ATI RN
Adult Medical Surgical ATI Questions
Question 1 of 5
Which action should the nurse take to reduce the risk of ventilator-associated pneumonia in a client with an endotracheal tube receiving mechanical ventilation?
Correct Answer: C
Rationale: The correct answer is C: Brush the client's teeth with a suction toothbrush every 12 hours. This is crucial in reducing the risk of ventilator-associated pneumonia as it helps prevent the buildup of bacteria in the oral cavity, which can be aspirated into the lungs. Brushing the teeth regularly maintains oral hygiene, decreasing the chances of infection. A: Positioning the head of the client's bed flat can increase the risk of aspiration and pneumonia. B: Turning the client every 4 hours is important for preventing pressure ulcers but does not directly reduce the risk of ventilator-associated pneumonia. D: Providing humidity within the ventilator tubing is important for preventing mucous plugs but does not directly address oral hygiene, which is key in preventing pneumonia.
Question 2 of 5
A client with tuberculosis is starting medication therapy with isoniazid, rifampin, and pyrazinamide. Which of the following instructions should the nurse include?
Correct Answer: D
Rationale: Rationale: Taking pyrazinamide on an empty stomach can cause stomach upset. Drinking water helps prevent this. A: Isoniazid should be taken on an empty stomach, not with an antacid. B: Sputum specimens are usually collected at the beginning of treatment, not every 2 weeks. C: Negative sputum cultures might not be achieved until later in treatment, not after 6 months.
Question 3 of 5
A client had a stroke involving the right cerebral hemisphere. The nurse should monitor for which of the following findings?
Correct Answer: A
Rationale: The correct answer is A: Poor impulse control. When a client has a stroke involving the right cerebral hemisphere, it can affect their ability to regulate emotions and impulses. The right hemisphere is responsible for inhibiting impulsive behavior, so damage to this area can lead to poor impulse control. This can manifest as impulsivity, lack of judgement, and difficulty controlling emotions. Summary of Incorrect Choices: B: Inability to discriminate words and letters - This is typically associated with left cerebral hemisphere damage, not right hemisphere. C: Deficits in the right visual field - This is associated with damage to the left occipital lobe, not the right hemisphere. D: Motor retardation - Motor functions are controlled by the opposite side of the brain, so right hemisphere damage would typically affect the left side of the body, not motor function in general.
Question 4 of 5
When teaching a client with chronic obstructive pulmonary disease who will start using fluticasone via MDI twice daily, which instruction should the nurse include?
Correct Answer: B
Rationale: The correct answer is B: Inspect your mouth for lesions daily. This instruction is essential because fluticasone, a corticosteroid, can cause oral thrush as a side effect. By inspecting the mouth daily, the client can detect any lesions early and seek appropriate treatment. Monitoring heart rate (A) is not necessary for fluticasone use, as it does not typically affect heart rate. While it is important not to skip doses (D), the specific instruction about the morning dose is not as crucial. Avoiding the use of fluticasone for acute attacks (C) is correct, but it is not the most important instruction in this scenario.
Question 5 of 5
A client with chronic obstructive pulmonary disease is receiving dietary teaching from a nurse. Which of the following instructions should the nurse include?
Correct Answer: B
Rationale: The correct answer is B: Limit fluid intake with meals. This instruction is important for a client with COPD because excessive fluid intake during meals can lead to increased stomach distention, which can worsen breathing difficulties. By limiting fluid intake with meals, the client can reduce the risk of feeling bloated and experiencing shortness of breath. A: Eating 3 balanced meals each day is generally a good recommendation, but it does not specifically address the needs of a client with COPD. C: Although reducing sodium intake can be beneficial for managing COPD, it is not as directly related to dietary considerations during meals. D: Taking a bronchodilator 1 hour before eating is not a dietary instruction and does not address the issue of fluid intake during meals.