ATI RN
ATI Medical Surgical Proctored Exam Questions
Question 1 of 5
Place the events below in the order they occur in the patient with obstructive sleep apnea (beginning with 1).
Correct Answer: C
Rationale: In a patient with obstructive sleep apnea (OSA), the correct order of events is as follows: 1) Narrowing of air passages with muscle relaxation during sleep (Option B) 2) Apnea lasting 10 to 90 seconds (Option C) 3) Brief arousal and airway opened (Option D) 4) Sleep just before going to work (Option A) The correct answer, Option C, is the first event because in OSA, the air passages become narrowed due to relaxation of the muscles during sleep. This narrowing leads to apnea, where breathing stops for a period of time, typically 10 to 90 seconds. Following this, the body briefly arouses itself to reopen the airway and resume breathing. Option B is incorrect as it occurs before the apnea in the sequence of events. Option D is also incorrect as it follows the apnea and arousal. Option A is the last event in the sequence as it indicates the patient's sleep just before going to work, which would occur after the cycle of apnea and arousal. Understanding the sequence of events in OSA is crucial for healthcare providers to recognize and manage this condition effectively. Educating students on these events helps them comprehend the pathophysiology of OSA and how it impacts patient health and well-being.
Question 2 of 5
A patient with trigeminal neuralgia has moderate to severe burning and shooting pain. In helping the patient to manage the pain, the nurse recognizes what about this type of pain?
Correct Answer: B
Rationale: The correct answer is B) Trigeminal neuralgia is a chronic condition characterized by severe burning and shooting pain along the trigeminal nerve. It is a type of neuropathic pain that typically requires long-term treatment due to its chronic nature. The pain in trigeminal neuralgia is often refractory to traditional analgesics like NSAIDs and opioids, making long-term management essential. Adjuvant analgesics may be used in combination with other medications to help manage neuropathic pain, but they are not the primary treatment for trigeminal neuralgia. Small to moderate doses of oral opioids are generally not effective in managing neuropathic pain like trigeminal neuralgia. Salicylates and NSAIDs are typically not effective in controlling neuropathic pain and are not recommended for the treatment of trigeminal neuralgia. In an educational context, it is important for nurses to understand the unique characteristics of neuropathic pain conditions like trigeminal neuralgia and the appropriate pharmacological management strategies. By recognizing the chronic nature of trigeminal neuralgia and the limitations of traditional analgesics, nurses can advocate for effective long-term treatment plans for patients experiencing this debilitating condition.
Question 3 of 5
A patient is receiving a continuous infusion of morphine via an epidural catheter following major abdominal surgery. Which actions should the nurse include in the plan of care (select all that apply)?
Correct Answer: B
Rationale: In this scenario, the correct action to include in the plan of care is to assess the patient's pain relief frequently (Option B). Rationale for B: Assessing the patient's pain relief frequently is crucial when a patient is receiving a continuous infusion of morphine via an epidural catheter. This is important to ensure that the pain is adequately controlled and to monitor for any signs of inadequate pain relief or potential complications related to the medication. Rationale for A, C, and D: Option A: Labeling the catheter as an epidural access is important but is not directly related to the immediate care of the patient or ensuring proper pain management. Option C: Using sterile technique when caring for the catheter is a standard practice in any medical procedure but does not directly impact the assessment of pain relief in this context. Option D: Monitoring the patient's level of consciousness (LOC) is important in general patient care but is not as directly related to assessing the effectiveness of pain relief in this specific situation. Educational Context: Understanding the rationale behind the correct action emphasizes the importance of pain assessment in patients receiving opioid medications like morphine. Regular pain assessment is essential for effective pain management and patient comfort, especially in the postoperative period. It also highlights the need for nurses to prioritize pain management interventions to ensure optimal patient outcomes.
Question 4 of 5
A patient with end-stage liver failure tells the nurse, “If I can just live to see my first grandchild who is expected in 5 months, then I can die happy.” The nurse recognizes that the patient is demonstrating which of the following stages of grieving?
Correct Answer: B
Rationale: In this scenario, the patient expressing a desire to live long enough to see their first grandchild demonstrates Kübler-Ross's stage of bargaining. This stage involves attempting to negotiate for more time or a different outcome in the face of impending death. The patient's statement reflects a plea to experience a specific event before accepting their fate. Option A, Prolonged grief disorder, is incorrect as this term refers to a persistent and intense form of grief lasting longer than expected. The patient's statement does not suggest prolonged grief, but rather a specific goal to achieve before death. Option C, Kübler-Ross’s stage of depression, is incorrect because the patient is not displaying feelings of sadness or hopelessness, which are characteristic of the depression stage. Instead, they are expressing a desire to reach a specific milestone. Option D, The new normal stage of the Grief Wheel, is incorrect as this stage refers to the period after acceptance of loss when the individual adjusts to a new reality. The patient's statement does not align with adapting to a new normal but rather with bargaining for more time. Understanding the stages of grief is crucial in nursing, especially in end-of-life care. Recognizing these stages can help nurses provide appropriate support and interventions to patients and their families as they navigate the complex emotions associated with loss and impending death.
Question 5 of 5
The dying patient and family have many interrelated psychosocial and physical care needs. Which ones can the nurse begin to manage with the patient and family (select all that apply)?
Correct Answer: A
Rationale: In the context of caring for a dying patient and their family, managing anxiety is a crucial aspect of holistic care. Addressing anxiety can help alleviate distress, improve communication, and enhance overall well-being. The correct answer, option A, is essential because anxiety is a common response to end-of-life situations and can significantly impact the patient and family's experience. Fear of pain, option B, is also a valid concern, but it is more specific and may not be as universally present as anxiety. The dying process, option C, is a broad concept that encompasses various physical, emotional, and spiritual aspects, which can be challenging to manage comprehensively. Anger toward the nurse, option D, is not an appropriate focus when providing end-of-life care, as it can hinder trust and collaboration between the healthcare team and the patient/family. Educationally, understanding the psychosocial and physical care needs of dying patients and their families is crucial for nurses. By prioritizing the management of anxiety, nurses can create a supportive environment that promotes comfort, dignity, and emotional well-being during this sensitive time.