A nurse is contributing to the plan of care for an older adult client who is postoperative following a right hip arthroplasty. Which of the following interventions should the nurse include in the plan? - Answer - Maintain abduction of the right hip.
A nurse is caring for a client who has heart f...
a nurse is contributing to the plan of care for an older adult client who is postoperative following a right hip arthroplasty which of the following interve
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ATI Med-Surg proctor Q/A 2022/2023
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ATI Med-Surg proctored Exam Q/A 2022/2023
A nurse is contributing to the plan of care for an older adult client who is postoperative
following a right hip arthroplasty. Which of the following interventions should the nurse
include in the plan? - Answer - Maintain abduction of the right hip.
A nurse is caring for a client who has heart failure and respiratory arrest. Which of the
following actions should the nurse take first? - Answer - Feel for a carotid pulse.
A nurse is caring for a client scheduled for coronary artery bypass grafting who reports
he is no longer certain he wants to have the procedure. Which of the following
responses should the nurse make? - Answer - "Bypass surgery must be very frightening
for you."
A nurse is caring for a client who is postoperative following foot surgery and is not to
bear weight on the operative foot. The nurse enters the room to discover the client
hopped on one foot to the bathroom, using an IV pole for support. Which of the following
actions should the nurse take? - Answer - Tell the client to remain in the bathroom after
toileting and obtain a wheelchair.
A nurse is assisting with the care of a client who is postoperative and has a closed-
wound drainage system in place. Which of the following actions should the nurse take?
- Answer - Fully recollapse the reservoir after emptying it.
A nurse is reinforcing discharge instructions with a client who has hepatitis A. Which of
the following statements by the client indicates an understanding of the teaching? -
Answer - "I will abstain from sexual intercourse."
A nurse is reinforcing discharge teaching on actions that improve gas exchange to a
client diagnosed with emphysema. Which of the following instructions should be
included in the teaching? - Answer - Breathe in through her nose and out through
pursed lips.
A nurse is caring for a client who is postoperative and has a history Addison's disease.
For which of the following manifestations should the nurse monitor? - Answer -
Hypotension
A nurse is reinforcing pre-operative teaching for a client who is scheduled for surgery
and is to take hydroxyzine preoperatively. Which of the following effects of the
medication should the nurse include in the teaching? (Select all that apply.) - Answer -
✔Decreasing anxiety
✔Controlling emesis
✔Reducing the amount of narcotics needed for pain relief
,A nurse is reinforcing teaching with a client who has a new prescription for epoetin alfa.
The nurse should reinforce to the client to take which of the following dietary
supplements with this medication? - Answer - Iron
A nurse is caring for a client after a radical neck dissection. To which of the following
should the nurse give priority in the immediate postoperative period? - Answer -
Ineffective airway clearance related to thick, copious secretion
A nurse is contributing to the plan of care for a client who has a spinal cord injury at
level C8 who is admitted for comprehensive rehabilitation. Which of the following long-
term goals is appropriate with regard to the client's mobility? - Answer - Propel a
wheelchair equipped with knobs on the wheels.
A nurse is reinforcing health teaching about skin cancer with a group of clients. Which of
the following risk factors should the nurse identify as the leading cause of non-
melanoma skin cancer? - Answer - Sun exposure.
Based on a client's recent history, a nurse suspects that a client is beginning
menopause. Which of the following questions should the nurse ask the client to help
confirm the client is experiencing manifestations of menopause? - Answer - "Do you
sleep well at night?"
A nurse is reinforcing teaching with a client about cancer prevention and plans to
address the importance of foods high in antioxidants. Which of the following foods
should the nurse include in the teaching? - Answer - Fresh berries
A nurse is assisting with caring for a client who has a new concussion following a motor-
vehicle crash. The nurse should monitor the client for which of the following
manifestations of increased intracranial pressure? - Answer - Lethargy
A nurse is reinforcing teaching about a tonometry examination with a client who has
manifestations of glaucoma. Which of the following statements should the nurse include
in the teaching? - Answer - "This test will measure the intraocular pressure of the eye."
A nurse is reviewing the laboratory results of a client who is taking cyclosporine
following a kidney transplant. Which of the following laboratory findings should the nurse
identify as the most important to report to the provider? - Answer - Increase in serum
creatinine
A nurse is checking for paradoxical blood pressure on a client who has constrictive
pericarditis. Which of the following findings should the nurse expect? - Answer - Drop in
systolic BP more than 10 mm Hg on inspiration
A nurse is caring for a client who has Alzheimer's disease. The nurse discovers the
client entering the room of another client, who becomes upset and frightened. Which of
, the following actions should the nurse take? - Answer - Attempt to determine what the
client was looking for.
A nurse is caring for a client immediately following a cardiac catheterization with a
femoral artery approach. Which of the following actions should the nurse take? - Answer
- Check pedal pulses every 15 min.
A nurse is assisting with planning an immunization clinic for older adult clients. Which of
the following information should the nurse plan to include about influenza? - Answer -
The composition of the influenza vaccine changes yearly.
A nurse is caring for an older adult client who has colon cancer. The client asks the
nurse several questions about his treatment plan. Which of the following actions should
the nurse take? - Answer - Help the client write down questions to ask his provider.
A nurse is caring for a client who has hemiplegia following a stroke. The client's adult
son is distressed over his mother's crying and condition. Which of the following
responses should the nurse make? - Answer - "It must be hard to see your mother so ill
and upset."
A nurse is reinforcing teaching with the family of a client who has primary dementia.
Which of the following manifestations of dementia should the nurse include in the
teaching? - Answer - Forgetfulness gradually progressing to disorientation
A nurse is contributing to the plan of care for a client who has labyrinthitis. Which of the
following interventions should the nurse include in the plan? - Answer - Monitor client's
cardinal fields of vision.
A nurse is contributing to the plan of care for a client who is admitted with a deep vein
thrombosis (DVT) of the left leg. Which of the following interventions should the nurse
include in the plan? - Answer - Monitor platelet levels
A nurse is caring for a client who comes to the clinic to be tested for tuberculosis (TB)
after a close family contact tests positive. Which of the following measures should the
nurse anticipate preparing for this client? - Answer - Chest x-ray
A nurse is reviewing data for a client who has a head injury. Which of the following
findings should indicate to the nurse that the client might have diabetes insipidus? -
Answer - Urine output 650 mL/hr
A nurse is caring for a client who has recurrent kidney stones and a history of diabetes
mellitus. The client is scheduled for an intravenous pyelogram (IVP). The nurse should
collect additional data about which of the following statements made by the client? -
Answer - "I took my metformin before breakfast."
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