ATI PN Medical Surgical practice questions with answers

Free ATI PN Medical Surgical Questions

A nurse is collecting data from an older adult client. Which of the following findings should indicate to the nurse that the client has a bladder infection?

A. Temperature 37.3° C (99.1° F)
B. Changed mental status
C. WBC count 9,000/mm³ (5,000 to 10,000/mm³)
D. Diminished reflexes

Explanation

Older adults often present atypically when they have an infection. Instead of showing classic signs such as fever or significant elevation in white blood cell count, they frequently develop acute confusion, agitation, lethargy, or other changes in mental status. This occurs because infections—especially urinary tract infections—can precipitate delirium in the elderly due to reduced physiological reserves and age-related neurological vulnerability. A temperature of 37.3°C is normal, the WBC count shown is within normal range, and diminished reflexes are unrelated to bladder infections. Therefore, a sudden or noticeable change in mental status is the most reliable indicator of a bladder infection in an older adult.

Correct Answer Is:

B. Changed mental status

A nurse is reviewing the laboratory data of a client who is scheduled for a liver biopsy. Which of the following values should the nurse report to the provider?

A. Bilirubin 1.0 mg/dL (0.3 to 1.0 mg/dL)
B. Aspartate aminotransferase 34 units/L (0 to 34 units/L)
C. Ammonia 55 mcg/dL (10 to 80 mcg/dL)
D. Platelets 60,000/mm³ (150,000 to 400,000/mm³)

Explanation

A liver biopsy carries a significant risk of bleeding because the liver is a highly vascular organ. Before the procedure, the nurse must assess the client’s coagulation status, and platelet count is one of the most critical indicators. A normal platelet range is 150,000–400,000/mm³, and a count of 60,000/mm³ is markedly low (thrombocytopenia). Platelets are essential for clot formation; therefore, a severely reduced platelet count greatly increases the risk of uncontrolled bleeding during or after the biopsy. This finding must be reported immediately because the provider will likely delay the biopsy until the client’s coagulation status is corrected, possibly requiring platelet transfusion or further evaluation. The other lab values are within normal limits and do not pose an immediate procedural risk.

Correct Answer Is:

D. Platelets 60,000/mm³

An occupational health nurse is interpreting the results of a tuberculin skin test for a group of clients who received the test 48 hrs ago. Which of the following clients should the nurse identify as having a positive test result?

a) A client whose injection site has an elevated area measuring 15 mm (0.6 in)
b) A client whose injection site is scabbed
c) A client whose injection site is firm and measures 3 mm (0.1 in)
d) A client whose injection site is ecchymotic

Explanation

a) A client whose injection site has an elevated area measuring 15 mm (0.6 in)
A tuberculin skin test is interpreted by measuring the area of induration, not redness, bruising, or scabbing. An induration of 15 mm or greater is considered positive for any client, regardless of risk factors. A positive result indicates exposure to Mycobacterium tuberculosis and requires follow-up testing, such as a chest x-ray. Scabbing and ecchymosis do not represent induration, and an induration of 3 mm is considered negative.

Correct Answer Is:

a) A client whose injection site has an elevated area measuring 15 mm (0.6 in)

A nurse is preparing to obtain a postprandial blood glucose level from a client who has diabetes mellitus. Which of the following actions should the nurse take?

a) Apply the first drop of blood to the test strip.
b) Clean the client's finger with hexachlorophene.
c) Prick the central tip of the client's finger.
d) Hold the client's finger in a dependent position.

Explanation

Holding the finger in a dependent (downward) position promotes blood flow to the fingertip, making it easier to obtain an adequate blood sample. This reduces the need for excessive squeezing, which can dilute the sample with tissue fluid and affect accuracy. Dependent positioning ensures a clean, sufficient blood drop for an accurate glucose measurement.

Correct Answer Is:

d) Hold the client's finger in a dependent position.

A nurse is reinforcing teaching about foot care with a client who has diabetes mellitus. Which of the following client statements indicates understanding of the teaching?

a) "I should put lotion between my toes every day to prevent dryness and cracking."
b) "I should apply a heating pad to my feet every night to help with circulation."
c) "I should use my wrist to test the temperature of the water before bathing."
d) "I should round the corners of my toenails with a nail file to prevent ingrown nails."

Explanation

c) "I should use my wrist to test the temperature of the water before bathing."
Clients with diabetes often experience peripheral neuropathy, which decreases sensation in the hands and feet. Because of this, they are unable to reliably detect excessively hot water and are at higher risk for burns. Using the wrist, which has better temperature sensitivity, allows the client to accurately assess water temperature and avoid injury. This method is a key safety practice in diabetic foot and skin care and demonstrates correct understanding of how to prevent burns and skin breakdown.

