ATI RN
ATI Advanced Med Surg Exam 3 Questions
Extract:
Medical History
Client was brought to the ED by their family member due to mental status changes. The family member reports that they visit the client every other day and today the client did not initially realize who they were until several minutes after talking with them. The client has diabetes mellitus and takes insulin daily. A wound is noted on the right foot.
Nurses' Notes
Family member reports that the client did not initially realize who they were when they went to visit. Client is currently somnolent but rouses to verbal stimuli and is oriented to person. Glascow coma score is 13 and Modified Early Warning System (MEWS) score is 6. Respirations are even. unlabored and deep, with few crackles noted in lung bases bilaterally with auscultation. Mucous members are dry and pink. Abdomen soft with hypoactive bowel sounds. Radial and pedal pulses are palpable, no edema noted.
Skin is warm and dry. The right foot has a 2.5 cm x 3.3 cm (1 in x 1.3 in) superficial wound to the ball of the foot. The wound is moist with a scant amount of purulent drainage. Client stated they stepped on something last week while walking but did not notice a wound had occurred.
Client's family member reports that the client takes 10 units of regular insulin subcutaneously every morning and 5 units every evening with last dose taken this am. Also states that the client took two aspirin yesterday for a headache.
Vital Signs
Temperature 38.5°C (101.3° F) Pulse 110/min
Blood pressure 98/60 mm Hg Respiratory rate 26/min
Oxygen saturation 93% on 2 L nasal cannula
Diagnostic Results
RBC count 5.0 (Male 4.7 to 6.1)
WBC count 9,500 mm3 (5,000 to 10,000/mm3) Platelets 97,000/mm3 (150,000 to 400,000/mm3) Hemoglobin 15 g/dL (Male 14 to 18 g/dL)
Hematocrit 45% (Male 42% to 52%; Female 37% to 47%) Glucose 186 mg/dL (74 to 106 g/dL)
Question 1 of 5
It has been identified that the client is in sepsis. Select the 4 actions that the nurse should complete in the first hour to manage sepsis and prevent further complications?
Correct Answer: C,D,E,F
Rationale: Administering antibiotics targets the infection, measuring lactate assesses tissue perfusion, fluid resuscitation restores volume, and blood cultures identify the causative organism, all critical within the first hour of sepsis management.
Extract:
Question 2 of 5
A nurse is collecting a medication history from a client who is scheduled to have a cardiac catheterization. Which of the following medications taken by the client interacts with contrast material and places the client at risk for acute kidney injury?
Correct Answer: B
Rationale: Metformin can increase the risk of lactic acidosis when combined with contrast material, especially in patients with renal impairment, requiring careful monitoring or temporary discontinuation.
Question 3 of 5
A nurse in an urgent care center is assessing a client who reports a sudden onset of irregular palpitations, fatigue, and dizziness. The nurse finds a rapid and irregular heart rate with a significant pulse deficit. Which of the following dysrhythmias should the nurse expect to find on the ECG?
Correct Answer: C
Rationale: Atrial fibrillation causes an irregularly irregular heart rhythm, leading to palpitations, fatigue, dizziness, and a pulse deficit due to inconsistent ventricular contractions.
Question 4 of 5
Norepinephrine has been prescribed for a patient who was admitted with dehydration and hypotension. Which data indicate that the nurse should consult with the health care provider before starting the norepinephrine?
Correct Answer: A
Rationale: Low central venous pressure indicates hypovolemia, requiring fluid resuscitation before vasopressors like norepinephrine to prevent worsening hypotension.
Question 5 of 5
Mr Jones came to the ER complaining of chest palpitations. He states his heart feels like it is 'racing'. The nurse found the following rhythm on the monitor. What is the next step would the nurse expect to take first?
Correct Answer: B
Rationale: The Valsalva maneuver, such as blowing into a syringe, can stimulate the vagus nerve to slow supraventricular tachycardia, making it the first non-invasive step.