ATI RN
ATI RN Adult Medical Surgical 2023 III Questions
Extract:
Question 1 of 5
A nurse is caring for a client who is postoperative and develops respiratory depression after receiving morphine for pain control. Which of the following medications should the nurse expect the provider to prescribe?
Correct Answer: D
Rationale: Naloxone reverses opioid-induced respiratory depression, restoring normal breathing.
Question 2 of 5
A nurse is caring for a client who has acute heart failure and received morphine IV 30 min ago. Which of the following findings should the nurse identify as an indication that the medication was effective?
Correct Answer: D
Rationale: Morphine reduces anxiety and preload in heart failure, improving comfort and respiratory effort.
Extract:
Medical History
HIV
Diagnostic Results
On Diagnosis:
Total WBC: 6,000/mm³ (Normal: 5,000 to 10,000/mm³)
Platelet Count: 154,000/mm³ (Normal: 150,000 to 400,000/mm³)
Sodium: 139 mEq/L (Normal: 136 to 145 mEq/L)
Potassium: 4.2 mEq/L (Normal: 3.5 to 5 mEq/L)
BUN: 16 mg/dL (Normal: 10 to 20 mg/dL)
3 Month Visit:
Total WBC: 5,500/mm³ (Normal: 5,000 to 10,000/mm³)
Platelet Count: 112,000/mm³ (Normal: 150,000 to 400,000/mm³)
Sodium: 136 mEq/L (Normal: 136 to 145 mEq/L)
Potassium: 3.8 mEq/L (Normal: 3.5 to 5 mEq/L)
BUN: 18 mg/dL (Normal: 10 to 20 mg/dL)
Question 3 of 5
The client is at risk for developing……. due to.....
Correct Answer: A,G
Rationale: Low platelet count in HIV increases bleeding risk due to impaired clotting.
Extract:
History and Physical
Presenting Complaint:
Time of Onset: 0630 hours
Symptoms: Client reports tightness in chest that radiates to left arm after eating breakfast. The pain was initially rated as 7/10 and reduced to 5/10 after treatment with nitroglycerin. Client also experienced nausea, diaphoresis, and shortness of breath. Heart rate was irregular and tachycardic.
Medical History:
Conditions: Hyperlipidemia, hypertension, type 2 diabetes mellitus.
Lifestyle: Non-smoker. Denies use of alcohol or recreational drugs.
Nurses' Notes
1000 Hours:
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.
1200 Hours:
Client states chest pain is now a 5 on a scale of 0 to 10 after 2 doses of nitroglycerin. Breathing easier with oxygen applied at 2 L/min via nasal cannula.
Vital Signs
1000 Hours:
Temperature: 37.1°C (98.8°F)
Heart Rate: 110/min, irregular
Respiratory Rate: 24/min
Blood Pressure: 164/80 mm Hg
Oxygen Saturation: 93% on room air
1015 Hours:
Temperature: 36.7°C (98.2°F)
Heart Rate: 120/min, irregular
Respiratory Rate: 22/min
Blood Pressure: 176/82 mm Hg
Oxygen Saturation: 89% on room air
1200 Hours:
Temperature: 36.7°C (98.2°F)
Heart Rate: 100/min, irregular
Respiratory Rate: 22/min
Blood Pressure: 110/62 mm Hg
Oxygen Saturation: 92% on 2 L/min via nasal cannula
Intake/Output:
Intake: 500 mL
Output: 32 mL
Diagnostic Results
Myoglobin: 100 mcg/L (Normal: <90 mcg/L)
Creatine Kinase: 180 units/L (Normal: 55-170 units/L)
Troponin T: 0.40 ng/mL (Normal: <0.1 ng/mL)
Troponin I: 0.35 ng/mL (Normal: <0.03 ng/mL)
Cholesterol: 244 mg/dL (Normal: <200 mg/dL)
Triglycerides: 180 mg/dL (Normal: 40-160 mg/dL)
LDL Cholesterol: 148 mg/dL (Normal: <130 mg/dL)
HDL Cholesterol: 42 mg/dL (Normal: >45 mg/dL)
C-reactive Protein: 2 mg/mL (Normal: <1.0 mg/mL)
Blood Glucose: 103 mg/dL (Normal: 74-106 mg/dL)
12-Lead ECG: Tachycardia with ST segment elevation and T wave changes
Chest X-ray: Lungs clear in all lobes
Provider's Prescriptions
Nitroglycerin: 0.4 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 100 mg PO twice daily
Peripheral IV Site: Initiated
IV Fluids: 0.9% sodium chloride at 50 mL/hr continuous infusion
Oxygen: 2 L/min via nasal cannula if O2 saturation < 90%
Question 4 of 5
The nurse is reviewing the client's medical record. Which of the following findings indicates the client's condition has improved? Select all that apply.
Correct Answer: B,D,E,F,G
Rationale: Improved blood pressure, pain, respiratory rate, heart rate, and oxygen saturation indicate stabilization of acute coronary syndrome.
Extract:
Question 5 of 5
A nurse is providing teaching to a client who is to start furosemide therapy for heart failure. Which of the following statements indicates that the client understands a potential adverse effect of this medication?
Correct Answer: B
Rationale: Limiting salt intake helps manage fluid retention, a key concern with furosemide's diuretic effect.