ATI RN
ATI RN Adult Medical Surgical Online Practice 2023 A
1. A nurse is assessing a client for a suspected anaphylactic reaction following a CT scan with contrast media. For which of the following client findings should the nurse intervene first?
- A. Urticaria
- B. Stridor
- C. Vomiting
- D. Hypotension
Correct answer: Stridor
Rationale:
2. What is the term for intestinal wounds associated with Crohn's disease that develop in different areas in the intestine, with normal tissue separating affected regions?
- A. Skip lesions
- B. Fistulas
- C. Fissures
- D. Loop ulcerations
Correct answer: A: Skip lesions
Rationale: Skip lesions are typical characteristics of Crohn's disease, where patches of diseased intestine are interspersed with areas of healthy tissue. This is why option A is the correct answer. Option B, fistulas, are abnormal connections between two body parts, which is not what the question is describing. Option C, fissures, are small tears in the lining of the anus, which also do not fit the description in the question. Option D, loop ulcerations, is not a recognized medical term, making it an incorrect choice.
3. A patient has been prescribed mifepristone (RU-486) to terminate a pregnancy. How does this drug achieve its therapeutic effect?
- A. By inhibiting the action of progesterone, which is necessary to maintain pregnancy.
- B. By increasing estrogen levels, which induce uterine contractions.
- C. By altering the uterine lining, preventing implantation.
- D. By stimulating uterine contractions, which expel the embryo.
Correct answer: A
Rationale: Mifepristone (RU-486) functions by inhibiting the action of progesterone, a hormone crucial for maintaining pregnancy. By blocking progesterone, mifepristone disrupts the uterine environment necessary for pregnancy continuation, ultimately leading to termination. Choice B is incorrect because mifepristone does not increase estrogen levels; instead, it acts on progesterone. Choice C is incorrect as mifepristone's mechanism does not involve altering the uterine lining to prevent implantation. Choice D is incorrect because mifepristone does not directly stimulate uterine contractions; its primary action is through progesterone inhibition.
4. A client has a new prescription for Filgrastim. Which of the following instructions should be included by the healthcare provider?
- A. Take this medication with food.
- B. Avoid taking this medication with orange juice.
- C. Report bone pain to your healthcare provider.
- D. Expect a persistent cough while taking this medication.
Correct answer: C
Rationale: The correct answer is C: 'Report bone pain to your healthcare provider.' Filgrastim is known to cause bone pain as a common side effect. Therefore, it is crucial for clients to report any bone pain to their healthcare provider to monitor for potential complications or the need for further management. Choices A, B, and D are incorrect because taking Filgrastim with food, avoiding it with orange juice, and expecting a persistent cough are not relevant instructions associated with this medication.
5. A patient with a history of breast cancer is being prescribed tamoxifen (Nolvadex). What should the nurse include in the patient education about the use of this medication?
- A. Tamoxifen may increase the risk of venous thromboembolism, so the patient should be aware of the signs and symptoms of blood clots.
- B. Tamoxifen may cause hot flashes, so the patient should be prepared for this side effect.
- C. Tamoxifen may decrease the risk of osteoporosis, so the patient should ensure adequate calcium intake.
- D. Tamoxifen may cause weight gain, so the patient should monitor their diet and exercise regularly.
Correct answer: A
Rationale: The correct answer is A. Tamoxifen is known to increase the risk of venous thromboembolism, a serious side effect. Patients should be educated about the signs and symptoms of blood clots, such as swelling, pain, or redness in the affected limb, and the importance of seeking immediate medical attention if they occur. Choice B is incorrect because hot flashes are a common side effect of tamoxifen but not a critical concern like venous thromboembolism. Choice C is incorrect as tamoxifen is not associated with a decreased risk of osteoporosis. Choice D is incorrect because while weight gain can occur with tamoxifen, it is not as crucial to educate the patient about as the risk of venous thromboembolism.
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