ATI PN Medical Surgical
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Free ATI PN Medical Surgical Questions
A nurse is assisting with the care of a client who has a closed-chest tube drainage system. Which of the following actions should the nurse take?
- Replace the unit when the drainage chamber is full.
- Pin the tubing to the client's bed sheets.
- Monitor for at least 150 mL of drainage every hour.
- Clamp the tube for 30 min every 8 hr.
Explanation
Explanation
A closed-chest tube drainage system must be replaced once the drainage chamber becomes full so that the system can continue to function properly. A full chamber prevents additional drainage from collecting, which can create backflow into the pleural space and put the client at risk for pneumothorax or impaired lung re-expansion. Replacing the unit when full ensures continuous, safe removal of air and fluid from the pleural cavity.Correct Answer Is:
A. Replace the unit when the drainage chamber is full.A nurse is contributing to the plan of care for a client who has disuse syndrome following cast removal from a lower extremity. Which of the following referrals should the nurse include in the plan of care?
- Dietitian
- Herbalist
- Occupational therapist
- Social worker
Explanation
Explanation
After cast removal, a client with disuse syndrome experiences weakness, stiffness, reduced mobility, and difficulty performing normal daily activities. An occupational therapist helps the client regain independence by teaching strategies to safely perform activities of daily living, improving functional mobility, and strengthening the affected limb. This referral directly supports recovery of movement, coordination, and self-care abilities—key components of managing disuse syndrome.Correct Answer Is:
c) Occupational therapistA nurse is caring for a client who has diabetes mellitus. Which of the following laboratory results should the nurse report to the provider?
- Glycosylated hemoglobin 5.2%
- Urine positive for ketones
- Urine negative for bilirubin
- Fasting blood glucose 70 mg/dL
Explanation
Explanation
The presence of ketones in the urine indicates that the body is breaking down fat for energy due to inadequate insulin availability. This can signal poor glycemic control and may be an early indicator of diabetic ketoacidosis (DKA), especially in clients with type 1 diabetes. Ketones should never be ignored because they require prompt evaluation and intervention to prevent rapid progression to a life-threatening emergency.Correct Answer Is:
b) Urine positive for ketonesA nurse is caring for a client who has a terminal illness and is in the active phase of dying. The client refuses further hydration and nourishment. Which of the following actions should the nurse take?
- Request a prescription for IV fluids.
- Ask the client's health care surrogate for permission to withhold nourishment.
- Provide regular oral care for the client with a moist swab.
- Explain the importance of oral hydration to the client.
Explanation
Explanation
c) Provide regular oral care for the client with a moist swab.In the active phase of dying, it is ethically and legally appropriate to respect the client’s refusal of food and fluids. Forced hydration does not improve comfort and may worsen symptoms such as dyspnea or edema. The nurse’s role is to promote comfort, and providing frequent oral care with moist swabs helps relieve dry mouth, maintain mucosal integrity, and support dignity. This aligns with palliative care principles that prioritize comfort and respect for client autonomy.
Correct Answer Is:
c) Provide regular oral care for the client with a moist swab.A nurse is collecting data from a client who has hyperthyroidism and is taking propylthiouracil. Which of the following statements by the client indicates the medication is effective?
- "I no longer feel nervous."
- "I no longer take a stool softener."
- "I have less oily skin."
- "I continue to lose weight."
Explanation
Explanation
Propylthiouracil works by reducing excessive thyroid hormone production, which decreases the metabolic overstimulation characteristic of hyperthyroidism. Symptoms such as nervousness, anxiety, and irritability typically improve as thyroid levels return toward normal. A reduction in nervousness is a clear sign that the medication is effectively controlling hypermetabolism. Continued weight loss or persistent symptoms would indicate inadequate treatment, while bowel changes and oily skin are less direct indicators of therapeutic response.Correct Answer Is:
a) "I no longer feel nervous."A nurse is contributing to the plan of care for a client who has developed an infectious wound with foul-smelling drainage. Which of the following actions should the nurse include in the plan of care?
