ATI RN
ATI RN Adult Medical Surgical Online Practice 2023 A
1. A client has a chest tube in place connected to wall suction due to a right-sided pneumothorax. The client complains of chest burning. Which of the following actions should be taken?
- A. Increase the wall suction.
- B. Strip the chest tube.
- C. Clamp the chest tube.
- D. Reposition the client.
Correct answer: Reposition the client.
Rationale: When a client with a chest tube connected to wall suction complains of chest burning, it may indicate that the tube is irritating or compressing nearby tissues. Repositioning the client can help relieve this irritation by ensuring the tube is not kinked or pulling on the tissues. Increasing suction, stripping the tube, or clamping it are not appropriate actions and could potentially worsen the situation or cause harm.
2. In dealing with a conflict on a unit, the nurse manager decides to ask one of the staff nurses, who is not moving towards resolution, to transfer to another unit. What tactic has the manager implemented?
- A. Avoidance
- B. Withdrawal
- C. Suppression
- D. Competition
Correct answer: C
Rationale: The correct answer is C: Suppression. In this scenario, the nurse manager has implemented a suppression tactic by asking the staff nurse to transfer to another unit, which eliminates one of the conflicting parties from the current unit. This technique aims to resolve the conflict by physically separating the individuals involved. Choices A, B, and D are incorrect: Avoidance involves ignoring the conflict, withdrawal is the act of pulling out or retreating, and competition refers to a situation where one party's gain is at the expense of the other.
3. The nurse is assessing the colostomy of a client who has had an abdominal perineal resection for a bowel tumor. Which assessment finding indicates that the colostomy is beginning to function?
- A. The passage of flatus
- B. Absent bowel sounds
- C. The client’s ability to tolerate food
- D. Bloody drainage from the colostomy
Correct answer: A
Rationale: The passage of flatus (gas) from the colostomy is an early sign that the bowel is beginning to function after surgery. This indicates that peristalsis, or the movement of the intestines, has resumed and that the digestive system is actively moving gas and eventually stool through the bowel and out of the colostomy. It’s a positive sign that the bowel is recovering from the surgery and starting to work as intended.
4. A client with rheumatoid arthritis is experiencing morning stiffness. Which of the following actions should the nurse take?
- A. Encourage the client to avoid physical activity in the morning.
- B. Encourage the client to take NSAIDs before bedtime.
- C. Apply cold packs to the affected joints in the morning.
- D. Perform passive range-of-motion exercises before getting out of bed.
Correct answer: C
Rationale: The correct action the nurse should take is to apply cold packs to the affected joints in the morning. Rheumatoid arthritis is characterized by inflammation, and applying cold packs can help reduce inflammation and stiffness in the joints. Encouraging the client to avoid physical activity in the morning (Choice A) may worsen stiffness, as movement is beneficial for joint mobility. While NSAIDs (Choice B) can help with pain and inflammation, applying cold packs directly to the affected joints is more targeted and effective. Performing passive range-of-motion exercises (Choice D) can be helpful, but applying cold packs is the priority for reducing inflammation and stiffness.
5. What are the expected ECG changes in hypokalemia?
- A. Flattened T waves
- B. ST elevation
- C. Wide QRS complex
- D. Tall T waves
Correct answer: A
Rationale: Flattened T waves are the most common ECG change seen in patients with hypokalemia. Hypokalemia leads to a decrease in serum potassium levels, affecting the repolarization phase of the cardiac action potential. This results in T wave flattening or inversion. ST elevation is typically seen in conditions like myocardial infarction, not in hypokalemia. Wide QRS complex is more associated with hyperkalemia than hypokalemia. Tall T waves are often seen in hyperkalemia, not hypokalemia.
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