ATI RN
ATI RN Adult Medical Surgical 2023 Questions
Extract:
Nurses' Notes
0900:
Client came to the ED this morning and reports not feeling well for the last 12 hr and increasing blood glucose. Client has a history of type 1 diabetes mellitus and hypertension. Client weight is 88 kg (194 lb). The client was recently treated for bronchitis and pneumonia. Client reports nausea and decreased appetite.
Client is alert and orientated x 4, heart and lung sounds are clear. Client states that they have been frequently urinating and are extremely thirsty. Bowel sounds are hyperactive in all 4 quadrants, Bilateral pedal pulses 1+. Slight tenting of skin. Peripheral IV established and labs drawn. A nurse is caring for a client in the emergency department.
Question 1 of 5
A nurse is caring for a client in the emergency department. The nurse understands that the client is at risk of developing which of the following complications? Select all that apply.
Correct Answer: C,D,E,F
Rationale: High blood glucose and dehydration in type 1 diabetes can lead to hypotension, arrhythmias, renal failure, and cerebral edema.
Extract:
Laboratory Results
0915:
Blood glucose 468 mg/dL (74 to 106 mg/dL)
pH 7.30 (7.35 to 7.45)
Potassium 5.5 mEq/L (3.5 to 5 mEq/L)
Sodium 138 mEq/L (136 to 145 mEq/L)
Chloride 101 mEq/L (98 to 106 mEq/L)
BUN 21 mg/dL (10 to 20 mg/dL)
Creatinine 1.7 mg/dL (0.5 to 1.1 mg/dL)
Urine dipstick positive for ketones (negative)
Question 2 of 5
A nurse is caring for a client in the emergency department. Which of the following 3 provider prescriptions does the nurse anticipate?
Correct Answer: B,C,F,
Rationale: These prescriptions address DKA with fluid resuscitation, insulin, monitoring, and potassium management.
Extract:
Nurses' Notes
0900:
Client came to the emergency department this morning and reports not feeling well for the last 12 hr and increasing blood glucose. Client has a history of type 1 diabetes mellitus and hypertension. Client weight is 88 kg (194 lb). The client was recently treated for bronchitis and pneumonia. Client reports nausea and decreased appetite.
Client is alert and orientated x 4, heart and lung sounds are clear. Client states that they have been frequently urinating and are extremely thirsty. Bowel sounds are hyperactive in all 4 quadrants. Bilateral pedal pulses 1+. Slight tenting of skin. Peripheral IV established and labs drawn.
1400:
Client admitted to the medical-surgical unit at 1200 today. Alert and orientated x4, heart and lung sounds clear. Client urinating 100 mL/hour. Client is tolerating soft diet and oral fluids. Bowel sounds are hyperactive in all 4 quadrants. Bilateral pedal pulses 2+. Blood glucose 310 mg/dL (74 to 106 mg/dL)
A nurse is caring for a client in the emergency department.
1400:
Client admitted to the medical-surgical unit at 1200 today. Alert and orientated x4, heart and lung sounds clear. Client urinating 100 mL/hour. Client is tolerating soft diet and oral fluids. Bowel sounds are hyperactive in all 4 quadrants. Bilateral pedal pulses 2+. Blood glucose 310 mg/dL (74 to 106 mg/dL)
Question 3 of 5
Select the findings that indicate that the client's condition is improving.
Correct Answer: A,B,D
Rationale: Lower blood glucose, normal vital signs, and improved oxygenation suggest DKA improvement.
Extract:
Question 4 of 5
A nurse is caring for a client who is receiving a 0.9% sodium chloride via IV infusion. The client has become dyspneic with a blood pressure of 140/100 mm Hg, a fluid intake of 960 mL, and an output of 300 mL in the past 12 hr. Which of the following actions should the nurse take?
Correct Answer: C
Rationale: Dyspnea and fluid overload signs require slowing the infusion and notifying the provider.
Question 5 of 5
A nurse is caring for a client who has an arteriovenous graft. Which of the following findings indicates adequate circulation of the graft?
Correct Answer: D
Rationale: A palpable thrill indicates adequate blood flow through the arteriovenous graft.