2023 ATI RN Advanced Medical Surgical Proctored Exam NGN With Answers (55 Solved Questions)

RN ATI ADVANCED MEDICAL SURGICAL PROCTORED EXAM 2023 WITH NGN (Answer key at the end) QUESTION 1 QUESTION 2 QUESTION 3 QUESTION 4 QUESTION 5 QUESTION 5 A patient is hospitalized for initiation of regional antibiotic irrigation for acute osteomyelitis of the right femur. Which intervention will be included in the plan of care? a. Immobilization of the right leg b. Avoiding administration of nonsteroidal anti-inflammatory drugs (NSAIDs) c. Frequent weight-bearing exercise d. Support of the right leg in a flexed position The correct answer is: Immobilization of the right leg Immobilization of the affected leg helps decrease pain and reduce the risk for pathologic fractures. Weight-bearing exercise increases the risk for pathologic fractures. NSAIDs are frequently prescribed to treat pain. Flexion of the affected limb is avoided to prevent contractures. Discharge teaching for the patient with esophageal reflux disease includes instructing the patient to: a. Decrease protein intake b. Elevate the foot of the bed with 6-inch blocks c. Eat a high-carbohydrate snack before bed d. Reduce caffeine intake and smoking The correct answer is: Reduce caffeine intake and smoking Once healing has occurred, persons with a hip prosthesis are encouraged to participate in: a. High-impact exercises such as swimming b. Low-impact exercises such as jogging c. High-impact exercises such as bowling d. Low-impact exercises such as walking The correct answer is: Low-impact exercises such as walking A patient with glaucoma who has been using timolol (Timoptic) drops for several days tells the nurse that the eyedrops cause eye burning and visual blurriness for a short time after administration. The best response to the patient’s statement is a. “These symptoms are caused by glaucoma and may indicate a need for an increased dosage of the eyedrops.” b. “The drops are uncomfortable, but it is very important for you to use them as prescribed to retain your vision.” c. “These are normal side effects of the drug, which should become less noticeable with time.” d. “If you occlude the puncta after you administer the drops, it will help relieve these side effects.” The correct answer is: “The drops are uncomfortable, but it is very important for you to use them as prescribed to retain your vision.” Patients should be instructed that eye discomfort and visual blurring are expected side effects of the ophthalmic drops but that the drops must be used to prevent further visual-field loss. The temporary burning and visual blurriness might not lessen with ongoing use, are not relieved by avoiding systemic absorption, and are not symptoms of glaucoma. Patients should be taught that Zollinger-Ellison syndrome is: a. An ulcerative syndrome caused by a gastrinoma b. An infectious syndrome caused by Helicobacter pylori c. Related to the indiscriminate use of nonsteroidal antiinflammatory drugs (NSAIDs) d. A type of peptic ulcer related to stress The correct answer is: An ulcerative syndrome caused by a gastrinoma After a patient has a short-arm plaster cast applied in the emergency department, which statement by the patient indicates a good understanding of the nurse’s discharge teaching? a. “I can use a cotton-tipped applicator to rub lotion on any dry areas under the cast.” b. “I should avoid moving my fingers and elbow until the cast is removed.” c. “I can get the cast wet as long as I dry it right away with a hair dryer.” d. “I will apply an ice pack to the cast over the fracture site for the next 24 hours.” The correct answer is: “I will apply an ice pack to the cast over the fracture site for the next 24 hours.” Ice application for the first 24 hours after a fracture will help reduce swelling and can be placed over the cast. Plaster casts should not get wet. The patient should be encouraged to move the joints above and below the cast. Patients should not insert objects inside the cast. The leading cause of blindness in the elderly is: a. Glaucoma b. Macular degeneration c. Ocular tumors d. Retinal detachment The correct answer is: Macular degeneration Which describes a fracture located at a 45-degree angle to the long axis of bone? a. Oblique fracture b. Impacted fracture c. Avulsion fracture d. Compound fracture The correct answer is: Oblique fracture Dumping syndrome after gastric surgery: a. Can be controlled by increasing fluid ingestion b. Produces a sudden decrease in blood glucose, initiating gastric emptying c. Is caused by rapid emptying of hypertonic chyme into the jejunum d. Is treated most effectively with a high-cholesterol, low-fat diet and fluid restriction The correct answer is: Is caused by rapid emptying of hypertonic chyme into the jejunum When performing an eye examination, the nurse will assess for accommodation by a. observing the pupils when the patient focuses on a close object and then on a distant object. b. shining a light into the patient’s eye and watching the pupil response in the opposite eye. c. touching the patient’s pupil with a small piece of sterile cotton and watching for a blink reaction. d. covering one eye for 1 minute and noting the pupil reaction when the cover is removed. Accommodation is defined as the ability of the lens to adjust to various distances. The other nursing actions also may be part of the eye examination, but they do not test for accommodation. The correct answer is: observing the pupils when the patient focuses on a close object and then on a distant object. Which is classic indication of hip fracture? a. Internal rotation of the injured leg b. Shortening and external rotation of the injured leg c. Groin pain accompanied by urinary retention d. Absence of pedal pulses on the affected side The correct answer is: Shortening and external rotation of the injured leg After ear surgery, patients are taught to: a. Open the mouth and nose while coughing b. Take medication to suppress coughing c. Avoid coughing for the first week after surgery d. Cough as infrequently as possible The correct answer is: Open the mouth and nose while coughing Long-term drug therapy for the patient with gastroesophageal reflux disease includes proton-pump inhibitors such as: a. Diazepam (Valium) b. Omeprazole (Prilosec) c. Bethanechol (Urecholine) d. Metoclopramide (Reglan) The correct answer is: Omeprazole (Prilosec) Which is the most common complication after hip or knee replacement? a. Deep vein thrombosis b. Paralytic ileus c. Pneumonia d. Joint dislocation The correct answer is: Deep vein thrombosis