ATI RN
ATI RN Adult Medical Surgical 2023 V Questions
Extract:
Question 1 of 5
A nurse is preparing to administer a unit of packed RBCs to a female client who has a hemoglobin of 7.2 g/dL (12 to 16 g/dL). Which of the following actions should the nurse take?
Correct Answer: C
Rationale: Verifying type and crossmatch ensures safe transfusion, preventing hemolytic reactions.
Question 2 of 5
A nurse is caring for a client who requires protective isolation following a hematopoietic stem cell transplant. Which of the following interventions should the nurse implement to protect the client from infection?
Correct Answer: B
Rationale: Positive-pressure airflow prevents contaminated air from entering, protecting immunocompromised clients.
Question 3 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.
Question 4 of 5
A nurse is preparing to receive a client from surgery following a transverse colon resection with colostomy placement. The nurse should expect to assess the stoma at which of the following locations?
Correct Answer: B
Rationale: A transverse colostomy stoma is typically located in the upper abdomen, near the midline.
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 5 of 5
A nurse is caring for a client in the emergency department. For each assessment finding, click to specify if the assessment finding is consistent with diabetic ketoacidosis (DKA) or hyperglycemic-hyperosmolar state (HHS). Each finding may support more than 1 disease process.
Correct Answer: A,B,C,D
Rationale: Poor skin turgor, high glucose, and elevated creatinine are common in both DKA and HHS; ketones are specific to DKA.