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 is receiving morphine through a PCA device. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct answer is A. Teaching the client how to self-medicate using the PCA device is essential to empower the client in managing their pain effectively. This promotes autonomy and ensures the client receives the appropriate dose at the right time, enhancing pain control.
Choice B is incorrect as family members should not press the PCA button for the client to maintain safety and prevent medication errors.
Choice C is incorrect as respiratory status should be monitored more frequently, ideally every 1-2 hours, when a client is receiving opioids due to the risk of respiratory depression.
Choice D is incorrect as administering an oral opioid for breakthrough pain may lead to overdose or adverse effects when already receiving morphine through PCA.
Question 2 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: The correct answer is D: Naloxone. Naloxone is an opioid antagonist that reverses the effects of opioids, including respiratory depression.
Therefore, the nurse should expect the provider to prescribe naloxone to counteract the respiratory depression caused by morphine. Flumazenil (
A) is a benzodiazepine antagonist and would not be effective in this situation. Calcium gluconate (
B) is used to treat calcium deficiencies and would not address respiratory depression. Diphenhydramine (
C) is an antihistamine and not indicated for reversing opioid-induced respiratory depression.
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.
Vital Signs (1000 Hours)
Temperature: 37.1°C (98.8°F). Heart Rate: 110/min, irregular. Respiratory Rate: 24/min. Blood Pressure: 164/80 mmHg. Oxygen Saturation: 93% on room air
Vital Signs (1015 Hours)
Temperature: 36.7°C (98.2°F). Heart Rate: 120/min, irregular. Respiratory Rate: 22/min. Blood Pressure: 176/82 mmHg. Oxygen Saturation: 89% on room air.
Diagnostic Results
Myoglobin: 100 mcg/L (high, normal <90 mcg/L), Creatine kinase: 180 units/L (normal, 55-170 units/L), Troponin T: 0.40 ng/mL (high, normal <0.1 ng/mL), Troponin I: 0.35 ng/mL (high, normal <0.03 ng/mL), Cholesterol: 244 mg/dL (high, normal <200 mg/dL), Triglycerides: 180 mg/dL (normal, 40-160 mg/dL), LDL: 148 mg/dL (high, normal <130 mg/dL), HDL: 42 mg/dL (good, normal >45 mg/dL), C-reactive protein: 2 mg/L (high, normal <1.0 mg/L), Blood glucose: 103 mg/dL (normal, 74-106 mg/dL), EKG: Tachycardia with ST segment elevation & T wave changes, Chest X-ray: Lungs clear in all lobes.
Provider's Prescriptions - 1020:
Nitroglycerin 0.5 mg SL every 5 min up to 3 doses for chest pain
Aspirin 160 mg PO daily - Morphine 6 mg IV bolus every 3 hr PRN pain
Metoprolol 25 mg PO every 6 hrs x 48 hrs, then 100 mg PO twice daily
Initiate IV site - 0.9% saline at 50 mL/hr IV infusion
Oxygen at 2 L/min via nasal cannula if oxygen saturation <90%
Schedule stat echocardiogram
Follow-up (1200 Hours)
Pain now 5/10 after two doses of nitroglycerin. Breathing easier with oxygen at 2L/min via nasal cannula.
Question 3 of 5
Which findings indicate the client's condition has improved? (Select all that apply)
Correct Answer: A, B
Rationale: The correct answers are A and B. Pain level indicates the client's subjective improvement, while respiratory rate reflects their physiological status. Pain reduction suggests improved comfort and possibly better overall health, while a decrease in respiratory rate may indicate improved oxygenation and reduced stress.
Choices C, D, E, F, and G are not directly linked to the client's overall condition improvement as they can vary for several reasons, independent of the client's actual health status.
Extract:
Question 4 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: A
Rationale: The correct answer is A: Blood pressure 90/50 mm Hg. Dopamine is a vasopressor used to increase blood pressure in hypovolemic shock. A low blood pressure reading of 90/50 mm Hg indicates inadequate perfusion, warranting an increase in dopamine dosage to improve cardiac output. Oxygen saturation (
B) and respiratory rate (
D) are not direct indicators for adjusting dopamine dosage. A heart rate of 60/min (
C) may be within normal limits depending on the client's condition.
Question 5 of 5
A nurse is administering furosemide 80 mg PO twice daily to a client who has pulmonary edema. Which of the following assessment findings indicates to the nurse that the medication is effective?
Correct Answer: C
Rationale: The correct answer is C: Weight loss of 1.8 kg (4 lb) in the past 24 hr. Furosemide is a diuretic that helps to reduce fluid retention, so weight loss indicates the medication is effectively reducing pulmonary edema. Adventitious breath sounds indicate respiratory issues, not medication effectiveness. A respiratory rate of 24/min could be within normal range and not necessarily indicative of medication effectiveness. Elevation in blood pressure could indicate a potential adverse effect of furosemide, not effectiveness. Weight loss is the most direct indicator of reduced fluid volume due to diuresis.