ATI RN
ATI RN Adult Medical Surgical 2023 Questions Correct Answers Questions
Extract:
A client reports after eating breakfast this morning 0630hrs that they began feeling a tightness in the chest that radiates to the left arm. History: Hyperlipidemea, Hpertension, type 2 diabetes mellitus, Non- smoker, Denies use of alcohol or recreational drug abuse.
Time: 1000hrs Temperature, Heart Rate, Respiratory Rate, Blood Pressure, Oxygen Saturation 1000 37.1°C (98.8°F) 110/min (irregular) 24/min 164/80 mmHg 93% on room air 1015 36.7°C (98.2°F) 120/min (irregular) 22/min 176/82 mmHg 89% on room air. Time: 1015hrs Temperature, Heart Rate, Respiratory Rate, Blood Pressure,Oxygen Saturation 1000 37.1°C (98.8°F) 110/min (irregular) 24/min 164/80 mmHg 1015 36.7°C (98.2°F) 120/min (irregular) 22/min 176/82 mmHg 89% on room air 1200 36.7°C (98.2°F)
Question 1 of 5
For each potential provider's prescription, click to specify if the potential prescription is anticipated, Non-essential or contraindicated for the client.
| Potential Prescription | Anticipated | Non-essential | Contraindicated |
|---|---|---|---|
| Metoprolol 15 mg IV bolus | |||
| Oxygen at 2 L/min via nasal cannula | |||
| Draw electrolytes along with Hgb and Hct | |||
| Morphine 6 mg IV bolus every 3 hrs as needed for pain | |||
| Nitroglycerin 0.5 mg SL now may repeat every 5 min up to 3 doses | |||
| Obtain daily weight |
Correct Answer: A,B,C,D E, F
Rationale: [1,1,1,1,1,1]
- Metoprolol 15 mg IV bolus: Anticipated for managing hypertension or tachycardia.
- Oxygen at 2 L/min via nasal cannula: Anticipated for hypoxemia.
- Draw electrolytes along with Hgb and Hct: Anticipated for baseline assessment.
- Morphine 6 mg IV bolus every 3 hrs: Anticipated for pain management.
- Nitroglycerin 0.5 mg SL: Not included in the options.
- Obtain daily weight: Important for monitoring fluid status.
Extract:
Client reports tightness in chest radiating to the left arm. Pain level: 7/10. Feels nauseous after breakfast. Client states: 'I had scrambled eggs and bacon like I do every morning.' Symptoms: Diaphoresis, shortness of breath, irregular and tachycardic heart rate. Neurological Status: Alert and oriented to person, place, and time. Lung Sounds: Clear in all lobes. Bowel Sounds: Present in all 4 quadrants. Peripheral Circulation: +1 pedal pulses, skin cool to touch, capillary refill <2 seconds.
Question 2 of 5
Which actions should the nurse take? (Select all that apply)
Correct Answer: A, B, D,E
Rationale: The nurse should anticipate cardiac catheterization prep (
A) to ensure client readiness. Continuous heparin infusion (
B) prevents clot formation during the procedure. Increased metoprolol dosage (
D) may be needed for cardiac stability. NPO status (E) is crucial to prevent complications during the procedure. Ambulation (
C) may be contraindicated due to the invasive nature of the procedure. Antibiotics (F) are not routinely needed for cardiac catheterization prep.
Extract:
Client reports tightness in chest radiating to the left arm.
Pain level: 7/10. Feels nauseous after breakfast.
Client states: 'I had scrambled eggs and bacon like I do every morning.'
Symptoms: Diaphoresis, shortness of breath, irregular and tachycardic heart rate.
Neurological Status: Alert and oriented to person, place, and time.
Lung Sounds: Clear in all lobes.
Bowel Sounds: Present in all 4 quadrants.
Peripheral Circulation: +1 pedal pulses, skin cool to touch, capillary refill <2 seconds.
Vital Signs (1000 Hours)
Temperature: 37.1°C (98.8°F). Heart Rate: 110/min, irregular. Respiratory Rate: 24/min. Blood Pressure: 164/80 mmHg. Oxygen Saturation: 93% on room air
Vital Signs (1015 Hours)
Temperature: 36.7°C (98.2°F). Heart Rate: 120/min, irregular. Respiratory Rate: 22/min. Blood Pressure: 176/82 mmHg. Oxygen Saturation: 89% on room air.
Diagnostic Results
Myoglobin: 100 mcg/L (high, normal <90 mcg/L), Creatine kinase: 180 units/L (normal, 55-170 units/L), Troponin T: 0.40 ng/mL (high, normal <0.1 ng/mL), Troponin I: 0.35 ng/mL (high, normal <0.03 ng/mL), Cholesterol: 244 mg/dL (high, normal <200 mg/dL), Triglycerides: 180 mg/dL (normal, 40-160 mg/dL), LDL: 148 mg/dL (high, normal <130 mg/dL), HDL: 42 mg/dL (good, normal >45 mg/dL), C-reactive protein: 2 mg/L (high, normal <1.0 mg/L), Blood glucose: 103 mg/dL (normal, 74-106 mg/dL), EKG: Tachycardia with ST segment elevation & T wave changes, Chest X-ray: Lungs clear in all lobes.
Provider's Prescriptions - 1020:
Nitroglycerin 0.5 mg SL every 5 min up to 3 doses for chest pain
Aspirin 160 mg PO daily - Morphine 6 mg IV bolus every 3 hr PRN pain
Metoprolol 25 mg PO every 6 hrs x 48 hrs, then 100 mg PO twice daily
Initiate IV site - 0.9% saline at 50 mL/hr IV infusion
Oxygen at 2 L/min via nasal cannula if oxygen saturation <90%
Schedule stat echocardiogram
Follow-up (1200 Hours)
Pain now 5/10 after two doses of nitroglycerin. Breathing easier with oxygen at 2L/min via nasal cannula.
Question 3 of 5
Which findings indicate the client's condition has improved? (Select all that apply)
Correct Answer: A, B
Rationale: The correct answers are A and B. Pain level indicates the client's subjective improvement, while respiratory rate reflects their physiological status. Pain reduction suggests improved comfort and possibly better overall health, while a decrease in respiratory rate may indicate improved oxygenation and reduced stress.
Choices C, D, E, F, and G are not directly linked to the client's overall condition improvement as they can vary for several reasons, independent of the client's actual health status.
Extract:
Question 4 of 5
A nurse is admitting a client who reports tightness in their chest that radiates to left arm. Which of the following findings require immediate follow-up?
Correct Answer: B
Rationale: The correct answer is B: Heart rate 110/min and irregular. This finding suggests cardiac distress or arrhythmia, which could indicate a heart attack. Immediate follow-up is necessary to assess the client's cardiac status and intervene promptly.
Incorrect choices:
A: Temperature within normal range.
C: Respiratory rate within normal range.
D: Blood pressure slightly elevated but not an immediate concern.
E: Oxygen saturation slightly low but not critically low.
Question 5 of 5
A nurse is caring for a client who has COPD. Which of the following findings require immediate follow-up?
Correct Answer: D
Rationale: The correct answer is D. Tachypnea, productive cough with yellow mucus in a client with COPD indicate a potential exacerbation requiring immediate follow-up. Tachypnea suggests respiratory distress, while yellow mucus may indicate infection. Prompt intervention can prevent worsening respiratory status.
Choices A, B, and C do not indicate acute respiratory distress. Option E may be concerning but doesn't necessitate immediate intervention like option D does.