ATI RN
Medical Surgical ATI Proctored Exam Questions
Question 1 of 5
Jill Means, 36, has had a vaginal radium implant placed as one of the treatments for her cervical cancer. She calls to tell you that during a coughing spell it has 'been pushed out'. You should:
Correct Answer: D
Rationale: Signs should be placed on the door after the implant has been done, and not just when the implant is dislodged. By picking the applicator up, Jill would experience burns on her fingers/hands that would be avoidable, so need to teach her not to do so. The applicator has been contaminated, it would not be replaced in any case. Calling the physician and apprising him would certainly be necessary, but would be done after the applicator has been taken care of. Lead containers should be available to place the applicator in, and forceps would be used to do so to protect from radiation burns.
Question 2 of 5
A 27-year-old male client develops malignant hyperthermia during a herniorrhaphy; his temperature is 105.4 degrees F. The client has had no previous health problems other than hypertension. A nurse orienting in the OR says, 'I thought only people with brain tumors had this problem.' Which of the following answers explains malignant hyperthermia?
Correct Answer: D
Rationale: Epinephrine is a hormone employed in the fight-or-flight stress response. It does not contribute to malignant hyperthermia. Stimulation of the sympathetic adrenal medullary mechanism helps the body cope with stress. It does not contribute to malignant hyperthermia. Catecholamine release is one of the physiological effects of stress. It does not contribute to malignant hyperthermia. Malignant hyperthermia is an inherited disorder of muscle metabolism that increases intracellular calcium, which causes generalized muscle rigidity, fever, tachycardia, and tachypnea.
Question 3 of 5
A client is considering laser abdominal surgery and asks the nurse if there is any advantage in having this type of surgery. The nurse's response should be based upon the knowledge that laser surgery:
Correct Answer: A
Rationale: A lower postoperative infection rate has been documented as a result of laser therapy versus routine surgery. Clients who choose laser surgery will still need preoperative sedation to facilitate anxiety reduction. Operating time may actually increase in some laser surgeries. The client who chooses laser surgery must still be observed for postoperative complications.
Question 4 of 5
After a thyroidectomy, a female client is returned to the unit from the recovery room. A major complication after a thyroidectomy is:
Correct Answer: A
Rationale: Respiratory obstruction due to edema of the glottis, bilateral laryngeal nerve damage, or tracheal compression from hemorrhage is a major complication after a thyroidectomy. Hypocalcemia and tetany from accidental removal of one or more parathyroid glands are major complications; not hypercalcemia. Fistula formation is not a major complication associated with a thyroidectomy. Fistula formation is a major complication with a laryngectomy. Myxedema is hypothyroidism occurring in adults. It is not a complication of a thyroidectomy. A thyroidectomy client tends to develop thyroid storm from an excess of the thyroid hormones released during surgery.
Question 5 of 5
A 47-year-old client is admitted for colon surgery. Intravenous antibiotics are started two hours prior to surgery even though the client has no known infection. The reason for giving antibiotics prior to surgery is to:
Correct Answer: B
Rationale: Cathartics, not antibiotics, promote the evacuation of intestinal contents. The client undergoing intestinal surgery is at an increased risk for infection from large numbers of anaerobic bacteria that inhabit the intestines. Administering antibiotics prophylactically can reduce the client's risk for infection. Antibiotics are indicated in the treatment of infections and have no effect on emotions. Antibiotics would have an effect on an infection which causes a temperature elevation, but they would not directly affect the temperature elevation.