ATI RN ADULT MEDICAL SURGICAL PROCTORED EXAM 2019
WITH NGN QUESTIONS AND ELABORATIONS GRADED A+
1. A nurse is caring for a client who is Postoperative following a bilateral adrenalectomy. The Nurse should
expect to administer glucocorticoids following the procedure to enhance which of the follow...
ATI RN ADULT MEDICAL SURGICAL PROCTORED EXAM 2019
WITH NGN QUESTIONS AND ELABORATIONS GRADED A+
1. A nurse is caring for a client who is Postoperative following a bilateral adrenalectomy. The Nurse should
expect to administer glucocorticoids following the procedure to enhance which of the following therapeutic
effects?
B. Inhibit glucose metabolism
C. Compensate for decreased cortisol levels
D. Decrease susceptibility to infection
E. Acts as a diuretic to maintain urine output
Answer B
Rational: with an adrenalectomy, the client requires glucocorticoids before, during, and after surgery to prevent
an adrenal crisis caused by a sudden drop in cortisol levels. One of the hormones produced by the
glucocorticoid. Loss of glucocorticoid secretion leads to a state of altered metabolism and an inability to deal
with stressors, Which is fatal if untreated
1. A nurse is reviewing the laboratory values for a client who has hyperglycemic hyperosmolar nonketotic
syndrome. Which of the following laboratory values is consistent with hyperglycemic hyperosmolar
nonketotic syndrome?
A. Positive Urine Ketones
B. Blood pH 7.34
C. Blood Glucose 320 mg/dL
D. Blood osmolality >350mOsm/kg
Answer C.
Rational: A client who has hyperglycemic hyperosmolar nonketotic syndrome should have a blood glucose
level >250 mg/dL, which will cause spilling of ketones in the urine and development of metabolic acidosis
3. A nurse is assisting with the plan of care for a client who has Cushing’s syndrome due to chronic
corticosteroid use. Which of the following actions should the nurse include in the plan of care? (SATA)
A. Check the client’s blood glucose for hypoglycemia
B. Check for hypertension
C. Weigh the client weekly
D. Insert an indwelling urinary catheter for the client
E. Check for infection
F. Weigh the client daily
G. Check for blood sugar
Rationale: The nurse should check the client for hypertension, which can indicate fluid volume overload.
4. A nurse is assisting with the plan of care for a client who has Cushing’s syndrome due to chronic
corticosteroids use. Which of the following actions should the nurse include in the plan of care?
A. Check the client’s blood glucose for the hyperglycemia
B. Check for hypertension
C. Weigh the client weekly
D. Insert an indwelling urinary catheter for the client.
1
,Answer: A
2
, Rational: The nurse should check the client for hyperglycemia because hypercortisolism elevated blood glucose
levels.
5. A nurse is preparing a 24- hour urine specimen for a client who is suspected to have
pheochromocytoma. Which of the following laboratory tests from the 24- hour specimen should the
nurse use to determine the client’s condition?
A. Creatinine clearance
B. Catecholamine metabolites
C. 17-hydroxycorticosteroids (17-OHCS)
D. Protein
Answer. B
Rational: The nurse should expect the 24-urine specimen to test for Catecholamine metabolites. The test is used
to determine if the client has pheochromocytoma, which measures the levels of catecholamines( epinephrine
and norepinephrine ) secretion in a 24- hr urine sample. pheochromocytoma is a rumor of the adrenal gland that
causes excess release of the catecholamines (epinephrine and norepinephrine), which are hormones that regulate
blood pressure and heart rate.
6. A Nurse is reinforcing teaching with a client who has Addison’s disease about healthy snacks foods.
Which of the following food choices by the client indicates an understanding of the teaching?
A. Sliced Bananas
B. Turkey and cheese sandwich
C. Baked potato
D. Plain yogurt with peaches
Answer B
Rational: A turkey and cheese sandwich is high in protein, carbohydrates, and sodium. The client who has
Addison’s disease requires a diet low in potassium and high in sodium, carbohydrates, and protein. Addison’s
disease is a hormone deficiency caused by damage to the outer layer of the adrenal gland (adrenal cortex).
Addison’s disease occurs when the adrenal glands do not produce enough of the hormone cortisol and, in some
cases, the hormone aldosterone.
7. A nurse is collecting data from a client who has manifestations of acromegaly. Which of the following
findings should the nurse expect?
A. Concave chest wall
B. Thinning of skeletal bone structure
C. Increased head size
D. Cardiomegaly
E. High-pitched voice
Answer C
Rational: The client who has acromegaly will manifest an enlarged head size due to the excessive production of
growth hormones after closing of the epiphyses (the "growth plate" at the ends of the long bones) by the
pituitary gland. It results in the gradual enlargement of the client's body tissues, such as the bones of the face,
jaw, hands, feet, and skull.
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