ATI RN
ATI RN Adult Medical Surgical 2023 V Questions
Extract:
Question 1 of 5
A nurse in the PACU is caring for a client following a thyroidectomy. Which of the following findings should the nurse report to the provider?
Correct Answer: D
Rationale: Dyspnea post-thyroidectomy may indicate airway obstruction or hematoma, a critical finding requiring immediate reporting.
Question 2 of 5
A nurse in the emergency department is monitoring a client who is receiving dopamine to treat hypovolemic shock. Which of the following findings should the nurse identify as an indication for increasing the client's dopamine dosage?
Correct Answer: D
Rationale: Low blood pressure (90/50 mm Hg) indicates persistent shock, necessitating an increased dopamine dose to improve perfusion.
Question 3 of 5
A nurse is caring for a client immediately following a cardiac catheterization through the right femoral artery. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: Keeping the leg straight prevents bleeding or hematoma at the femoral puncture site, a critical post-catheterization precaution.
Extract:
History and Physical
1000:
Client reports after eating breakfast this morning at 0630 that they began feeling tightness in chest that radiates to left arm. History:
Hyperlipidemia, hypertension, type 2 diabetes mellitus. Non-smoker. Denies use of alcohol or recreational drug use.
Nurses' Notes
1000:
Client reports tightness in chest that radiates to left arm. States pain as 7 on a scale of 0 to 10. Started to feel nauseous after breakfast. Client states, "I had scrambled eggs and bacon like I do every morning." Client is diaphoretic and short of breath. Heart rate irregular and tachycardic. Alert and oriented to person, place, and time. Lungs clear to auscultation in all lobes. Bowel sounds are present in all 4 quadrants. +1 pedal pulses. Skin is cool to touch. Capillary refill less than 2 seconds.
Vital Signs
1000:
• Temperature 37.1° C (98.8° F)
• Heart rate 110/min and irregular
• Respiratory rate 24/min
• Blood pressure 164/80 mm Hg
• Oxygen saturation 93% on room air
Diagnostic Results
1000:
• Myoglobin 100 mcg/L (less than 90 mcg/L)
• Creatine kinase 180 units/L (55 to 170 units/L)
• Troponin T 0.40 ng/mL (less than 0.1 ng/mL)
• Troponin 10.35 ng/mL (less than 0.03 ng/mL)
• Cholesterol 244 mg/dL (less than 200 mg/dL)
• Triglycerides 180 mg/dL (40 to 160 mg/dL)
• LDL cholesterol 148 mg/dL (less than 130 mg/dL)
• HDL cholesterol 42 mg/dL (greater than 45 mg/dL)
• C-reactive protein 2 mg/mL (less than 1.0 mg/mL)
• Blood glucose 103 mg/dL (74 to 106 mg/dL)
12-lead electrocardiogram: tachycardia with ST segment elevation and T wave changes
Chest x-ray: lungs are clear in all lobes
Provider prescriptions
1020:
• Nitroglycerin 0.5 mg SL may repeat every 5 min up to 3 doses as needed for chest pain
• Aspirin 160 mg PO daily
• Morphine 6 mg IV bolus every 3 hr PRN pain
• Metoprolol 25 mg PO every 6 hr x 48 hr, then metoprolol 100 mg PO twice daily
• Initiate peripheral IV site
• 0.9% sodium chloride 50 mL/hr by continuous IV infusion
• Oxygen at 2 L/min via nasal cannula if oxygen saturation is less than 90%
• Schedule stat echocardiogram
• 2 g sodium diet
Question 4 of 5
The nurse is reviewing the client's medical record. For each potential provider's prescription, click to specify if the potential prescription is anticipated, nonessential, or contraindicated for the client.
| Options | Anticipated | Nonessential | Contraindicated |
|---|---|---|---|
| Metoprolol 5 mg every 2 to 3 min up to three doses | |||
| Oxygen at 2 L/min via nasal cannula | |||
| Draw electrolytes along with Hgb and Hct | |||
| Morphine 6 mg IV bolus every 3 hr as needed for pain | |||
| Nitroglycerin 0.4 mg SL now may repeat every 5 min up to 3 doses | |||
| Obtain daily weight | |||
| Atropine 0.5 mg IV bolus every 5 min up to 2 mg |
Correct Answer: B,C,D,E,F
Rationale: Oxygen, labs, morphine, nitroglycerin, and weight monitoring support acute coronary syndrome management; metoprolol IV dosing and atropine are inappropriate.
Extract:
Question 5 of 5
A nurse is providing discharge teaching to a client who has pulmonary tuberculosis. Which of the following findings should the nurse include as an indication the client is no longer infectious?
Correct Answer: A
Rationale: Negative sputum cultures confirm the client is no longer infectious with tuberculosis.