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1. A nurse is caring for a client wh...
ATI RN ADULT MEDICAL SURGICAL PROCTORED EXAM
2023/2024 VERSION (NGN) WITH 100% CORRECT
ANSWERS
1. A nurse is providing care for a woman in the first stage of labor. Upon assessment,
the nurse notices the umbilical cord has descended through the vaginal opening
ahead of the baby's presenting part. Which of the following is the most appropriate
action for the nurse to take first?
- Contact the physician/midwife immediately
- Insert a gloved hand into the vagina to relieve pressure on the cord.
- Reassure the client that this is a normal part of labor
- Document the findings and continue to monitor the fetal heart rate
2. How should a nurse respond if a colleague wraps an arm around them and comments,
"I'm sure you're an excellent lover"
- Report the incident to a supervisor or human resources department to address the
inappropriate behavior according to the workplace policies.
- Respond by clearly stating that such personal comments are not acceptable in a
professional setting and request that it not happen again.
- Politely ask the colleague to remove their arm and express that the comment is
inappropriate and makes them uncomfortable.
- Ignore the comment and physical gesture at the moment, but document the incident and
seek advice from a trusted mentor on how to proceed.
3. When a nurse observes neck flushing and a rapid heartbeat in a patient receiving
intravenous vancomycin, what steps should the nurse take?
- Decrease the infusion rate to prevent further adverse effects.
- Notify the healthcare provider or physician of the patient's symptoms, as they
may indicate an adverse reaction to the medication.
- Monitor the patient's vital signs closely, including blood pressure and oxygen
saturation, to assess their condition.
, - Provide supportive care to the patient, such as ensuring they are comfortable
and administering prescribed treatments for the reaction, if any.
4. When conducting an assessment on an elderly male client at home, what should a nurse
prioritize?
- Mobility and balance issues.
- Dysphagia
- Medication adherence and understanding.
- Signs of cognitive decline or confusion.
5. What should be included in the care plan for a patient with Alzheimer's disease by a nurse
in a long-term care facility?
-Talk the client through tasks one step at a time.
-Assign complex new tasks daily to challenge cognitive skills.
-Frequently rearrange the room to provide variety.
-Limit social interactions to reduce overstimulation.
6. In managing a cancer patient who has been prescribed ondansetron for chemotherapy-
induced nausea, what side effect should a nurse monitor for?
- Increased appetite
- Headache
- Improved hair growth
- Enhanced sense of taste
7. What adverse effect of metronidazole should a nurse warn a patient about regarding
, changes in taste?
Metallic taste
8. Which task can a nurse on a medical-surgical unit safely assign to nursing assistive
personnel (AP)?
Collecting a random stool sample
9. How should a nurse respond to a patient expressing feelings of hopelessness and stating
life isn’t worth living?
“I care about you and I am concerned that you feel so sad.”
10. For a patient with chronic renal disease on epoetin alfa therapy, which lab result should a
nurse check to evaluate the medication's effectiveness?
The hematocrit (Hct) level
11. Before administering amphotericin B to a patient with a fungal infection, which lab result
should a nurse communicate to the healthcare provider?
BUN 55 mg/dL
12. For a female patient with a T4 spinal cord injury at risk for UTIs, what should be included
in her care plan by the nurse?
Encourage fluid intake during and between meals
13. An elderly man is brought to the ER after being found disoriented outside. He winces
during abdominal palpation but only nods and smiles in response to questions. What is the
most likely reason for his behavior according to the nurse?
Confusion
14. When a nurse is informed by an LPN that a patient with an IV infusion exhibits warmth
around the insertion site, what condition should the nurse suspect?
“The area surrounding the insertion site feels warm to the touch.”
15. A patient experiencing chemotherapy-induced peripheral neuropathy is likely to report
what symptom, according to the nurse’s expectation?
, Tingling feelings in the extremities
16. At a health fair for seniors, what food item should a nurse advise participants to avoid when
taking medication?
Grapefruit juice
17. What symptom indicates placenta previa in a patient who is 36 weeks pregnant, as
observed by a nurse?
Painless red vaginal bleeding
18. A pregnant woman in her first trimester expresses doubts about her pregnancy despite it
being planned. How should the nurse respond?
“Ambivalent feelings are very common for women early in pregnancy.”
19. Is it acceptable for a charge nurse to share her personal password for accessing electronic
patient records?
No
20. If a patient accidentally starts a fire in his bathroom by dropping a cigarette, what is the
nurse's immediate action?
Move any clients in the immediate vicinity.
21. In reviewing the arterial blood gas results of a patient with chronic kidney disease, what
values should the nurse anticipate seeing?
pH 7.25, HCO3- 19mEq/L, PaCO2 30 mmHg
22. When caring for a child suspected of having Wilms tumor, what type of warning sign
should the nurse hang over the patient's bed?
Do not palpate abdomen
23. If a patient experiences abdominal cramps while receiving a tap water enema for
constipation, what should the nurse do to alleviate the discomfort?
Lower the height of the solution container.
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