ATI RN
Adult Medical Surgical ATI
1. A client had a total hip arthroplasty. Which of the following prescriptions should the nurse verify with the provider?
- A. Administer enoxaparin 30 mg subcutaneously every 12 hr
- B. Place a wedge or pillow between the client's legs when turning.
- C. Instruct the client to restrict flexion of the hip past 120°.
- D. Encourage the client to perform foot and calf exercises every 2 hr
Correct answer: Instruct the client to restrict flexion of the hip past 120°.
Rationale: Following a total hip arthroplasty, the client should be instructed to restrict hip flexion past 90 degrees to prevent dislocation of the prosthesis. Restricting flexion past 120 degrees is excessive and could lead to complications. Therefore, the nurse should verify this prescription with the provider to ensure the client's safety and proper postoperative care.
2. Maryann is pregnant and works in a smoke-filled environment. What can you tell her about passive smoking?
- A. The negative effects of smoking are only evident in children born to heavy smokers.
- B. Passive smoking is related to low birth weight, infant death, and childhood respiratory illnesses.
- C. Smoke-filled environments are harmful to expectant mothers, but not to their unborn children.
- D. The effects of passive smoking are not yet known.
Correct answer: B
Rationale: Passive smoking, also known as secondhand smoke, can have harmful effects on pregnancies. Research has shown that exposure to smoke-filled environments during pregnancy is linked to low birth weight, infant death, and childhood respiratory illnesses. Pregnant women should avoid exposure to secondhand smoke to protect the health of their unborn babies. Choice A is incorrect because passive smoking affects both the mother and the unborn child, not just children born to heavy smokers. Choice C is incorrect as it underestimates the risks of smoke-filled environments on unborn children. Choice D is incorrect as research has already established the harmful effects of passive smoking on pregnancies.
3. What are the expected findings in a patient with hypokalemia?
- A. Cardiac dysrhythmias
- B. Seizures and confusion
- C. Bradycardia
- D. Muscle weakness
Correct answer: A
Rationale: The correct answer is A: Cardiac dysrhythmias. Hypokalemia is commonly associated with cardiac dysrhythmias due to the role potassium plays in maintaining proper electrical conduction in the heart. Choices B, C, and D are incorrect. While hypokalemia can lead to muscle weakness, the most critical and life-threatening manifestation is cardiac dysrhythmias. Seizures and confusion are more commonly associated with other electrolyte imbalances, such as hyponatremia. Bradycardia is not a typical finding in hypokalemia, as it tends to cause tachycardia or other arrhythmias.
4. This medication type is used to relax and widen blood vessels, improving blood flow and reducing blood pressure.
- A. Vasodilator
- B. Anticoagulant
- C. Diuretic
- D. Beta-blocker
Correct answer: A
Rationale: The correct answer is A: Vasodilator. Vasodilators are medications that work by relaxing and widening blood vessels, which improves blood flow and reduces blood pressure. They are commonly used in the treatment of heart conditions. Anticoagulants (choice B) are medications that prevent blood clot formation, diuretics (choice C) increase urine production to reduce fluid retention, and beta-blockers (choice D) reduce heart rate and workload on the heart. These mechanisms differ from the action of vasodilators.
5. A school nurse is assessing a female high school student who is overly concerned about her appearance. The client's mother states, 'That's not something to be stressed about!' Which is the most appropriate nursing response?
- A. Teenagers! They don't know a thing about real stress.
- B. Stress occurs only when there is a loss.
- C. When you are in poor physical condition, you can't experience psychological well-being.
- D. Stress can be psychological. A threat to self-esteem may result in high stress levels.
Correct answer: D
Rationale: The correct answer is D. Stress can manifest as physical or psychological. A perceived threat to self-esteem can be as stressful as a physiological change. Choice A is dismissive of the teenager's concerns and does not address the issue professionally. Choice B is incorrect as stress can result from various factors, not just loss. Choice C oversimplifies the relationship between physical condition and psychological well-being, neglecting the impact of mental stressors on overall health.
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