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PN ATI Capstone Adult Medical-Surgical 1 Quiz
1. While reviewing the medical record of a client with unstable angina, which of the following findings should the nurse report to the provider?
- A. BP 106/62 mm Hg, Temp 38°C (100.4°F), HR 112/min, Resp rate 26/min, urine output 90 mL/hr
- B. Skin is cool and moist with pallor
- C. Bilateral breath sounds with crackles heard at bases of lungs
- D. Creatinine kinase 100 units/L, C-reactive protein 0.8 mg/dL, Myoglobin 88 mcg/L
Correct answer: A
Rationale: The correct answer is A. The nurse should report these vital signs to the provider immediately as they indicate increased temperature, tachycardia, and tachypnea, which are signs of possible infection or systemic inflammatory response. This could exacerbate the client's unstable angina and needs prompt evaluation. Choices B, C, and D are not as urgent as the vital signs in option A and do not directly indicate a worsening condition in the context of unstable angina.
2. A nurse is providing dietary teaching for a client who has chronic cholecystitis. Which of the following diets should the nurse recommend?
- A. Low potassium diet
- B. High fiber diet
- C. Low fat diet
- D. Low sodium diet
Correct answer: C
Rationale: The correct answer is C: 'Low fat diet.' A client with chronic cholecystitis should follow a low-fat diet to decrease the frequency of biliary colic episodes. Fats can trigger the release of cholecystokinin, which stimulates the gallbladder to contract, potentially causing pain in individuals with cholecystitis. Choices A, B, and D are incorrect. A low potassium diet is prescribed for individuals with specific kidney conditions or on certain medications. A high fiber diet is beneficial for conditions like constipation, diverticulosis, or to promote general bowel health. A low sodium diet is often recommended for conditions like hypertension or heart failure to reduce fluid retention.
3. A nurse is admitting a client who has suspected appendicitis. Which of the following findings should the nurse report to the provider immediately?
- A. Distended, board-like abdomen
- B. WBC count of 15,000/mm³
- C. Rebound tenderness over McBurney’s point
- D. Temperature of 37.3°C (99.1°F)
Correct answer: A
Rationale: A distended, board-like abdomen is a concerning sign indicating the possibility of a ruptured appendix and peritonitis, which are medical emergencies. Reporting this finding immediately is crucial for prompt intervention. Choice B, an elevated WBC count, could indicate infection but is not as urgent as the risk of a ruptured appendix. Choice C, rebound tenderness over McBurney’s point, is a classic sign of appendicitis but does not indicate an immediate threat like a possible rupture. Choice D, a slightly elevated temperature, is a nonspecific finding and not as critical as the risk of peritonitis associated with a distended, board-like abdomen.
4. A home health nurse is providing teaching to the family of a client who has a seizure disorder. Which of the following interventions should the nurse include in the teaching?
- A. Keep a padded tongue depressor near the bedside
- B. Place a pillow under the client’s head while in bed during a seizure
- C. Administer diazepam intravenously at the onset of seizures
- D. Position the client on their side during a seizure
Correct answer: D
Rationale: Clients who have seizures are at risk for injury and aspiration. Therefore, the nurse should instruct the family to position the client on their side during a seizure to maintain a clear airway. Placing a padded tongue depressor near the bedside (Choice A) is not recommended, as it can lead to oral injury during a seizure. Placing a pillow under the client’s head (Choice B) can obstruct the airway and increase the risk of aspiration. Administering diazepam orally (Choice C) is not typically done by family members during a seizure; this is usually prescribed by healthcare providers for specific situations.
5. A nurse is providing teaching to a client who is scheduled for electromyography (EMG). Which of the following information should the nurse include in the teaching?
- A. “You will receive a fixed dose of radioisotope 2 hours before the procedure.”
- B. “Momentary flushing may occur at the beginning of the procedure.”
- C. “You should inform your provider if you are claustrophobic.”
- D. “You should expect insertion of small needle electrodes into the muscles.”
Correct answer: D
Rationale: The correct answer is D. During an electromyography (EMG) procedure, small needle electrodes are inserted into the muscles to identify muscle weakness and evaluate local nerve responses. This information is crucial for the client to know beforehand. Choice A is incorrect because radioisotopes are not used in EMG procedures. Choice B is incorrect because flushing is not a common occurrence during EMG. Choice C is incorrect because claustrophobia is more relevant to MRI or CT scans, not EMG procedures.
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