- Discard soiled wound care supplies in a trash receptacle outside the client's room.
- Administer antibiotic therapy before culturing the client's wound.
- Place the client in a private room with a private bathroom.
- Instruct visitors to perform hand hygiene for 5 seconds after leaving the client's room.
Explanation
Explanation
A foul-smelling, draining wound indicates a suspected infectious process, possibly involving organisms that spread through contact. To prevent cross-contamination and protect other clients, the nurse should place the client in a private room with a private bathroom, following contact precautions until culture results identify the organism. Isolation minimizes the risk of transmitting pathogens on surfaces or through direct contact. Keeping supplies and waste contained within the room is an essential part of infection control, as is emphasizing proper and thorough hand hygiene—well beyond 5 seconds. Antibiotics must never be given before obtaining cultures because doing so can distort results and delay correct treatment. Therefore, isolating the client appropriately is the priority measure.Correct Answer Is:
C. Place the client in a private room with a private bathroom.A nurse is caring for a client who has dysphagia following a stroke. When assisting the client at mealtime, which of the following actions should the nurse plan to take?
- Instruct the client to tilt their head back to facilitate swallowing.
- Schedule physical therapy directly before meals.
- Provide oral care before meals.
- Encourage the client to use a straw.
Explanation
Explanation
Providing oral care before meals helps reduce the risk of aspiration in clients with dysphagia. Clearing the mouth of secretions, debris, or bacteria improves the client’s ability to control food and swallow safely. Oral hygiene also enhances taste sensation, stimulates saliva production, and promotes a more effective swallowing response, all of which support safer eating for clients recovering from a stroke.Correct Answer Is:
C. Provide oral care before meals.A nurse is reinforcing teaching with a client who has a new colostomy. Which of the following statements by the client indicates an understanding of the teaching?
- "I should clean around the stoma with moisturizing soap."
- "I should avoid broccoli and chewing gum."
- "I should decrease the amount of fresh fruit in my diet."
- "I should place an aspirin in the pouch to eliminate odor."
Explanation
Explanation
Broccoli, beans, onions, and chewing gum are known to increase gas production, which can lead to excessive pouch inflation and discomfort for clients with a colostomy. Avoiding gas-forming foods demonstrates correct understanding of colostomy dietary management. Moisturizing soaps can interfere with pouch adhesion, fresh fruits are encouraged for healthy bowel function, and aspirin inside the pouch can damage the stoma and appliance and is unsafe.Correct Answer Is:
b) "I should avoid broccoli and chewing gum."A nurse is caring for a client who has a tracheostomy. When providing tracheostomy care, which of the following actions should the nurse perform first?
- Change the dressing on the tracheostomy site.
- Suction the tracheostomy tube.
- Auscultate the client's lungs.
- Clean the inner cannula.
Explanation
Explanation
The first priority anytime tracheostomy care is performed is to ensure the airway is clear and patent. Suctioning the tracheostomy tube removes secretions that could obstruct airflow or compromise oxygenation during the remainder of the procedure. Providing suction before cleaning or dressing changes prevents potential respiratory distress and maintains adequate ventilation. Once the airway is secured and free of obstruction, the nurse can safely proceed with the rest of the tracheostomy care steps.Correct Answer Is:
B. Suction the tracheostomy tube.A nurse is collecting data from a client who has a newly placed colostomy. Which of the following findings should indicate to the nurse the client has accepted their new altered body image?
- Denies feelings of sadness about the ostomy
- Prefers not to look at the stoma site
- Accepts that sexual activity will decrease
- Participates in performing ostomy care
Explanation
Explanation
Active participation in ostomy care is one of the strongest indicators that a client is adapting to and accepting body image changes after colostomy surgery. By engaging in pouch changes, skin care, and self-management tasks, the client demonstrates willingness to integrate the ostomy into daily life. Avoidance behaviors or assumptions about sexual limitations reflect ongoing adjustment challenges rather than acceptance.Correct Answer Is:
d) Participates in performing ostomy careHow to Order
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