ATI RN
ATI Advanced Med Surg Final Exam 0924 Questions
Extract:
Question 1 of 5
A nurse is reviewing the medication history of a client who has a new prescription for colchicine. Which of the following medications increases the client's risk when used in combination with colchicine for developing rhabdomyolysis?
Correct Answer: D
Rationale: Atorvastatin increases the risk of rhabdomyolysis when used with colchicine, as both can contribute to muscle damage.
Question 2 of 5
A nurse is monitoring a client who has a leaking cerebral aneurysm. Which of the following manifestations should indicate to the nurse the client is experiencing an increase in intracranial pressure (ICP)? (Select all that apply.)
Correct Answer: A,B,C,E
Rationale: Slurred speech, headache, pupillary changes, and disorientation are all signs of increased ICP affecting neurological function. Neck pain and stiffness are more associated with meningitis or other conditions.
Extract:
Medical History
Day 1:
Patient came from ER complaining of chest pain. CPR initiated in ER and return to ROSC after 3 minutes. Intubated in ER (ACVC FIO2 100% Mode; RR13; PEEP 3: Tidal Volume 300ml and transferred to ICU for further care.
Nurses' Notes
Day 1:
S/p intubation, patient was given rocuronium, fentanyl and versed per radiology. Patient currently sedated. Lung crackles and bronchi. Heart regular and moderate. Pulses +1 on all extremities with +2 pitting edema. Hypoactive bowel sounds.
Diagnostic Results
Day 1:
Chest x-ray shows bilateral basilar infiltration
CBC
WBC 7.8
HGB13
K+3.9
Creatinine 2.0
BUN 60
GFR 38
BNP 1800
Troponin 1.7
ABG (Before intubation): pH7.2 CO2 76 HCO3 18
Vital Signs
Day 1
IN ER before cardiac arrest: Temperature 37.6° C (99.7° F)
Blood pressure 174/86 mm Hg
Heart rate 98/min
Respiratory rate 27/min
Pulse oximetry 93% on room air
After Intubation:
Temp 100.0F
Blood Pressure 87/40
HR 125/min. Sinus Tachycardia
RR: 13
Pulse Ox 100%
Question 3 of 5
For each potential nursing action, click to specify if the action is essential, nonessential, or contraindicated for the client.
| Options | Essential | Nonessential | Contraindicated |
|---|---|---|---|
| Administer furosemide | |||
| Administer ordered Epinephrine drip | |||
| Administer ordered low dose dopamine | |||
| Insert an indwelling urinary catheter | |||
| Administer ordered nitroglycerin | |||
| Administed 0.9% NS 500ML bolus |
Correct Answer: A,B,C,D,F
Rationale: Furosemide, epinephrine, dopamine, urinary catheter, and NS bolus are essential for managing pulmonary edema, hypotension, and monitoring fluid balance. Nitroglycerin is nonessential unless indicated for ongoing angina.
Extract:
Medical History
75-year-old male who reports increased dyspnea x 4 days. Denies cough or fever.
Past medical history: Two pack a day smoker for 50 years. Diagnosed with lung cancer 4 years ago and treated. Over the last year has developed frequent pleural effusions treated with thoracentesis. Hypertension.
Surgical history: Right lower lobectomy 4 years ago. Left hernia repair 25 years ago.
Nurses' Notes:
1000:
Alert and oriented x3. Reports difficulty breathing.
Respirations 28/min and labored.
Oxygen saturation 91%
Crackles auscultated left lung base. Fremitus decreased left chest wall.
1200:
Thoracentesis performed by provider.
1,000 mL cloudy yellow fluid removed, labeled and sent to lab for testing.
Dressing applied to puncture site.
Respiratory rate 24/min and regular. Oxygen saturation 95%
Question 4 of 5
The nurse is caring for the client following a thoracentesis. (Select the 3 findings that require immediate follow-up.)
Correct Answer: A,B,D
Rationale: Decreased lung sounds, heart rate 110/min, and subcutaneous emphysema indicate potential complications like pneumothorax or procedure-related issues requiring immediate follow-up.
Extract:
Question 5 of 5
A nurse is reviewing the laboratory findings for a client who has idiopathic thrombocytopenic purpura (ITP). Which of the following findings should the nurse expect to be decreased?
Correct Answer: D
Rationale: Platelets are expected to be decreased in ITP, which is characterized by an immune-mediated destruction of platelets.