ATI RN
ATI Med Surg Woolery Final Exam Questions
Extract:
Question 1 of 5
A nurse in an ophthalmology clinic is assessing a client who has suspected primary open-angle glaucoma (PAOG). Which assessment finding would support a diagnosis of this type of glaucoma?
Correct Answer: A
Rationale: Loss of peripheral vision is a hallmark of primary open-angle glaucoma.
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 2 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:
Vital signs
0900:
Temperature 36.7° C (98° F)
Heart rate 119/min
Respiratory rate 26/min
Blood pressure 149/95 mm Hg
Oxygen saturation 92% on room air
Nurses' Notes
0900:
Client is a 45-year-old male brought to ED by family member due to new- onset chest pain and shortness of breath. Client describes pain as 10/10, substernal, and radiating to the left scapula.
Oriented to person, place, time, and situation.
Skin pale, cool, and diaphoretic, peripheral pulses weak.
$152 heard upon auscultation. Lungs clear bilaterally.
Client denies medical history and states no home medications.
Diagnostic results
0915:
12 Lead EKG:
ST-Elevation in leads V2-V6, rate 119 Point of Care Troponin:
1,40 ng/mL
Question 3 of 5
Select the 3 orders that the nurse should expect for this client.
Correct Answer: A,E,F
Rationale: Cardiac catheterization, supplemental oxygen, and nitroglycerin are standard for acute myocardial infarction management.
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:
Nurses' Notes
0900:
Client resting comfortably in bed. The client states that she has been experiencing progressive weakness of the facial muscles, and difficulty swallowing, which prompted her to seek treatment. She states that her muscle strength is usually better in the morning, and her facial muscles become more fatigued as she uses them throughout the day. Bilateral ptosis of eyelids noted. Client has difficulty talking during the assessment, and states that her jaw muscles became fatigued when she tried to eat breakfast this morning. Bilateral hand grip and upper extremity strength within normal limits, bilateral lower extremity strength and range of motion within normal limits. Client is scheduled for an edrophonium (Tensilon) test today.
Question 5 of 5
Based on the information provided, the client is likely experiencing..... which is caused by.......
Correct Answer: A,B
Rationale: Myasthenia Gravis symptoms include facial muscle weakness and fatigue, caused by autoantibodies targeting acetylcholine receptors.