ATI MED SURGE PROCTORED EXAM 2019 FORM B

ATI MED SURGE PROCTORED EXAM 2019

FORM B


1. A nurse is caring for a client who has Cushing's syndrome. Which of the following clinical

manifestations should the nurse expect to observe? (Select all that apply.)

1) Buffalo hump

2) Purple striations

3) Moon face

INCORRECT

4) Tremors

INCORRECT

5) Obese extremities

Answer Rationale:

Buffalo hump is correct. Cushing's syndrome is a disease caused by an increased production ofcortisol or by excessive use

of corticosteroids. Buffalo hump, a collection of fat between the shoulders, is a common manifestation of Cushing's

syndrome.Purple striations is correct.

Purple striations on the skin of the abdomen, thighs, and breasts are a common manifestation ofCushing's syndrome.

This is due to the collection of body fat in these areas.Moon face is correct. Moon face is a common manifestation of

Cushing's syndrome. Clients who have this manifestation present with a round, red, full face.Tremors is

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incorrect. Tremors are not a common finding of Cushing's syndrome.Obese extremities is incorrect. Clients who have

Cushing's syndrome have truncal obesity, a protuberant abdomen,with thin extremities, which is due to an alteration in

protein metabolism.

2. A nurse is assisting with the care of a client immediately following a lumbar puncture. Which

of the following actions should the nurse take? (Select all that apply.)

1) Encourage fluid intake.

2) Monitor the puncture site for hematoma.

INCORRECT

3) Insert a urinary catheter.

INCORRECT

4) Elevate the client’s head of bed.

INCORRECT

5) Apply a cervical collar to the client.

Answer Rationale:

Encourage fluid intake is correct. The nurse should encourage fluids, unless contraindicated, toreplace the cerebrospinal

fluid that was removed during the procedure and reduce the risk for a headache.

Monitor the puncture site for a hematoma is correct. The nurse should monitor and report a

hematoma at the insertion site because this can indicate bleeding.

Insert a urinary catheter is incorrect. There is no indication for a urinary catheter insertion.

Elevate the client’s head of bed is incorrect. The client should remain flat in bed for 1 hr ormore

to reduce the risk for a headache.

Apply a cervical collar to the client is incorrect. There is no indication for a cervical collar forthis

client.

3. A nurse is reinforcing pre-operative teaching for a client who is scheduled for surgery and is to

take hydroxyzine preoperatively. Which of the following effects of the medication should the

nurse include in the teaching? (Select all that apply.)

1) Decreasing anxiety

2) Controlling emesis

INCORRECT

3) Relaxing skeletal muscles

INCORRECT

4) Preventing surgical site infections

5) Reducing the amount of narcotics needed for pain relief

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