ATI RN
ATI Advanced Med Surg Final Exam 0924 Questions
Extract:
Question 1 of 5
A nurse is preparing to administer fluconazole 400 mg by intermittent IV bolus daily. Available is fluconazole 400 mg in 0.9% sodium chloride (NaCl) 200 mL to infuse over 2 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest tenth/whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Correct Answer: B
Rationale:
Total volume to infuse: 200 mL. Time for infusion: 2 hours. The IV pump rate is calculated as: 200 mL / 2 hr = 100 mL/hr.
Extract:
Nurses' Notes
Day 1:
0900:
Client admitted from emergency department with hemoptysis, dull chest pain, increasing fatigue, anorexia, nausea, chest tightness, and 3.2 kg (7 lb) weight loss in 2 weeks. Heart rate regular, lung sounds with crackles in bilateral upper lobes. No edema. Airborne precautions initiated upon admission.
Day 2:
1100:
Client reports shortness of breath, nausea, and fatigue. Crackles auscultated bilaterally throughout lung fields. Productive cough, with thick, blood-streaked sputum. Bowel sounds active, no edema.
Day 3:
0900:
Client reports some improvement in dyspnea. Client coughing up thick, yellow, blood-streaked sputum. Crackles auscultated in bilateral upper lobes of lungs. Sclera noted to be yellow. Client’s weight is 0.7 kg (1.6 lb) less than at admission. Encouraged to increase intake of oral fluids. Client reports urine appears reddish orange in color.
Medical history
Client has no chronic illnesses. Traveled out of the country 2 months ago.
Vital Signs
Day 1:
Temperature 38.6°C (101.4°F)
Heart rate 96/min
Respiratory rate 26/min
Blood pressure 158/88 mm Hg
Oxygen saturation 91% on room air
Day 2:
Temperature 38.4°C (101.2°F)
Heart rate 88/min
Respiratory rate 24/min
Blood pressure 152/82 mm Hg
Oxygen saturation 92% on 02 at 4L/min via nasal cannula
Day 3:
Temperature 37.8°C (100.1°F)
Heart rate 82/min
Respiratory rate 22/min
Blood pressure 130/78 mm Hg
Oxygen saturation 96% on 02 at 4L/min via nasal cannula
Provider prescriptions
Day 1:
Purified protein derivative 0.1 mL intradermal to right forearm
Isoniazid 300 mg PO daily
Rifampin 600 mg PO daily
Acetaminophen 500 mg 1-2 tablets PO every 4 to 6 hr PRN fever, pain
Diagnostic Results
Day 1
ALT 36 SI/L (4-36 SI/L)
AST 35 units/L (0-35 units/L)
Alkaline phosphatase 118 units/L (30-120 units/L)
Chest x-ray caseation with inflammation throughout upper lobes
Day 3:
Mantoux Test: 12 mm induration (negative, reaction less than 5 mm) ALT 38 SI-36 SI/L)
AST 36 units/L (0-35 units/L)
Alkaline phosphatase 129 units/L (30-120 units/L)
Question 2 of 5
A nurse on a medical-surgical unit is caring for a newly admitted client with a diagnosis of R/O tuberculosis. Which of the following findings should the nurse report to the provider?
Correct Answer: A
Rationale: Yellow sclera indicates jaundice, which could be a sign of liver dysfunction, especially concerning given the client is on isoniazid and rifampin, which can cause hepatotoxicity.
Extract:
Question 3 of 5
A nurse in the emergency department is caring for a client who sustained a head injury. The nurse notes the client's IV fluids are infusing at 125 mL/hr. Which of the following is an appropriate action by the nurse?
Correct Answer: D
Rationale: Continuing the rate at 125 mL/hr is appropriate for maintaining the current IV fluid regimen unless there are specific orders or conditions that require a change.
Question 4 of 5
A nurse is caring for a client who reports heart palpitations. An ECG confirms the client is experiencing ventricular tachycardia (VT). The nurse should anticipate the need for taking which of the following actions?
Correct Answer: B
Rationale: Defibrillation is used for pulseless ventricular tachycardia or ventricular fibrillation to restore a normal heart rhythm.
Question 5 of 5
A nurse is caring for a client who is postoperative following an open reduction internal fixation (ORIF) of a femur fracture. Which of the following parameters should the nurse include in the evaluation of the neurovascular status of the client's affected extremity? (Select all that apply.)
Correct Answer: B,C,D,E
Rationale: Skin integrity, temperature, color, and sensation are all critical parameters for assessing neurovascular status to detect complications like impaired circulation or nerve damage.