ATI RN
ATI Med Surg Woolery Final Exam Questions
Extract:
Question 1 of 5
A client who received a kidney transplant 3 months ago is in the nephrologists office for a follow up appointment. Which finding would indicate that the client is experiencing a complication which is common after a kidney transplant?
Correct Answer: C
Rationale: An elevated WBC count could indicate infection or rejection, common complications post-transplant.
Question 2 of 5
A client has had recurrent kidney stones. Upon lab analysis of the client's urine, it is found that excessive oxalate intake is the underlying cause. Which of the following high-oxalate foods should the nurse instruct the client to avoid?
Correct Answer: A
Rationale: Spinach is high in oxalates, which can contribute to calcium oxalate kidney stones.
Extract:
Nurses' Notes
0600:
Client was brought to the emergency department by her husband for complaints of abdominal pain 8/10 in all quadrants. Client is alert and oriented x4, states she has had a fever, nausea, and vomiting "off and on" for 2 days. Existing medical conditions include insulin-dependent type-2 diabetes, hypertension, and end-stage renal disease. Abdomen assessed, found to be rigid and distended. Rebound tenderness noted on palpation. Bowel sounds auscultated, hyperactive in all quadrants. Catheter present in abdominal wall, currently clamped. Client states "I do my own dialysis every day. Yesterday the effluent was cloudy. I haven't done an exchange yet today." STAT BMP and CBC have resulted. Physician notified. Awaiting orders.
Vital Signs
0600:
Temperature: 39.1°C (102.3°F)
Pulse rate: 110/min
Respiratory rate: 24/min
Blood pressure: 123/70 mmHg
Oxygen saturation: 95% room air
Laboratory results
0600:
BMP:
Creatinine: 3.8 mg/dL
Glucose: 180 mg/dL
Potassium: 5.4 mEq/L
Sodium: 134 mEq/L
BUN: 68 mg/dL CBC:
WBC: 15,000/mm3
RBC: 4.3 x 10/μL
Platelets: 250,000/μL
Hemoglobin: 12 g/dL
Hematocrit: 39%
Question 3 of 5
The client is experiencing...... caused by.....
Correct Answer: A,B
Rationale: Peritonitis is indicated by abdominal pain, fever, and cloudy dialysis effluent, caused by peritoneal dialysis.
Extract:
Nurses' Notes
1000:
Client presents with reports of shortness of breath, dizziness, and "feelings of pressure" in jaw, neck, and left arm. Was mowing the lawn when feelings of discomfort began. Pressure has not subsided with rest. Provider updated, orders received.
1010:
Nitroglycerin sublingual tablet administered x2 doses, 5 min apart. Updated provider on diagnostic results.
1025:
Client states relief from discomfort after 2nd nitroglycerin tab, no current shortness of breath, dizziness, or feelings of pressure, continues to deny chest pain.
Provider updated, orders received.
Vital Signs
1000:
Temperature 36.4°C (97.6°F) Heart rate 112/min Respiratory rate 28/min
Blood pressure 146/74 mm Hg SaO2 93% on room air
1015:
Temperature 36.4°C (97,6°F) Heart rate 92/min Respiratory rate 24/min
Blood pressure 126/64 mm Hg
SaO2 96% on oxygen @ 2L/min via nasal cannula
Provider Orders
1005:
12 Lead EKG
Serum cardiac enzymes
Nitroglycerin 0.3 mg sublingual now, may repeat every 5 min for 2 additional doses for continued chest pain
Oxygen at 2 L/minute via nasal cannula for O2 saturation less than 95%
1030:
Schedule cardiac stress test Consult cardiology
Diagnostic Results
1010:
12 Lead EKG: Sinus tachycardia with ST depression Troponin I: 0.01 ng/mL
Troponin T: 0.03 ng/mL
Question 4 of 5
For each of the following findings in the client's medical record, click to specify if they are consistent with unstable angina or a myocardial infarction (MI). Each finding may support more than one disease process.
| Options | Unstable Angina | Myocardial Infarction |
|---|---|---|
| Client's response to nitroglycerin therapy (Unstable Angina) | ||
| Client's initial report of manifestations (Unstable Angina, Myocardial Infarction) | ||
| 12 Lead EKG report (Unstable Angina) | ||
| Troponin results (Unstable Angina) |
Correct Answer: A,B,C,D
Rationale: Nitroglycerin relief and normal troponins support unstable angina; symptoms and EKG findings can indicate both conditions.
Extract:
Question 5 of 5
A client diagnosed with acute glomerulonephritis has pitting edema in both feet, and has had 300 mL of urine output in the last 24 hours. The nurse should monitor this client for which complication associated with this finding?
Correct Answer: C
Rationale: Fluid retention in acute glomerulonephritis can lead to hypertension due to increased blood pressure.