ATI RN
ATI RN Adult Medical Surgical 2023 Questions Correct Answers Questions
Extract:
Question 1 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: B
Rationale: The correct answer is B: Administer aspirin. Administering aspirin is the priority action for a client with acute angina as it helps in reducing platelet aggregation and improving blood flow to the heart. This action can potentially prevent further clot formation and decrease the risk of a heart attack. It is essential to address the acute symptoms first before proceeding with other interventions. Measuring blood pressure (
A), administering nitroglycerin (
C), and initiating IV access (
D) are important actions but administering aspirin takes precedence in this scenario to address the acute angina symptoms promptly.
Extract:
Client reports tightness in chest radiating to the left arm. Pain level: 7/10. Feels nauseous after breakfast. Client states: 'I had scrambled eggs and bacon like I do every morning.' Symptoms: Diaphoresis, shortness of breath, irregular and tachycardic heart rate. Neurological Status: Alert and oriented to person, place, and time. Lung Sounds: Clear in all lobes. Bowel Sounds: Present in all 4 quadrants. Peripheral Circulation: +1 pedal pulses, skin cool to touch, capillary refill <2 seconds.
Question 2 of 5
Which actions should the nurse take? (Select all that apply)
Correct Answer: A, B, D,E
Rationale: The nurse should anticipate cardiac catheterization prep (
A) to ensure client readiness. Continuous heparin infusion (
B) prevents clot formation during the procedure. Increased metoprolol dosage (
D) may be needed for cardiac stability. NPO status (E) is crucial to prevent complications during the procedure. Ambulation (
C) may be contraindicated due to the invasive nature of the procedure. Antibiotics (F) are not routinely needed for cardiac catheterization prep.
Extract:
Question 3 of 5
A nurse is assessing a client who has a pressure injury. Which of the following findings should the nurse expect as an indication the wound is healing?
Correct Answer: D
Rationale: The correct answer is D: Dark red granulation tissue. Granulation tissue is a sign of healing in a wound, indicating new blood vessels and collagen formation. Dark red color indicates good blood supply. A: Firm wound tissue can indicate infection or inadequate healing. B: Dry brown eschar is a sign of necrotic tissue, not healing. C: Light yellow exudate can indicate infection or inflammation.
Question 4 of 5
A nurse is caring for a client who is experiencing diabetic ketoacidosis (DKA). Which of the following is the priority intervention by the nurse?
Correct Answer: D
Rationale: The correct answer is D: Administer 0.9% sodium chloride. The priority intervention in DKA is fluid resuscitation to correct dehydration and electrolyte imbalances. 0.9% sodium chloride helps restore intravascular volume and improves kidney perfusion. Checking potassium levels (
A) is important but can wait until after fluid resuscitation. Beginning bicarbonate infusion (
B) is not recommended as it can worsen acidosis. Initiating continuous IV insulin infusion (
C) is important but should follow fluid resuscitation. Administering 0.9% sodium chloride takes precedence in managing DKA.
Question 5 of 5
A nurse is providing instructions about foot care for a client who has peripheral arterial disease. The nurse should identify that which of the following statements by the client indicates an understanding of the teaching?
Correct Answer: A
Rationale: The correct answer is A because applying a lubricating lotion to the cracked areas on the soles of the feet helps prevent further skin breakdown and infection, which is crucial in peripheral arterial disease.
Choice B may improve circulation, but it does not address foot care directly.
Choice C can lead to burns or injury due to decreased sensation in peripheral arterial disease.
Choice D poses a risk of injury or infection due to the potential for skin damage while soaking the feet. Overall, choice A is the most appropriate for maintaining foot health in peripheral arterial disease.