ATI RN
ATI RN Adult Medical Surgical 2023 V Questions
Extract:
Question 1 of 5
A nurse in a clinic is assessing a client who has type 1 diabetes mellitus. The client is diaphoretic, has a heart rate of 92/min, and reports palpitations. The client states, 'I went for my morning run and feel exhausted.' Which of the following responses should the nurse make?
Correct Answer: A
Rationale: Exercise can lower blood glucose, and inadequate insulin adjustment may lead to hypoglycemia, suggested by diaphoresis and palpitations.
Extract:
Medical History
• Type 2 diabetes mellitus
• Hypertension, controlled by diuretic and ace-inhibitor therapy Osteoarthritis
Medication Administration Record
• Home medications:
• Metformin 1,000 mg PO BID
• Lisinopril 20 mg PO daily
• Celecoxib 100 mg PO BID
Diagnostic Results
Preoperative laboratory results: Basic Metabolic Profile (BMP):
• Glucose 190 mg/dL (74 to 106 mg/dL)
• BUN 16 mg/dL (10 to 20 mg/dL)
• Creatinine 0.8 mg/dL (0.5 to 1 mg/dL)
• Hemoglobin A1C 9.5% (Poor diabetic control: greater than 99%)
Current laboratory results:
Basic Metabolic Profile (BMP):
• Glucose 280 mg/dl (74 to 106 mg/dl)
• BUN 15 mg/dL (10 to 20 mg/dL)
• Creatinine 0.7 mg/dL (0.5 to 1 mg/dl)
Vital Signs
Preoperative:
• Temperature 36.4° C (97.6° F)
• Heart rate 82/min
• Respiratory rate 20/min
• Blood pressure 126/74 mm Hg
• Oxygen saturation 95% on room air
Current:
• Temperature 37 2 C (99° F)
• Heart rate 92/min
• Respiratory rate 22/min
• Blood pressure 136/85 mm Hg
• Oxygen saturation 98% on 2 L/min nasal cannula
Question 2 of 5
A nurse is caring for a client who is postoperative following a total knee arthroplasty. Complete the following sentence by using the lists of options. The client in a higher pick for..... as evidenced by the client's......
Correct Answer: A,F
Rationale: Elevated blood glucose (280 mg/dL) increases infection risk post-surgery, as hyperglycemia impairs wound healing and immune response.
Extract:
Question 3 of 5
A nurse is caring for a client who has acute angina. Which of the following actions should the nurse take first?
Correct Answer: C
Rationale: Nitroglycerin relieves angina pain by dilating coronary arteries, improving blood flow, and is the priority to address acute symptoms.
Extract:
Medical History
• Dehydration
• Hyperlipidemia
• Hypertension
• Coronary artery disease (CAD)
Diagnostic Results
• WBC count 14,000/mm3 (5,000 to 10,000/mm3)
• Hgb 14 g/dL (12 to 16 g/dL)
• Hct 40% (34 to 47%)
• Sodium 132 mEq/L (136 to 146 mEq/L)
• Potassium 6.2 mEq/L (3.5 to 5 mEq/L)
• Calcium 10 mg/dL (9 to 10.5 mg/dL)
• BUN 20 mg/dL (10 to 20 mg/dL)
• Albumin 2.8 g/dL (3.5 to 5 g/dL)
• Fasting blood glucose 140 mg/dL (74 to 106 mg/dL)
• Triglycerides 134 mg/dL (34 to 160 mg/dL)
Nurses' Notes
Client is lying in bed. Awake, alert, and oriented to time, place, and person. Client is febrile and reports weakness. Receiving TPN via central line in left antecubital. Client is NPO and has had diarrhea x3 in past 4 hr. Crackles auscultated in posterior lobes. Client has a productive cough and sputum is yellow in color. Client receiving 2 U/min oxygen via nasal cannula with an oxygen saturation of 90%. Abdomen is distended and tender. Active range of motion to all extremities. Denies pain at this time.
Question 4 of 5
A nurse is caring for a client who is receiving TPN. Which of the following actions should the nurse take? For each potential nursing intervention, click to specify if the potential intervention is anticipated, nonessential, or contraindicated for the client.
| Options | Anticipated | Nonessential | Contraindicated |
|---|---|---|---|
| Notify provider to increase TPN rate/hr. | |||
| Decrease the client's oxygen to 1.5 L/min oxygen via nasal cannula. | |||
| Obtain client weight twice daily. | |||
| Request a prescription for insulin. | |||
| Request an antibiotic to be administered. | |||
| Have 3 nurses verify the TPN solution prescription. |
Correct Answer: C,D,E
Rationale: Weight monitoring tracks fluid balance, insulin addresses hyperglycemia, and antibiotics treat suspected infection (fever, elevated WB
C).
Extract:
Medical History
• Dehydration
• Hyperlipidemia
• Hypertension
• Coronary artery disease (CAD)
Diagnostic Results
• WBC count 14,000/mm3 (5,000 to 10,000/mm3)
• Hgb 14 g/dL (12 to 16 g/dL)
• Hct 40% (34 to 47%)
• Sodium 132 mEq/L (136 to 146 mEq/L)
• Potassium 6.2 mEq/L (3.5 to 5 mEq/L)
• Calcium 10 mg/dL (9 to 10.5 mg/dL)
• BUN 20 mg/dL (10 to 20 mg/dL)
• Albumin 2.8 g/dL (3.5 to 5 g/dL)
• Fasting blood glucose 140 mg/dL (74 to 106 mg/dL)
• Triglycerides 134 mg/dL (34 to 160 mg/dL)
Nurses' Notes
Client is lying in bed. Awake, alert, and oriented to time, place, and person. Client is febrile and reports weakness. Receiving TPN via central line in left antecubital. Client is NPO and has had diarrhea x3 in past 4 hr. Crackles auscultated in posterior lobes. Client has a productive cough and sputum is yellow in color. Client receiving 2 U/min oxygen via nasal cannula with an oxygen saturation of 90%. Abdomen is distended and tender. Active range of motion to all extremities. Denies pain at this time.
Question 5 of 5
A nurse is caring for a client who is receiving TPN. Which of the following actions should the nurse take? For each potential nursing intervention, click to specify if the potential intervention is anticipated, nonessential, or contraindicated for the client.
| Options | Anticipated | Nonessential | Contraindicated |
|---|---|---|---|
| Notify provider to increase TPN rate/hr. | |||
| Decrease the client's oxygen to 1.5 L/min oxygen via nasal cannula. | |||
| Obtain client weight twice daily. | |||
| Request a prescription for insulin. | |||
| Request an antibiotic to be administered. | |||
| Have 3 nurses verify the TPN solution prescription. |
Correct Answer: C,D,E
Rationale: Weight monitoring ensures nutritional adequacy, insulin corrects hyperglycemia, and antibiotics address infection signs (crackles, yellow sputum).