RN ATI ADVANCED MEDICAL SURGICAL PROCTORED EXAM 2023/2024 WITH NGN

A patient with a comminuted fracture of the right femur has Buck's traction in place while waiting for surgery. To assess for pressure areas on the patient's back and sacral area and to provide skin care, the nurse should a. turn the patient partially to each side with the assistance of another nurse. b. loosen the traction and have the patient turn onto the unaffected side. c. place a pillow between the patient's legs and turn gently to each side. d. have the patient lift the buttocks by bending and pushing with the left leg. The correct answer is: have the patient lift the buttocks by bending and pushing with the left leg. The patient can lift the buttocks off the bed by using the left leg without changing the right-leg alignment. Turning the patient will tend to move the leg out of alignment. Disconnecting the traction will interrupt the weight needed to immobilize and align the fracture. Which teaching is appropriate for the person with recently diagnosed peptic ulcer disease? a. "Nausea is a common side effect of the medications that have been prescribed for you." b. "You will recover more quickly if you follow your drug treatment guidelines closely." c. "Increasing your intake of milk and milk-based products will facilitate healing." d. "Limiting your physical activities will help decrease the acid your stomach produces." The correct answer is: "You will recover more quickly if you follow your drug treatment guidelines closely." A patient with recurring heartburn receives a new prescription for esomeprazole (Nexium). In teaching the patient about this medication, the nurse explains that this drug a. treats gastroesophageal reflux disease by decreasing stomach acid production b. reduces the reflux of gastric acid by increasing the rate of gastric emptying. c. coats and protects the lining of the stomach and esophagus from gastric acid. d. neutralizes stomach acid and provides relief of symptoms in a few minutes. The correct answer is: treats gastroesophageal reflux disease by decreasing stomach acid production. The proton pump inhibitors decrease the rate of gastric acid secretion. Promotility drugs such as metoclopramide (Reglan) increase the rate of gastric emptying. Cryoprotective medications such as sucralfate (Carafate) protect the stomach. Antacids neutralize stomach acid and work rapidly. Which nursing action is completed for the postoperative patient who has a new prosthetic hip device? a. Advise patient to prevent adduction of the affected leg for at least 4 months b. Obtain an overhead trapeze frame for the bed c. Discourage patient from abducting the affected leg for at least 2 months d. Assist the patient to a sitting position at least daily The correct answer is: Discourage patient from abducting the affected leg for at least 2 months Compartment syndrome may occur if which condition is present? a. Nerve damage preceding ischemic changes b. Increased tissue pressure leading to decreased blood supply c. A cast or traction applied to the affected limb d. Metabolic acidosis resulting in electrolyte imbalance The correct answer is: Increased tissue pressure leading to decreased blood supply When admitting a patient with a stroke who is unconscious and unresponsive to stimuli, the nurse learns from the patient's family that the patient has a history of gastroesophageal reflux disease (GERD). The nurse will plan to do frequent assessments of the patient's a. breath sounds. b. apical pulse. c. abdominal girth. d. bowel sounds. The correct answer is: breath sounds. Because GERD may cause aspiration, the unconscious patient is at risk for developing aspiration pneumonia. Bowel sounds, abdominal girth, and apical pulse will not be affected by the patient's stroke or GERD and do not require more frequent monitoring than the routine. Which nursing actions effectively control swelling of a fractured extremity? a. Heating pad and massage b. Massage and an ice pack c. Extremity elevation and ice d. Narcotic analgesic and heating pad The correct answer is: Extremity elevation and ice Which sign indicates neurovascular impairment? a. Patient complaints of dull aching of the affected limb b. Decreased capillary refill time proximal to a fracture c. Diminished or absent pulses below the fracture d. Pale toes distal to a fracture that are warm to the touch The correct answer is: Diminished or absent pulses below the fracture Prednisone (Deltasone) is prescribed for a patient with an acute exacerbation of rheumatoid arthritis. Which laboratory result will the nurse monitor to determine whether the medication has been effective? a. Blood glucose test b. Serum electrolyte levels c. Liver function tests d. C-reactive protein level The correct answer is: C-reactive protein level C-reactive protein is a marker for inflammation, and a decrease would indicate that the corticosteroid therapy was effective. Blood glucose and serum electrolyte levels also will be monitored to check for side effects of prednisone. Liver function is not routinely monitored for patients receiving steroids. The nurse at the eye clinic advises all patients to wear sunglasses that protect the eyes from ultraviolet light because ultraviolet sunlight exposure is associated with the development of a. cataracts. b. glaucoma. c. anisocoria. d. exophthalmos. The correct answer is: cataracts. Ultraviolet light exposure is associated with the accelerated development of cataracts. Glaucoma is caused by increased intraocular pressure, exophthalmos is associated with hyperthyroidism, and anisocoria can occur normally in a small percentage of the population or may be caused by injury or central nervous system disorders. In reviewing a 50-year-old patient's medical record, the nurse notes that the last eye examination revealed an intraocular pressure of 28 mm Hg. The nurse will plan to assess a. color perception. b. peripheral vision.