ATI RN
ATI RN Adult Medical Surgical 2023 V Questions
Extract:
Question 1 of 5
A nurse is caring for a client who has COPD and reports dyspnea. In which of the following positions should the nurse place the client?
Correct Answer: B
Rationale: Fowler's position (semi-upright) eases breathing in COPD by reducing pressure on the diaphragm.
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.
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.
Vital Signs
0900:
• Temperature 36.8° C (98.2° F)
• Pulse rate 110/min
• Respiratory rate 18/min
• Blood pressure 96/65 mm Hg
• Oxygen saturation 96% on room air
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 3 of 5
A nurse is caring for a client in the emergency department. Complete the following sentence by using the lists of options. The nurse should plan to first administer..... followed by.......
Correct Answer: A,F
Rationale: Saline corrects dehydration first, followed by insulin to lower glucose in DKA management.
Extract:
Question 4 of 5
A nurse is caring for a client following a cardiac catheterization who has hives and urticaria following administration of IV contrast dye. Which of the following medications should the nurse plan to administer?
Correct Answer: C
Rationale: Diphenhydramine treats allergic reactions like hives and urticaria caused by contrast dye.
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)
Vital Signs
0900:
• Temperature 36.8° C (98.2° F)
• Pulse rate 110/min Respiratory rate 18/min
• Blood pressure 96/65 mm Hg
• Oxygen saturation 96% on room air
1400:
• Temperature 36.8° C (98.2" F) Pulse rate 84/min
• Respiratory rate 16/min
• Blood pressure 106/76 mm Hg
• Oxygen saturation 96% on room air
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) S
• odium 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)
Provider Prescriptions
0930:
• Administer 0.9% sodium chloride at 15 ml/kg/hr for 1 hr and then reduce to 10 ml/kg/hr.
• Potassium chloride 20 mEq/L intravenous PRN potassium less than 5.0 mEq/L
• Regular insulin continuous infusion, titrate per DKA protocol once potassium is greater than 3.3 mEq/L.
• ondansetron 4mg intravenous bolus every 4 hr PRN nausea
• Acetaminophen 650 mg every 4 hr. PRN pain
• Magnesium sulfate 2 g intravenously over 2 hr for hypomagnesemia
• Strict I & O
• Blood glucose level hourly
• Initiate cardiac monitoring
Question 5 of 5
A nurse is caring for a client in the emergency department. Select the findings that indicate that the client's condition is improving.
Correct Answer: C,D,E
Rationale: Improved pulses, lower pulse rate, higher blood pressure, and reduced glucose indicate DKA resolution.