ATI RN
ATI Nur 175 Med Surg Exam Questions
Extract:
Question 1 of 5
A nurse is caring for an older adult client who has a terminal illness and is ventilator-dependent. The client is alert and oriented and he wants to discontinue use of the ventilator. The nurse should be aware that continued treatment against the client's wishes is a violation of which of the following ethical principles?
Correct Answer: B
Rationale: Fidelity refers to the principle of keeping promises and being faithful to one's commitments. It involves loyalty and maintaining trust in the nurse-client relationship. While fidelity is important, it is not the most relevant principle in the context of respecting a client's decision to discontinue treatment. Autonomy is the ethical principle that recognizes an individual's right to make their own decisions and choices regarding their healthcare. Respecting a client's autonomy means acknowledging their right to refuse or discontinue treatment, even if the healthcare team disagrees with their decision. In this case, continued treatment against the client's wishes would violate their autonomy. Justice refers to the principle of fairness and equality in the distribution of resources and care. It involves ensuring that all clients receive equitable treatment. While justice is a key ethical principle, it is not the primary issue when considering the client's wish to discontinue ventilator support. Veracity refers to the principle of truthfulness and honesty in communication with clients. It involves providing accurate and complete information to enable clients to make informed decisions. While veracity is essential, it does not directly address the issue of respecting the client's decision to discontinue treatment.
Question 2 of 5
The nurse is caring for a client being prepared for a left total knee replacement surgery. The nurse is witnessing the surgeon obtain informed consent before the procedure. Which essential components must be present to obtain informed consent? (Select all that apply)
Correct Answer: A,B,C,D,E
Rationale:
Choice A reason: Informing the client when the procedure or treatment will be done is crucial for obtaining informed consent. This information helps the client understand the timeline and schedule for the procedure, which is essential for their planning and mental preparation. Knowing the exact date and time also allows the client to arrange for any necessary assistance or support they might need before and after the procedure.
Choice B reason: The purpose of the proposed treatment or procedure must be clearly explained to the client. This information helps the client understand why the procedure is necessary and what it aims to achieve. Providing a clear rationale for the treatment ensures that the client is fully aware of the medical reasons behind the procedure, which is a fundamental aspect of informed consent.
Choice C reason: The expected outcomes of the proposed treatment or procedure should be discussed with the client. This includes both the potential benefits and the goals of the treatment. By understanding the expected outcomes, the client can make an informed decision about whether to proceed with the procedure, weighing the potential benefits against the risks and alternatives.
Choice D reason: Identifying who will perform the treatment or procedure is an essential component of informed consent. The client has the right to know the qualifications and expertise of the healthcare professional who will be performing the procedure. This information helps build trust and ensures the client feels confident in the care they will receive.
Choice E reason: An explanation of the possible risks from the treatment or procedure is necessary for obtaining informed consent. Clients must be fully informed about the potential risks and complications associated with the procedure so that they can make an educated decision about whether to proceed. This transparency is critical for respecting the client's autonomy and ensuring they are fully aware of all aspects of their care.
Question 3 of 5
The emergency department nurse is triaging clients arriving from a mass casualty incident. During the triage, the nurse confirms that each client has a disaster tag. What information should be placed on the tag for each client? (Select all that apply)
Correct Answer: A,B,C,D,E
Rationale:
Choice A reason: Including client information on the disaster tag is crucial for identification and tracking purposes. This information ensures that each client can be accurately identified, which is essential for providing appropriate care and for communication with family members and other healthcare providers.
Choice B reason: Triage priority is an essential piece of information that indicates the level of urgency for each client's care. This prioritization helps healthcare providers quickly identify which clients need immediate attention and which can wait, thereby optimizing the use of limited resources during a mass casualty incident.
Choice C reason: Next of kin information is important for contacting family members and loved ones in case of emergency. This information is essential for communicating the client's status, obtaining additional medical history, and providing support to the family during a stressful time.
Choice D reason: Decontamination information, if applicable, indicates whether the client has undergone decontamination procedures. This is critical for ensuring that contaminated clients do not pose a risk to others, including healthcare providers and other patients, and for maintaining a safe environment within the healthcare facility.
Choice E reason: Documenting medications and treatments administered is vital for continuity of care. This information allows healthcare providers to track what treatments have been given, avoid duplication of medications, and monitor the client's response to treatment. It also ensures that any subsequent healthcare providers have a complete record of the client's care.
Question 4 of 5
As a member of the quality improvement committee, a nurse is evaluating the results of recently implemented measures designed to reduce medication errors. Which of the following methods should the nurse use to evaluate the success of the changes?
Correct Answer: C
Rationale: Conducting a study about the time and money costs of implementing the change is valuable for understanding the resource implications of the measures. However, it does not directly evaluate the effectiveness of the changes in reducing medication errors. Providing the staff with a questionnaire to quantify staff satisfaction with the changes can offer insights into how well the measures are being received by the staff and may indicate potential areas for improvement in implementation. Nonetheless, it does not measure the direct impact on medication error rates. Comparing the number of medication errors before and after the action was implemented is the most direct and effective method to evaluate the success of the changes. This approach allows the committee to measure the actual impact of the interventions on reducing medication errors, providing clear evidence of their effectiveness. Establishing a benchmark to identify a standard of performance is essential for setting goals and expectations. However, it is not a method for evaluating the success of changes that have already been implemented. It is more relevant for future goal-setting and performance measurement.
Question 5 of 5
The nurse is working on the step-down unit and receives the shift-to-shift report on four clients. Based on the report information, which client would be the highest priority to assess first?
Correct Answer: C
Rationale: A 32-year-old male with a femur fracture in traction is stable but needs ongoing pain management and monitoring for complications like infection or deep vein thrombosis (DVT). While this client requires attention, they are not in immediate critical condition compared to other patients on the list. A 38-year-old female with a grade 1 liver laceration admitted 2 days ago also requires close observation for signs of bleeding or worsening liver function. However, given that the liver laceration is of a lesser severity (grade 1), the immediate priority is less critical compared to a client with respiratory compromise. A 41-year-old male with 4 rib fractures, pneumothorax, and a chest tube is the highest priority. The presence of pneumothorax indicates a potential life-threatening condition that requires close monitoring to ensure the chest tube is functioning correctly and the lung is re-expanding. Any compromise in the chest tube's functionality can lead to respiratory distress or failure, making this client the most critical and requiring immediate assessment. A 55-year-old female admitted 6 days ago with a chest contusion and scheduled for discharge today is likely stable and does not have the same level of urgency as a client with a pneumothorax. This client needs final evaluations and discharge planning, but their condition does not present an immediate life-threatening risk.