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410 MED SURG EXAM
ATI 410 MED SURG EXAM
Total Questions : 50
Showing 10 questions Sign up for moreA nurse is providing teaching to a client who has neutropenia. Which of the following information should the nurse include in the teaching?
Explanation
A. Avoid crowds - Neutropenic patients are highly susceptible to infections. Crowded places increase the risk of exposure to pathogens.
B. Eat plenty of fresh fruits and vegetables - While generally healthy, fresh fruits and vegetables can harbor bacteria, posing a risk for infection in neutropenic individuals. Cooked or properly washed and peeled produce is safer.
C. Take temperature weekly - Neutropenic patients should monitor their temperature daily, not weekly, to detect infections early.
D. Perform mild exercise, such as gardening - Gardening can expose individuals to soil-borne organisms that could lead to infections. Indoor exercises or those that don’t involve potential pathogen exposure are safer.
A home health nurse is assessing an older adult client in the home who has decreased vision due to a history of glaucoma. Which of the following findings should the nurse identify as a safety risk?
Explanation
A. Scatter rugs are present in the kitchen - Scatter rugs can cause tripping and slipping, posing a significant fall risk for someone with vision impairment.
B. Handrails are present in the bathroom - Handrails provide support and help prevent falls, making them a safety feature, not a risk.
C. Electrical cords are placed along the walls - This helps prevent tripping over cords, thus reducing fall risk.
D. Uses a microwave for cooking - A microwave is generally safer than a stove as it reduces the risk of burns and fires, making it a safety feature.
A nurse is caring for a client with a chronic wound. Which of the following is a potential complication of a chronic wound?
Explanation
A. Electrolyte abnormalities - These are not typically a direct complication of chronic wounds unless they are associated with severe infections or extensive fluid loss, which is uncommon.
B. Altered hemoglobin A1C - While chronic wounds are common in diabetics, the wound itself does not directly alter hemoglobin A1C; this test measures long-term blood glucose control.
C. Psychological distress - Chronic wounds can lead to significant emotional and psychological stress due to prolonged treatment, appearance issues, and limitations in activities.
D. Fluid volume overload - This is not a direct complication of chronic wounds. Chronic wounds might cause fluid loss due to exudate, but not fluid overload.
A nurse is teaching a group of clients about the specific types of fluids that protect the structures of the inner ear. Which of the following statements should the nurse include in the teaching?
Explanation
A. Endolymph fluid provides protection to the structures of the inner ear. - Endolymph is found within the inner ear, specifically in the membranous labyrinth, and plays a crucial role in hearing and balance.
B. Sanguineous fluid provides protection to the structures of the inner ear - Sanguineous fluid refers to blood or fluid containing blood. It is not present in the inner ear.
C. Aqueous humor provides protection to the structures of the inner ear - Aqueous humor is the fluid found in the eye, not the ear.
D. Vitreous humor provides protection to the structures of the inner ear - Vitreous humor is found in the eye, not the ear.
A nurse is caring for a client who has developed pulmonary embolism (PE). Which of the following diagnostic tests should the nurse anticipate the provider to prescribe to confirm the client's condition?(Select All that Apply.)
Explanation
A. D-dimer blood test - A D-dimer test measures clot breakdown products in the blood. Elevated levels suggest the presence of an abnormal blood clot, such as in PE, although it is not specific.
B. Complete blood count (CBC) - A CBC is not typically used to diagnose PE. It may be ordered to check for other conditions or as part of the overall health assessment, but it doesn't confirm PE.
C. CT scan - A CT pulmonary angiography is the gold standard for diagnosing PE. It provides detailed images of the blood vessels in the lungs.
D. Chest x-ray - A chest x-ray is not diagnostic for PE. It is often performed to rule out other causes of the client’s symptoms (e.g., pneumonia, pneumothorax) but does not confirm the presence of a pulmonary embolism.
E. Lung ventilation and perfusion scan (VQ scan)
A VQ scan is another diagnostic tool for PE, especially in clients who cannot tolerate contrast dye required for CT scans. It assesses the ventilation and perfusion of the lungs and identifies mismatches suggestive of PE.
A nurse is planning care for a client who is to receive packed RBCs. The nurse should plan for the total infusion time to not exceed which of the following?
Explanation
A. 4 hr - The total infusion time for packed RBCs should not exceed 4 hours. Infusing beyond this period increases the risk of bacterial growth in the blood product, which can lead to sepsis and other serious complications.
B. 2 hr - While blood can be infused in 2 hours for some patients, especially in non-emergent situations, the standard maximum time allowed is 4 hours to prevent complications.
C. 8 hr - Infusing blood over 8 hours is too long and increases the risk of bacterial contamination and decreased efficacy of the blood product.
D. 6 hr - Similar to 8 hours, a 6-hour infusion time is too lengthy and poses significant risks for bacterial growth and sepsis.
A nurse is caring for an adolescent who has hemophilia A and is scheduled for wisdom teeth extractions. Prior to the procedure, the nurse should anticipate that the client will receive which of the following products?
Explanation
A. Packed RBCs - These are used to treat anemia or significant blood loss but do not address the clotting deficiency in hemophilia.
B. Fresh frozen plasma - This contains all clotting factors, but in hemophilia A, specifically replacing factor VIII is more effective and targeted.
C. Recombinant - Recombinant factor VIII is a synthetic form of the clotting factor that patients with hemophilia A are deficient in. It is used to increase factor VIII levels before procedures to prevent excessive bleeding.
D. Prophylactic antibiotics - These are used to prevent infection but do not help in managing the bleeding risks associated with hemophilia.
A nurse is preparing a plan of care for a client who is postoperative following a cochlear implant insertion. Which of the following instructions should the nurse include in the plan of care?
Explanation
A. Lie on your back when sleeping - While specific sleeping positions might be recommended, lying on the back is not necessarily required unless specified by the surgeon.
B. Wash your hair 24 hr after surgery - Hair washing is usually advised against within the first 24-48 hours post-surgery to prevent infection and avoid disturbing the surgical site.
C. Resume your exercise routine - Exercise is typically restricted initially to prevent strain or injury to the surgical area.
D. Eat foods that are soft - Soft foods are recommended to avoid strain on the surgical site, reduce the risk of dislodging any packing or stitches, and promote comfort during the initial healing period.
A nurse is admitting a client who has sustained severe burn injuries in a grease fire. The nurse shades in a diagram indicating the burned surface areas. Using the Rule of Nines, the nurse should estimate that the client has burned what percentage of body surface area? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
Explanation
Anterior= 18% (trunk) + 4.5 % (upper limb) +2.25% (forearm) =24.75%
Posterior= 4.5% (upper limb) +2.25% (forearm)= 6.75%
Total TBSA= 31.5%
A nurse is caring for a client who has a prescription for one unit of packed RBCs. The nurse should plan to remain in the room with the client at which of the following times during the infusion to observe for a transfusion reaction?
Explanation
A. The first 2 min - This is too short a period to monitor effectively for transfusion reactions.
B. The final 2 min - Transfusion reactions are more likely to occur at the beginning of the transfusion rather than at the end.
C. The final 15 min - While it’s still important to monitor, reactions are most likely to be detected earlier in the infusion.
D. The first 15 min - Transfusion reactions typically occur within the first 15 minutes of starting the blood transfusion. The nurse should remain with the patient during this critical period to monitor for any signs of a reaction, such as fever, chills, rash, or difficulty breathing.
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