ATI RN
Adult Medical Surgical ATI Questions
Question 1 of 5
A 44-year-old male client had abdominal surgery this morning. The nurse noticed a small amount of bloody drainage on the client's surgical dressing. This type of drainage is:
Correct Answer: C
Rationale: Drainage from a surgical incision is initially sanguineous (red), proceeding to serosanguineous (pink), then to serous (straw-colored). Purulent drainage usually indicates infection. This drainage should not be seen initially from a surgical incision. An incision with a Penrose drain may be expected to have a moderate amount of serosanguineous drainage in the first 24 hours, but in general drainage from a surgical incision is initially sanguineous (red), proceeding to serosanguineous (pink), then to serous (straw-colored). Catarrhal is a type of exudate seen in upper respiratory infections, not in surgical incisions.
Question 2 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 3 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 4 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.
Question 5 of 5
Which task is appropriate to delegate to the nursing assistant?
Correct Answer: A
Rationale: In the context of adult medical-surgical care, delegating tasks to nursing staff should align with their scope of practice and level of training. The appropriate task to delegate to a nursing assistant in this scenario is chest compressions (Option A). Nursing assistants are often trained in basic life support (BLS) which includes performing chest compressions during cardiopulmonary resuscitation (CPR). This task is within their skill set and responsibilities. Options B, C, and D involve more advanced skills that require specialized training and knowledge beyond what a nursing assistant typically possesses. Bag-valve mask ventilation (Option B), assisting with oral intubation (Option C), and placing defibrillator pads (Option D) are tasks that should be performed by licensed healthcare providers such as registered nurses or respiratory therapists who have the required expertise and training. Educationally, understanding the principles of delegation is crucial for nurses and nursing assistants to provide safe and effective patient care. Nurses must assess the competency of staff members before delegating tasks to ensure that the right task is assigned to the right person. This promotes patient safety, optimizes workflow, and enhances teamwork within the healthcare team. By knowing the scope of practice for different healthcare roles, nurses can delegate tasks appropriately, maximizing efficiency and quality of care.