Correct Answer Is:

c) "I should use my wrist to test the temperature of the water before bathing."

A nurse is caring for a client who has a prescription for propranolol for the treatment of atrial fibrillation. Which of the following actions should the nurse take?

A. Request a dosage increase if the apical heart rate is less than 60/min.
B. Withhold the medication if the systolic blood pressure is less than 90 mm Hg.
C. Administer the medication with an antacid.
D. Instruct the client to expect increased hair growth.

Explanation

Propranolol, a beta-blocker, lowers heart rate and blood pressure. The nurse should hold the medication if the systolic BP is less than 90 mm Hg because giving it could cause severe hypotension. The medication should also be withheld if the apical pulse is less than 60/min, not increased as in option A. Antacids can interfere with absorption, so option C is incorrect. Propranolol does not cause increased hair growth.

Correct Answer Is:

B. Withhold the medication if the systolic blood pressure is less than 90 mm Hg.

A nurse is reinforcing teaching with a client who has ovarian cancer and will receive chemotherapy through a peripherally inserted central catheter (PICC) line. Which of the following statements by the client indicates an understanding of the teaching?

a) "I will wear an arm immobilizer to prevent dislodgement of this device."
b) "I will monitor my temperature for fever while I have this device."
c) "It's okay to get the device wet when I shower."
d) "I should pull the dressing away from the insertion site when I change it."

Explanation

Clients with PICC lines are at risk for central line–associated bloodstream infections (CLABSIs). Monitoring temperature daily allows early detection of infection, which is especially important for immunocompromised clients receiving chemotherapy. This statement shows correct understanding of PICC line care. The device should not get wet, dressings must be removed gently and sterilely, and arm immobilizers are not required and increase clotting risk.

Correct Answer Is:

b) "I will monitor my temperature for fever while I have this device."

A nurse is caring for a client who is in skin traction. Which of the following actions should the nurse take?

a) Loosen the ropes of the pulleys when repositioning the client in bed.
b) Inspect the client's skin every 12 hr for signs of breakdown.
c) Ensure the weights hang freely from the client's bed.
d) Maintain 6.8 kg (15 lb) of weight for the client's skin traction.

Explanation

c) Ensure the weights hang freely from the client's bed.
For skin traction to be effective, the weights must hang freely at all times without resting on the floor or bed. This constant, unobstructed pull maintains proper alignment of the affected extremity and reduces muscle spasms. If the weights do not hang freely, traction is interrupted, which can lead to pain, ineffective treatment, or injury. The nurse’s priority is to ensure proper setup and functioning of the traction system.

Correct Answer Is:

c) Ensure the weights hang freely from the client's bed.

A nurse is reinforcing teaching with a client who has gastroesophageal reflux disease. Which of the following dietary instructions should the nurse include?

a) Chew food thoroughly.
b) Use a straw when drinking liquids.
c) Drink carbonated beverages with meals.
d) Limit meals to three per day with no snacking in between.

Explanation

Chewing food thoroughly helps reduce the workload on the stomach and decreases the risk of reflux by promoting easier, more efficient digestion. Well-chewed food is less likely to contribute to gastric distention, which can worsen GERD symptoms. Additionally, taking time to chew slows down eating, which helps prevent overeating—another trigger for reflux. The other options worsen GERD by increasing swallowed air, gastric pressure, or by encouraging large meals rather than smaller, more frequent ones.

Correct Answer Is:

a) Chew food thoroughly.

10.

A nurse is preparing a client for a colposcopy following an abnormal Papanicolaou (Pap) test. Which of the following actions should the nurse take?

a) Place the client in the Sims' position.
b) Reinforce teaching that the procedure involves dilation of the cervix.
c) Insert a tampon following the procedure.
d) Instruct the client to avoid sexual intercourse until the cervix is healed.

Explanation

Following a colposcopy—especially when a cervical biopsy is taken—the client must avoid sexual intercourse, douching, and tampon use for several days to allow proper cervical healing and reduce infection risk. The procedure does not require cervical dilation, tampons should be avoided (not inserted), and the client should be placed in the lithotomy position, not Sims'. This instruction ensures safe recovery after the procedure.

Correct Answer Is:

d) Instruct the client to avoid sexual intercourse until the cervix is healed.

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ATI PN Medical Surgical

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ATI PN Medical Surgical practice questions with answers | nursingprepplug.com

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