ATI RN
Adult Medical Surgical ATI Questions
Question 1 of 5
A 35-year-old female client has returned to her room following surgery on her right femur. She has an IV of D5 1/2 NS infusing at 125 cc/hr, and is receiving morphine sulfate 10-15 mg IM q4h prn for pain. The client last voided 5 1/2 hours ago when she was given her preoperative medication. To monitor and promote the return of urinary function after surgery, the nurse should:
Correct Answer: C
Rationale: Provision of food and fluids promotes bowel elimination. Postoperative nutritional needs are physician determined, not client determined. Increasing IV fluids postoperatively will not cause a client to void. Any change in the rate of administration of IV fluids is determined by the physician, not the nurse. If the postoperative client with normal kidney function cannot void 8 hours after surgery, the client is retaining urine. The client may need catheterization or medication. The physician will provide orders for either, as necessary. While morphine sulfate can cause urinary retention, withholding pain medication will not ensure that the client will void. The client with uncontrolled pain will probably not be able to void.
Question 2 of 5
Yesterday, a male client had a transurethral resection of the prostate (TURP). Today, the client is concerned about the small amount of blood found in his urine. The nurse should explain to the client that the blood:
Correct Answer: C
Rationale: Some hematuria is usual for several days after surgery. The client should not be concerned, unless the amount increases. The client will continue to have a small amount of hematuria even after the Foley catheter is removed. Some hematuria is usual for several days after surgery. The client should not be concerned, unless the amount increases. Irrigating the bladder will not remove the hematuria. Irrigation is performed to remove blood clots and to facilitate urinary drainage.
Question 3 of 5
A 25-year-old client is admitted for a tonsillectomy and informs the nurse of having had episodes of muscle cramps, weakness, and an unexplained temperature elevation. Many years ago, the client's father died shortly after surgery subsequent to developing a high fever. The surgeon has ordered dantrolene sodium (Dantrium) prophylactically prior to the tonsillectomy to reduce the risk of:
Correct Answer: B
Rationale: Dantrolene sodium (Dantrium) is a peripheral skeletal muscle relaxant and would have no effect on a postoperative infection. Dantrolene sodium (Dantrium) is indicated prophylactically for clients with malignant hyperthermia or with a family history of the disorder. The mortality rate for malignant hyperthermia is high. Neuroleptic malignant syndrome is an exercise-induced muscle pain and spasm and is not related to malignant hyperthermia. Dantrolene sodium (Dantrium) is a peripheral skeletal muscle relaxant and would have no effect on a postoperative fever.
Question 4 of 5
A client is scheduled for a coronary artery bypass graft (CABG) in the morning using a saphenous vein. The physician does not use the internal mammary artery for the bypass graft, because the internal mammary artery:
Correct Answer: A
Rationale: Many physicians do not use the internal mammary artery because it is time consuming. Removing the internal mammary artery does not pose a greater risk of reocclusion. In fact, it may stay patent longer. The internal mammary artery is larger in diameter than the saphenous vein. The internal mammary artery does not have too many valves.
Question 5 of 5
List the order in which you will assess these patients.
Correct Answer: B
Rationale: In this scenario, the correct order to assess patients is as follows: 1. **B) An irritable infant with a fever, petechiae, and nuchal rigidity** - This patient presents with signs and symptoms that are concerning for meningitis, a serious and potentially life-threatening condition. Prompt assessment and intervention are crucial in this situation to prevent complications. 2. **C) A 35-year-old jogger with a twisted ankle, having pedal pulse and no deformity** - This patient's condition, a twisted ankle with intact pedal pulse and no deformity, is a less urgent situation compared to the infant with suspected meningitis. While still important, this patient can be assessed after addressing the more critical cases. 3. **D) A 50-year-old female with moderate abdominal pain and occasional vomiting** - Abdominal pain and vomiting can indicate various conditions, some of which may require immediate attention. However, they are generally not as time-sensitive as a potential case of meningitis in an infant. 4. **A) An ambulatory, dazed 25-year-old male with a bandaged head wound** - While head injuries should always be taken seriously, in this case, the patient is ambulatory and dazed, indicating a less severe presentation compared to the other scenarios. This patient can be assessed after addressing the more urgent cases. Educational Context: This question assesses the prioritization of patient assessment based on the severity and urgency of their conditions. Understanding the principles of triage and prioritization in healthcare is essential for healthcare providers to deliver safe and effective care. By correctly identifying the most critical patient in need of immediate assessment and intervention, healthcare professionals can optimize patient outcomes and provide timely care to those who need it most.