain and neuropathic discomfort.Correct Answer Is:
d) "This form of pain management involves mild electrical stimulus applied to the area of pain."A nurse is caring for a client who has pneumonia with dyspnea. The client's ABG results are pH 7.30, PaCO2 50 mm Hg, HCO₃ 26 mEq/L. The nurse should recognize that the client has which of the following acid–base imbalances?
- Metabolic alkalosis
- Respiratory alkalosis
- Metabolic acidosis
- Respiratory acidosis
Explanation
Explanation
A pH of 7.30 indicates acidemia, and an elevated PaCO₂ of 50 mm Hg shows that CO₂ retention is the cause. Because CO₂ is an acid, high levels result from inadequate ventilation, commonly seen in pneumonia due to impaired gas exchange. The bicarbonate level is normal, confirming the imbalance is respiratory rather than metabolic. The combination of low pH and high PaCO₂ is characteristic of respiratory acidosis.Correct Answer Is:
D. Respiratory acidosisA nurse is reviewing a client's medical record. Which of the following findings is the priority for the nurse to report?
- Urine output 200 mL/8 hrs
- A client's rating of ear pain as 5 on a scale from 0 to 10
- Potassium level 6.2 mEq/L
- Abnormal hepatoiminodiacetic acid (HIDA) scan
Explanation
Explanation
A potassium level of 6.2 mEq/L indicates severe hyperkalemia, a life-threatening electrolyte imbalance that can cause fatal cardiac dysrhythmias such as ventricular fibrillation or asystole. This finding requires immediate intervention, including cardiac monitoring and medications to stabilize the myocardium and shift potassium intracellularly. Because hyperkalemia poses an immediate threat to life, it takes priority over pain, low urine output, or an abnormal diagnostic scan.Correct Answer Is:
c) Potassium level 6.2 mEq/LHow to Order
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