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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 providing discharge teaching to a client following a heart transplant. Which of the following information should the nurse include in the teaching?
- A. Immunosuppressant medications need to be taken for up to 1 year
- B. Shortness of breath might be an indication of transplant rejection
- C. The surgical site will heal in 3 to 4 weeks after surgery
- D. Begin 45 minutes of moderate aerobic exercise per day following discharge
Correct answer: B
Rationale: The correct answer is B because shortness of breath is an indication of transplant rejection, along with other manifestations like fatigue, edema, bradycardia, and hypotension. Choice A is incorrect because immunosuppressant medications are usually taken for life to prevent rejection. Choice C is incorrect as the surgical site may take longer to heal fully. Choice D is incorrect as the initiation of exercise post-heart transplant should be gradual and individualized based on the client's condition.
3. A nurse is providing discharge teaching for a client who has COPD about nutrition. Which of the following instructions should the nurse include?
- A. Eat three large meals daily
- B. Consume high-calorie, high-protein foods
- C. Limit caffeinated drinks to two per day
- D. Drink fluids between meals
Correct answer: B
Rationale: The correct answer is B: 'Consume high-calorie, high-protein foods.' Clients with COPD often have increased energy needs due to the work of breathing. Consuming high-calorie, high-protein foods can help provide the necessary energy and prevent weight loss. Choice A is incorrect because eating three large meals daily may lead to increased shortness of breath due to a full stomach. Choice C is incorrect because limiting caffeinated drinks is important, but the recommendation should focus on reducing intake, not specifying a number. Choice D is incorrect because drinking fluids during mealtime can lead to early satiety, making it difficult for the client to consume enough calories.
4. A nurse is caring for a client who has a peripherally inserted central catheter (PICC). For which of the following findings should the nurse notify the provider?
- A. The dressing was changed 7 days ago
- B. The circumference of the client’s upper arm has increased by 10%
- C. The catheter has not been used in 8 hours
- D. The catheter has been flushed with 10 mL of sterile saline after medication use
Correct answer: B
Rationale: The correct answer is B. The circumference of the upper arm above the insertion site of the PICC should be measured at the time of insertion and then again during assessments. An increase in circumference could indicate deep vein thrombosis, which could be life-threatening. Choice A is not a concern as changing the dressing 7 days ago is within the recommended timeframe. Choice C is not alarming as the catheter not being used for 8 hours does not necessarily indicate a problem. Choice D indicates proper catheter care by flushing it with sterile saline after medication use, so it does not require provider notification.
5. A client with rheumatoid arthritis is taking prednisone. Which of the following findings should the nurse identify as an adverse effect of this medication?
- A. Weight loss
- B. Hypoglycemia
- C. Hypertension
- D. Hyperkalemia
Correct answer: C
Rationale: The correct answer is C: Hypertension. Prednisone, a corticosteroid, can lead to hypertension as an adverse effect. Prednisone can cause sodium and water retention, leading to increased blood pressure. Options A, B, and D are incorrect. Weight loss is not typically associated with prednisone use; instead, weight gain is more common. Hypoglycemia is not a common adverse effect of prednisone; in fact, it can elevate blood sugar levels. Hyperkalemia is also not a typical adverse effect of prednisone; instead, it can cause hypokalemia, or low potassium levels.
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