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ATI Medical Surgical Proctored Exam 2019 Quizlet
1. A client diagnosed with major depressive disorder refuses to get out of bed, eat, or participate in group therapy. Which intervention is most important for the nurse to implement?
- A. Offer the client high-calorie snacks and frequent small meals.
- B. Ask the client why they are not participating in therapy.
- C. Sit with the client and offer support without demanding participation.
- D. Encourage the client to discuss their feelings of hopelessness.
Correct answer: C
Rationale: In cases of major depressive disorder where the client is non-participatory and withdrawn, sitting with the client and providing support without pressuring them to engage in activities like eating or therapy is crucial. This approach respects the client's current state, builds trust, and creates a supportive environment that can eventually lead to the client opening up and accepting help.
2. When assessing a client reporting severe pain in the right lower quadrant of the abdomen, which sign would most likely indicate appendicitis?
- A. Rebound tenderness at McBurney's point.
- B. Positive Murphy's sign.
- C. Rovsing's sign.
- D. Cullen's sign.
Correct answer: A
Rationale: Rebound tenderness at McBurney's point is a classic sign of appendicitis. This sign indicates peritoneal irritation, a common feature of appendicitis. McBurney's point is located in the right lower quadrant of the abdomen and is a focal point for assessing tenderness. Positive Murphy's sign is associated with cholecystitis, not appendicitis. Rovsing's sign is elicited by palpation of the left lower quadrant resulting in pain in the right lower quadrant, also suggestive of appendicitis. Cullen's sign is associated with acute pancreatitis and manifests as periumbilical ecchymosis.
3. A client with chronic obstructive pulmonary disease (COPD) is receiving prednisone (Deltasone). Which side effect should the nurse monitor for?
- A. Hypoglycemia
- B. Infection
- C. Hypotension
- D. Weight loss
Correct answer: B
Rationale: The correct answer is B: Infection. Prednisone is an immunosuppressant medication commonly used in COPD to reduce inflammation. Due to its immunosuppressive effects, clients are at an increased risk of developing infections. Therefore, nurses should closely monitor clients receiving prednisone for signs and symptoms of infections to provide timely interventions.
4. An 89-year-old male client complains to the nurse that people are whispering behind his back and mumbling when they talk to him. What age-related condition is likely to be occurring with this client?
- A. Delirium
- B. Presbyopia
- C. Presbycusis
- D. Cerebral dysfunction
Correct answer: C
Rationale: The correct answer is C, Presbycusis. Presbycusis is age-related hearing loss that often affects the ability to hear high-pitched sounds, making speech appear mumbled. This condition is common in older adults and can lead to difficulties in understanding conversations, as in the case of the client complaining about people whispering and mumbling.
5. When should surgical correction of hypospadias typically occur for a newborn infant as advised by the nurse?
- A. Repair should be done within one month to prevent bladder infections.
- B. Repairs should typically be done before the child is potty-trained.
- C. Delaying the repair until school age reduces castration fears.
- D. To form a proper urethra repair, it should be done after sexual maturity.
Correct answer: B
Rationale: Surgical repair of hypospadias is recommended to be performed before the child is potty-trained to prevent complications. Early correction helps in achieving better outcomes and reduces the risk of issues related to urination and development of the genitalia.
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