ATI RN
ATI Med Surg Pharm Comprehensive Exam 1 Questions
Extract:
Question 1 of 5
A nurse is reviewing the medical record of a client who has a potassium level of 3.0 mEq/L. Which of the following findings should the nurse recognize as a potential causative factor?
Correct Answer: B
Rationale: NG tube to gastric suction can lead to potassium loss through gastric secretions, potentially causing hypokalemia.
Question 2 of 5
A nurse is reviewing laboratory results of a client who has atrial fibrillation and is taking warfarin. For which of the following results should the nurse notify the provider?
Correct Answer: A
Rationale: A PT of 45 seconds is prolonged and indicates a potential risk of bleeding due to excessive anticoagulation with warfarin. The nurse should notify the provider for further evaluation and adjustment of the warfarin dosage.
Extract:
History and Physical
Diabetes mellitus type 2 for 15 years
Hypertension for 25 years
Hyperlipidemia for 20 years
History of smoking 40 packs per year
Cerebrovascular accident (CVA) 5 days ago
Nurses' Notes
Day 1, Medical-Surgical Unit (5 days post-CVA):
Client transferred from ICU via gurney, hand-off report received. Client asleep, respirations eupneic, heart rate regular. Abdomen soft, nondistended, active bowel sounds x4 quadrants. No edema noted, compression stockings present. Indwelling urinary catheter draining clear yellow urine. 14 French NG tube noted in right nares, clamped.
Day 2, Medical-Surgical Unit (6 days post-CVA):
Assessment completed. Client awakens for short periods of time, unable to speak, occasional moans noted. Client incontinent of stool, cleaned skin and barrier ointment applied. Skin intact without any areas of erythema. Client unable to reposition self. Occasional movement of left arm and leg noted, right side without movement. Physical therapists in to see client for morning exercises. NG tube noted in right nares, clamped.
Provider Prescriptions
Day 1, Medical-Surgical Unit (5 days post-CVA):
Begin clopidogrel 75 mg via NG tube daily
Diagnostic Results
Day 1, Medical-Surgical Unit (5 days post-CVA):
WBC count 6,900/mm3 (5,000 to 10,000/mm3)
Hgb 16 g/dL (12 g/dL to 16 g/dL)
Hct 41% (37% to 47%)
Platelet count 310,000/mm3 (150,000 to 400,000/mm3)
Day 2, Medical-Surgical Unit (6 days post-CVA):
WBC count 7,200/mm3 (5,000 to 10,000/mm3)
Hgb 16.5 g/dL (12 g/dL to 16 g/dL)
Hct 42% (37% to 47%)
Day 1, Medical-Surgical Unit (5 days post-CVA):
WBC count 6,900/mm3 (5,000 to 10,000/mm3)
Hgb 16 g/dL (12 g/dL to 16 g/dL)
Hct 41% (37% to 47%)
Platelet count 310,000/mm3 (150,000 to 400,000/mm3)
Day 2, Medical-Surgical Unit (6 days post-CVA):
WBC count 7,200/mm3 (5,000 to 10,000/mm3)
Hgb 16.5 g/dL (12 g/dL to 16 g/dL)
Hct 42% (37% to 47%)
Question 3 of 5
The client is at risk for developing _ and _
Correct Answer: A,B
Rationale: The client is at risk for developing pressure injury and foot drop. Given the client's history of a recent cerebrovascular accident (CV
A) and the inability to reposition themselves, there is a heightened risk for pressure injuries due to prolonged periods of immobility. Additionally, the observed occasional movement of the left arm and leg with the right side without movement suggests a potential for muscle weakness or paralysis, which can lead to foot drop.
Extract:
Question 4 of 5
A nurse is caring for the client who has Ménière's disease and asks if he is allowed to ambulate independently. Which of the following responses should the nurse make?
Correct Answer: D
Rationale: Assisting the client when they wish to get out of bed ensures safety by preventing falls, which are a significant risk for those with Ménière's disease due to vertigo.
Extract:
Vital Signs
1200:
Temperature 38.6° C (10.5° F)
Heart rate 109/min
Respiratory rate 28/min
Blood pressure 106/54 mm Hg
Oxygen saturation 94% on room air
Nurses' Notes
Client presents to ED with report of shortness of breath for 2 days, with headache, chills, fever, sore throat, and cough. States they went to a music concert recently "and probably picked up some kind of virus." Oriented to person, place, and time. Appears lethargic, difficulty answering questioning due to shortness of breath. Follows simple commands, moves all extremities with weakness.
Client's face is flushed, sinus tachycardia, rate of 109/min, S152 heart sounds heard on auscultation. Pulses palpable.
Breath sounds with crackles to right lower lobe, tachypnea, rate of 28/min. Frequent productive cough with thick yellow sputum. Client denies hemoptysis. Unable to lie down, states they are "more comfortable sitting up."
Bowel sounds active x 4 quadrants. Denies diarrhea, last bowel movement yesterday. States "no appetite since I've been sick."
Reports decreased urination over past 24 hr. "Haven't been drinking as much water as I should because my throat hurts."
Client reports they have not had a pneumococcal vaccine and does not get annual influenza vaccinations. States, "I just hate needles."
Diagnostic Results
1230:
Chest x-ray:
Areas of increased density and white infiltrates to lower right lobe indicative of pneumonia
Medical History
1215:
70 years of age
No significant medical history other than primary concern
Well nourished
Home Medications:
Daily multi-vitamin
Vitamin D
Social History.
Lives alone, partner died 5 years ago
Drinks 1 to 2 glasses of red wine daily
Has never smoked
Walks 2 to 3 miles 6 days/week
Question 5 of 5
Select 4 findings in the client's medical record that place them at risk for pneumonia.
Correct Answer: A,C,E,F
Rationale: The client has not received pneumococcal vaccine, which increases susceptibility to pneumococcal pneumonia. The client has not received influenza vaccine, which increases susceptibility to influenza-related pneumonia. The client's fluid intake seems to be reduced, as indicated by their decreased urination and reports of not drinking much water due to a sore throat, which can contribute to the risk of infection. Being 70 years old increases susceptibility to respiratory infections like pneumonia.