ATI RN
ATI RN Adult Medical Surgical 2023 III Questions
Extract:
Patient Summary
Presenting Complaint:
Time of Arrival: 0900 hours
Symptoms: Client reports not feeling well for the past 12 hours, with increasing blood glucose levels. Client has a history of type 1 diabetes mellitus and hypertension. Recent treatment for bronchitis and pneumonia. Reports nausea, decreased appetite, frequent urination, and extreme thirst.
Medical History:
Conditions: Type 1 diabetes mellitus, hypertension.
Recent Illnesses: Bronchitis, pneumonia.
Nurses' Notes
0900 Hours:
Client presents with a history of type 1 diabetes mellitus and hypertension. The client is alert and oriented x4. Heart and lung sounds are clear. The client reports frequent urination, extreme thirst, nausea, and decreased appetite. Bowel sounds are hyperactive in all 4 quadrants. Bilateral pedal pulses are 1+. Slight tenting of skin noted. Peripheral IV established, and labs drawn.
Vital Signs
0900 Hours:
Temperature: 36.8°C (98.2°F)
Pulse Rate: 110/min
Respiratory Rate: 18/min
Blood Pressure: 96/65 mm Hg
Oxygen Saturation: 96% on room air
1400 Hours:
Temperature: 36.8°C (98.2°F)
Pulse Rate: 84/min
Respiratory Rate: 16/min
Blood Pressure: 106/76 mm Hg
Laboratory Results
0915 Hours:
Blood Glucose: 468 mg/dL (Normal: 74-106 mg/dL)
pH: 7.30 (Normal: 7.35-7.45)
Potassium: 5.5 mEq/L (Normal: 3.5-5.0 mEq/L)
Sodium: 138 mEq/L (Normal: 136-145 mEq/L)
Chloride: 101 mEq/L (Normal: 98-106 mEq/L)
BUN: 21 mg/dL (Normal: 10-20 mg/dL)
Creatinine: 1.7 mg/dL (Normal: 0.5-1.1 mg/dL)
Urine Dipstick: Positive for ketones (Normal: Negative)
Provider's Prescriptions
Fluids: Administer 0.9% sodium chloride at 15 ml/kg/hr for 1 hr, then reduce to 10 ml/kg/hr.
Potassium: Potassium chloride 20 mEq/L IV PRN if potassium is less than 5.0 mEq/L.
Insulin: Regular insulin continuous infusion, titrate per DKA protocol once potassium is greater than 3.3 mEq/L.
Anti-nausea: Ondansetron 4 mg IV bolus every 4 hr PRN for nausea.
Pain Relief: Acetaminophen 650 mg every 4 hr PRN for pain.
Magnesium: Magnesium sulfate 2 g IV over 2 hr for hypomagnesemia.
Monitoring: Strict intake and output, blood glucose level hourly.
Question 1 of 5
Complete the following sentence by using the lists of options. The nurse should administer a total..... sodium chloride in the first hourAND......... each subsequent hour.
Correct Answer: B,C
Rationale: 1320 mL in the first hour and 10 ml/kg/hr subsequently align with fluid resuscitation protocols for DKA.
Extract:
Question 2 of 5
A nurse is caring for a client who has a peripherally inserted central catheter (PICC) line in her left forearm. The client is receiving an antibiotic via intermittent IV bolus every 12 hr. Which of the following actions should the nurse take in managing the client's PICC line?
Correct Answer: D
Rationale: Flushing the PICC line with 0.9% sodium chloride after each use prevents occlusion and maintains patency of the catheter.
Question 3 of 5
A nurse is preparing a teaching plan for a client who has mucositis related to chemotherapy treatment. Which of the following instructions should the nurse include?
Correct Answer: D
Rationale: Gentle flossing helps maintain oral hygiene without irritating mucositis lesions caused by chemotherapy.
Question 4 of 5
A charge nurse on a neurological unit is making room assignments for a group of clients. Which of the following clients should the nurse assign to the room closest to the nurses' station?
Correct Answer: C
Rationale: A Glasgow Coma Scale score of 10 indicates neurological impairment requiring close monitoring.
Extract:
Diagnostic Results
Day of Admission:
Brain Natriuretic Peptide (BNP): 450 pg/mL (Normal: <100 pg/mL)
Potassium: 4.8 mEq/L (Normal: 3.5-5 mEq/L)
Sodium: 132 mEq/L (Normal: 136-145 mEq/L)
BUN: 10 mg/dL (Normal: 10-20 mg/dL)
Day 2 of Hospitalization:
Brain Natriuretic Peptide (BNP): 110 pg/mL (Normal: <100 pg/mL)
Potassium: 3.3 mEq/L (Normal: 3.5-5 mEq/L)
Sodium: 135 mEq/L (Normal: 136-145 mEq/L)
BUN: 20 mg/dL (Normal: 10-20 mg/dL)
Medical Administration Record
Day of Admission:
• Medication: Furosemide 80 mg IV, 3 times per day
Vital Signs
Day of Admission:
Temperature: 36.6°C (97.8°F)
Heart Rate: 112/min
Respiratory Rate: 24/min
Blood Pressure: 186/84 mmHg
Oxygen Saturation: 93% on room air
Weight: 97.5 kg (215 lb)
Day 2 of Hospitalization:
Temperature: 36.6°C (97.8°F)
Heart Rate: 78/min
Respiratory Rate: 18/min
Blood Pressure: 102/78 mmHg
Oxygen Saturation: 98% on 2 L/min oxygen via nasal cannula
Weight: 90.7 kg (200 lb)
Question 5 of 5
The client is at risk for developing……. and……...
Correct Answer: B,D
Rationale: Heart failure increases the risk of fluid volume deficit and dysrhythmias due to cardiac strain and electrolyte imbalances.