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Advanced Med Surg Final Exam 0924
ATI Advanced Med Surg Final Exam 0924
Total Questions : 87
Showing 10 questions Sign up for moreA nurse is preparing to administer 0.45% sodium chloride (NaCl) 2000 mL IV to infuse over 8 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Explanation
- Total volume of IV fluid: 2000 mL
- Total time for infusion: 8 hours
Infusion rate: 2000/8 = 250ml/hr
=250
A nurse is teaching a client who has gout about dietary recommendations. The nurse should teach the client that which of the following beverages can trigger an attack?
Explanation
A. Coffee has not been shown to significantly increase the risk of gout attacks and may even have a protective effect due to its antioxidant properties.
B. Alcohol, especially beer and spirits, can trigger gout attacks by increasing the level of uric acid in the blood. Alcohol consumption should be limited or avoided to reduce the risk of gout flare-ups.
C. Milk and other low-fat dairy products are actually recommended for people with gout, as they may help lower uric acid levels.
D. Orange juice, while high in vitamin C, does contain fructose, which can increase uric acid production. However, it is not as significant a trigger as alcohol. Moderation is key.
A nurse is assessing a client who has a long history of smoking and is suspected of having laryngeal cancer. The nurse should anticipate that the client will report that her earliest manifestation was
Explanation
A. Weight loss can occur as laryngeal cancer progresses, but it is not typically an early sign.
B. Hoarseness is often the earliest and most common symptom of laryngeal cancer. It occurs due to the involvement of the vocal cords.
C. Dysphagia, or difficulty swallowing, may develop as the cancer advances, but it is not usually the initial symptom.
D. Dyspnea, or difficulty breathing, can occur if the tumor obstructs the airway, but it is generally a later manifestation of laryngeal cancer.
A nurse is reviewing the arterial blood gas values of a client who has chronic kidney disease. Which of the following sets of values should the nurse expect?
Explanation
A. pH 7.25, HCO₃- 19 mEq/L, PaCO₂ 30 mm Hg indicates metabolic acidosis with partial respiratory compensation. This is a common finding in chronic kidney disease due to the kidneys' reduced ability to excrete hydrogen ions and reabsorb bicarbonate.
B. pH 7.30, HCO₃- 26 mEq/L, PaCO₂ 50 mm Hg suggests respiratory acidosis with a normal bicarbonate level, which is not typical for chronic kidney disease.
C. pH 7.50, HCO₃- 20 mEq/L, PaCO₂ 32 mm Hg indicates respiratory alkalosis, which is not characteristic of chronic kidney disease.
D. pH 7.55, HCO₃- 30 mEq/L, PaCO₂ 31 mm Hg indicates metabolic alkalosis, which is also not typical for chronic kidney disease.
A nurse is caring for a client who has undergone a transurethral prostatectomy. Following catheter removal, the nurse should inform the client that he should expect which of the following variations in the color of his urine?
Explanation
A. Bright red urine would indicate active bleeding and is not an expected finding after catheter removal.
B. Pale pink urine is expected as some bleeding is normal following a transurethral prostatectomy.
C. Bright yellow urine is typical of normal, well-hydrated urine and is not expected immediately postoperatively.
D. Dark amber urine could indicate dehydration and is not typical following this procedure.
A nurse in the ICU is caring for a client who has heart failure and is receiving a dobutamine drip. The nurse should identify that which of the following findings indicates that the medication is effective?
Explanation
A. Dobutamine does not directly affect blood glucose levels.
B. While dobutamine can increase heart rate, this is not a primary indicator of its effectiveness in treating heart failure.
C. Increased urine output indicates improved cardiac output and kidney perfusion, suggesting that dobutamine is effectively enhancing the heart's pumping ability.
D. Dobutamine may cause a slight decrease in blood pressure, but this is not a primary measure of its effectiveness in heart failure treatment.
A nurse is teaching a client who is receiving treatment for metastatic colorectal cancer about the adverse effects of bevacizumab. The nurse should instruct the client to report which of the following findings as an adverse effect of the medication?
Explanation
A. Nosebleeds (epistaxis) are a common adverse effect of bevacizumab, as it can cause bleeding due to its anti-angiogenic properties.
B. Temporary loss of smell is not a recognized adverse effect of bevacizumab.
C. Weight gain is not typically associated with bevacizumab treatment.
D. Mild hearing loss is not a common adverse effect of bevacizumab.
A nurse is teaching a newly licensed nurse about the difference between a plaster cast and a synthetic cast. Which of the following information should the nurse include in the teaching?
Explanation
A. A synthetic cast is lighter in weight compared to a plaster cast, making it more comfortable for the patient.
B. Both plaster and synthetic casts effectively immobilize bone fractures; the choice often depends on the specific clinical situation and patient preference.
C. Drying time is actually shorter with a synthetic cast compared to a plaster cast, which can take up to 24-72 hours to fully dry.
D. A plaster cast does not require expensive equipment for application; the materials and application process are generally less costly compared to synthetic casts.
A nurse is caring for a client who has increased intracranial pressure (ICP) following a closed-head injury. Which of the following actions should the nurse take?
Explanation
A. Placing the client in a supine position can increase ICP. The head of the bed should be elevated 30-45 degrees to promote venous drainage from the head.
B. Using log rolling to reposition the client helps to maintain spinal alignment and prevent increases in ICP.
C. A warming blanket is not typically necessary unless the client is hypothermic; it does not directly affect ICP management.
D. Instructing the client to cough and deep breathe can increase ICP and should be avoided in clients with elevated ICP.
A nurse is planning care for a client following a cardiac catheterization accessed through his femoral artery. Which of the following actions should the nurse plan to take?
Explanation
A. Fluids should not be restricted; adequate hydration is necessary to help flush the contrast dye used during the procedure out of the client's system.
B. Performing neurovascular checks with vital signs is essential to monitor for complications such as bleeding, hematoma, or compromised circulation to the extremity.
C. The client should avoid range-of-motion exercises to the lower extremities immediately following the procedure to prevent disruption of the femoral artery site.
D. The client should remain on bed rest for several hours following the procedure to reduce the risk of bleeding at the catheter insertion site.
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