ATI RN
ATI Capstone Adult Medical Surgical Assessment 1
1. A client who has burn injuries covering their upper body is concerned about their altered appearance. Which of the following statements should the nurse make?
- A. It is okay to not want to touch the burned areas of your body.
- B. Cosmetic surgery should be performed within the next year to be effective.
- C. Reconstructive surgery can completely restore your previous appearance.
- D. It could be helpful for you to attend a support group for people who have burn injuries.
Correct answer: D
Rationale: The nurse should encourage the client to attend a support group for individuals who have burn injuries. Support groups can provide emotional support, shared experiences, and coping strategies for accepting their altered appearance. Choice A is not the best response as it does not offer proactive support. Choice B is not appropriate as the timing of cosmetic surgery should be determined by healthcare providers, not immediate. Choice C is misleading as reconstructive surgery may improve appearance but may not completely restore the previous look.
2. A nurse is caring for a client with rheumatoid arthritis who has been 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 retention and potassium loss, leading to increased blood pressure. Weight loss (choice A) is not a common adverse effect of prednisone; in fact, weight gain is more common. Hypoglycemia (choice B) is not typically associated with prednisone use; instead, hyperglycemia is a common concern. Hyperkalemia (choice D) is also unlikely with prednisone use; instead, hypokalemia is a potential electrolyte imbalance.
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 should be reported to the provider immediately because it indicates peritonitis, a serious complication of appendicitis resulting from a ruptured appendix. Option B, an elevated WBC count, may indicate infection but is not as urgent as a board-like abdomen. Option C, rebound tenderness over McBurney's point, is a classic sign of appendicitis but does not indicate immediate life-threatening complications. Option D, a slightly elevated temperature, is not as concerning as a distended, board-like abdomen.
4. A nurse is caring for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and is receiving 3% sodium chloride via continuous IV. Which of the following laboratory findings should the nurse identify as an indication that the SIADH is resolving?
- A. Urine specific gravity 1.020
- B. Sodium 119 mEq/L
- C. BUN 8 mg/dL
- D. Calcium 8.7 mg/dL
Correct answer: A
Rationale: A urine specific gravity of 1.020 is within the expected reference range and indicates that the kidneys are appropriately concentrating urine, which is a sign that the syndrome of inappropriate antidiuretic hormone (SIADH) is resolving. A low sodium level (choice B) is associated with SIADH, so a sodium level of 119 mEq/L is not indicative of resolution. BUN (choice C) and calcium levels (choice D) are typically not directly related to SIADH resolution.
5. A nurse at a provider's office is interviewing a client who has multiple sclerosis and has been taking dantrolene for several months. Which of the following client statements should the nurse identify as an indication that the medication is effective?
- A. I don't have muscle spasms as frequently.
- B. I haven't gotten any colds, even though it is flu season.
- C. I feel like my nerve pain has improved.
- D. It is easier to urinate now.
Correct answer: A
Rationale: The correct answer is A: 'I don't have muscle spasms as frequently.' Dantrolene is a medication that relaxes skeletal muscles and is commonly prescribed to treat muscle spasms in clients with multiple sclerosis. Therefore, a reduction in muscle spasms frequency would be an indication of the medication's effectiveness. Choices B, C, and D are incorrect because dantrolene is not indicated for preventing colds, improving nerve pain, or easing urination. The focus should be on the medication's intended purpose, which is to address muscle spasms in clients with multiple sclerosis.
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