Medical Surgical ATI

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A nurse is providing teaching to a client who has chronic kidney disease and a new prescription for erythropoietin. Which of the following statements by the client indicates an understanding of the teaching?

"I am taking this medication to increase my energy level." The goal of erythropoietin therapy is to increase the level of hematocrit in clients who have anemia. When the medication is effective, the client should have a decrease in fatigue and an improvement in activity tolerance.

A nurse is providing teaching to a client who has esophageal cancer and is to undergo radiation therapy. Which of the following statements should the nurse identify as an indication that the client understands the teaching?

"I will use my hands rather than a washcloth to clean the radiation area." The client should gently wash the radiation area with their hands using warm water and mild soap to protect the skin from further irritation.

A nurse is caring for a client who has pancreatitis. The nurse should expect which of following laboratory results to be below the expected reference range?

A client who has pancreatitis is expected to have decreased calcium and magnesium levels due to fat necrosis. Expected findings are Elevated bilirubin, alkaline phosphatase, amylase

A nurse in a community clinic is caring for a client who reports an increase in the frequency of migraine headaches. T help reduce the risk for migrant headaches, which of the following foods should the nurse recommend the client avoid?

Aged cheese Foods that contain tyramine, such as aged cheese and sausage, can trigger migraine headaches.

A nurse is caring for a client who has Diabetic Ketoacidosis (DKA). Which of the following laboratory findings should expect?

DKA results in osmotic diuresis and subsequent dehydration. The nurse should expect a client who has DKA to have elevated BUN, creatinine, and specific gravity levels resulting from the excess glucose present in the urine.

A nurse in an emergency department is caring for a client who reports vomiting and diarrhea for the past 3 days. Which of the following findings should indicate to the nurse that the client is experiencing fluid volume deficit?

Heart rate 110/min (The norm is 60-100) A client who has a 3-day history of vomiting and diarrhea is likely to have fluid volume deficit and an elevated heart rate.

A nurse is planning care for a client who has extensive burn injuries and is immunocompromised. Which the following precautions should the nurse include in the plan of care to prevent a Pseudomonas aeruginosa infection?

Live plants can harbor P. aeruginosa, and this bacterium can infect burn wounds and cause life-threatening complications. The nurse should ensure no one brings live plants or flowers into the client's room.

A nurse is providing discharge instructions to a client who has a partial- thickness burn on the hand. Which of the following instructions should the nurse include?

*Wrap fingers with individual dressings. The nurse should instruct the client to wrap the fingers individually to allow for functional use of the hand while healing occurs. The nurse should also instruct the client to perform range-of-motion exercises to each finger every hour while awake to promote function of the injured hand.

A nurse is preparing a client who has supra ventricular tachycardia for elective cardio version/ Which of the following prescribed medications should the nurse instruct the client to withhold for 48 hr prior to cardio version?

Digoxin Cardiac glycosides, such as digoxin, are withheld prior to cardioversion. These medications can increase ventricular irritability and put the client at risk for ventricular fibrillation after the synchronized countershock of cardioversion.

A nurse is reviewing the laboratory results of a client who has cirrhosis. Which of the following laboratory values should the nurse expect?

Elevated bilirubin level Bilirubin levels reflect the liver's ability to conjugate and excrete bilirubin, a byproduct of the hemolysis of red blood cells. Bilirubin levels rise with liver disease and clinically reflect the client's degree of jaundice.

A nurse is an acute care facility is caring for a client who is at risk for seizures. Which of the following precautions should the nurse implement?

Ensure that the client has a patent IV. The nurse should ensure the client has IV access in the event that the client requires medication to stop seizure activity.

A nurse is planning to provide discharge teaching for the family of an older adult client who has hemianopsia and is at risk for falls. Which of the following instructions should the nurse include?

Remind the client to scan their complete range of vision during ambulation. The nurse should instruct the family to remind a client who has hemianopsia, or blindness in half of the visual field, to use visual scanning to look over their complete range of vision during ambulation. This practice can accommodate for the loss of vision and help to reduce the risk for falls.

A nurse is an emergency department is reviewing the provider's prescriptions for a client who sustained a rattlesnake bite to the lower leg. Which of the following prescriptions should the nurse expect?

The nurse should expect a prescription for an opioid analgesic to promote comfort following a rattlesnake bite.

A nurse is assessing a male client for an inguinal hernia. Which of the following areas should the nurse palpate to verify that the client has an inguinal hernia?

The nurse should palpate this location to assess the client for an inguinal hernia. An inguinal hernia forms from the peritoneum, which contains part of the intestine, and can protrude into the scrotum in men.


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