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PN ATI Capstone Adult Medical-Surgical 1 Quiz
1. A nurse is assessing a client who has meningitis. The nurse should identify which of the following findings as a positive Kernig’s sign?
- A. After stroking the lateral area of the foot, the client’s toes contract and draw together
- B. After hip flexion, the client is unable to extend their leg completely without pain
- C. The client’s voluntary movement is not coordinated
- D. The client reports pain and stiffness when flexing their neck
Correct answer: B
Rationale: A positive Kernig’s sign is identified when a client is unable to extend their leg completely without pain after hip flexion. This finding indicates meningeal irritation. Choices A, C, and D do not describe Kernig’s sign. Choice A describes a normal plantar reflex, choice C refers to coordination issues, and choice D describes neck pain and stiffness, which are not specific to Kernig’s sign.
2. A nurse is caring for a client who has dehydration. The client has a peripheral IV and has a prescription for an infusion of 0.9% sodium chloride 1,000 mL with 40 mEq potassium chloride to infuse over 1 hr. Which of the following actions should the nurse take first?
- A. Teach the client to report findings of IV extravasation
- B. Evaluate the patency of the IV
- C. Consult with the pharmacist about the prescription
- D. Verify the prescription with the provider
Correct answer: D
Rationale: The priority action is to verify the prescription with the provider. Verifying the prescription ensures patient safety by preventing fluid volume overload and dysrhythmias, which can result from infusing potassium too rapidly. Teaching the client about IV extravasation, evaluating IV patency, and consulting with the pharmacist are important but should come after verifying the prescription to ensure the ordered treatment is appropriate and safe for the client's condition.
3. A client newly diagnosed with nephrotic syndrome is being taught by a nurse. Which statement indicates that the client understands the teaching?
- A. “I can expect swelling in my hands and on my face.”
- B. “The amount of protein in my blood is high.”
- C. “I might have some pain and gas in my stomach from this condition.”
- D. “I will use a soft bristle toothbrush, so my gums don’t bleed.”
Correct answer: A
Rationale: The correct answer is A: “I can expect swelling in my hands and on my face.” Nephrotic syndrome leads to increased permeability of the glomeruli, resulting in edema, especially in the face and dependent areas. Choice B is incorrect because nephrotic syndrome leads to protein loss in the urine, not an increase in blood protein levels. Choice C is incorrect as stomach pain and gas are not typical symptoms of nephrotic syndrome. Choice D is unrelated to the teaching about nephrotic syndrome and gum bleeding.
4. A client with GERD is receiving discharge instructions from a nurse. Which statement by the client indicates an understanding of the teaching?
- A. “I should take my medicine with orange juice.”
- B. “Having a bedtime snack will prevent heartburn.”
- C. “I will lie down after meals.”
- D. “I will limit activities that require bending at the waist.”
Correct answer: D
Rationale: The correct answer is D. Limiting activities that require bending at the waist can help prevent episodes of reflux in clients with GERD. Choices A, B, and C are incorrect. Taking medicine with orange juice may not be appropriate as citrus juices can aggravate GERD. Having a bedtime snack can exacerbate heartburn by increasing stomach acid production, and lying down after meals can worsen symptoms of GERD by allowing stomach acid to flow back into the esophagus.
5. A nurse is administering a blood transfusion to a client and suspects that the client is having an adverse reaction to the blood. Which of the following actions should the nurse take first?
- A. Maintain IV access
- B. Obtain the client’s vital signs
- C. Contact the provider
- D. Stop the transfusion
Correct answer: D
Rationale: The correct answer is to stop the transfusion. When a nurse suspects an adverse reaction to a blood transfusion, the priority is to stop the infusion immediately to prevent further harm to the client. Maintaining IV access and obtaining vital signs can be important steps but should come after stopping the transfusion to ensure the client's safety. Contacting the provider is necessary but not the first action to take in this situation. Therefore, the nurse should prioritize stopping the transfusion to address the potential adverse reaction.
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