ATI RN
ATI Advanced Med Surg Final Exam 0924 Questions
Extract:
Question 1 of 5
A nurse in an emergency department is caring for a client who reports substernal chest pain and dyspnea. The client is vomiting and is diaphoretic. Which of the following laboratory tests are used to diagnose a myocardial infarction? (Select all that apply.)
Correct Answer: A,C,D
Rationale: Myoglobin is an early biomarker for myocardial injury and can be used for initial detection of myocardial infarction. Troponin T and Troponin I are highly specific biomarkers for myocardial infarction and are used to confirm the diagnosis of an MI.
Question 2 of 5
A nurse is preparing to administer fluconazole 400 mg by intermittent IV bolus daily. Available is fluconazole 400 mg in 0.9% sodium chloride (NaCl) 200 mL to infuse over 2 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest tenth/whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Correct Answer: B
Rationale:
Total volume to infuse: 200 mL. Time for infusion: 2 hours. The IV pump rate is calculated as: 200 mL / 2 hr = 100 mL/hr.
Extract:
Medical History
Day 1:
Patient came from ER complaining of chest pain. CPR initiated in ER and return to ROSC after 3 minutes. Intubated in ER (ACVC FIO2 100% Mode; RR13; PEEP 3: Tidal Volume 300ml and transferred to ICU for further care.
Nurses' Notes
Day 1:
S/p intubation, patient was given rocuronium, fentanyl and versed per radiology. Patient currently sedated. Lung crackles and bronchi. Heart regular and moderate. Pulses +1 on all extremities with +2 pitting edema. Hypoactive bowel sounds.
Diagnostic Results
Day 1:
Chest x-ray shows bilateral basilar infiltration
CBC
WBC 7.8
HGB13
K+3.9
Creatinine 2.0
BUN 60
GFR 38
BNP 1800
Troponin 1.7
ABG (Before intubation): pH7.2 CO2 76 HCO3 18
Vital Signs
Day 1
IN ER before cardiac arrest: Temperature 37.6° C (99.7° F)
Blood pressure 174/86 mm Hg
Heart rate 98/min
Respiratory rate 27/min
Pulse oximetry 93% on room air
After Intubation:
Temp 100.0F
Blood Pressure 87/40
HR 125/min. Sinus Tachycardia
RR: 13
Pulse Ox 100%
Question 3 of 5
For each potential nursing action, click to specify if the action is essential, nonessential, or contraindicated for the client.
| Options | Essential | Nonessential | Contraindicated |
|---|---|---|---|
| Administer furosemide | |||
| Administer ordered Epinephrine drip | |||
| Administer ordered low dose dopamine | |||
| Insert an indwelling urinary catheter | |||
| Administer ordered nitroglycerin | |||
| Administed 0.9% NS 500ML bolus |
Correct Answer: A,B,C,D,F
Rationale: Furosemide, epinephrine, dopamine, urinary catheter, and NS bolus are essential for managing pulmonary edema, hypotension, and monitoring fluid balance. Nitroglycerin is nonessential unless indicated for ongoing angina.
Extract:
Question 4 of 5
A nurse is suctioning the endotracheal tube of a client who is on a ventilator. The client's heart rate increases from 86/min to 110/min and becomes irregular. Which of the following actions should the nurse take?
Correct Answer: B
Rationale: Performing pre-oxygenation prior to suctioning can help prevent hypoxia and subsequent cardiac arrhythmias caused by the suctioning procedure.
Question 5 of 5
A nurse in the emergency department is caring for a client who sustained a head injury. The nurse notes the client's IV fluids are infusing at 125 mL/hr. Which of the following is an appropriate action by the nurse?
Correct Answer: D
Rationale: Continuing the rate at 125 mL/hr is appropriate for maintaining the current IV fluid regimen unless there are specific orders or conditions that require a change.