ATI RN
ATI Advanced Med Surg Final Exam 0924 Questions
Extract:
Question 1 of 5
A nurse is teaching a client about risk factors for osteoporosis. Which of the following factors should the nurse include in the teaching? (Select all that apply.)
Correct Answer: A,B,D
Rationale: Aging increases the risk for osteoporosis due to natural bone density loss over time. Secondhand smoke contributes to bone loss and increases the risk for osteoporosis. Caffeine intake is associated with increased calcium loss, which can contribute to osteoporosis.
Extract:
Nurse's Notes
Client admitted to the unit for a lower GI bleed. Continues to have frequent bloody stools and is scheduled for a lower endoscopy in 4 hr. The client is receiving their fourth unit of packed red blood cells (packed RBCs). Unit of fourth packed RBCS started at a rate of 250 cc/hr. Thirty minutes after the transfusion started, client started reporting dyspnea and restlessness. Crackles auscultated in bilateral lower lobes. oxygen saturation 92% on 2L nasal cannula, and jugular vein distension noted.
Vital Signs
Temperature 37.3" (99.1" F)
Blood pressure 189/90 mm Hg
Pulse rate 100/min
Respiratory rate 28/min
Question 2 of 5
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.
Correct Answer: B,C
Rationale: The client's symptoms are consistent with TACO. Administer furosemide to reduce fluid overload and diphenhydramine for possible mild allergic reaction. Monitor intake and output and weight to assess fluid balance.
Extract:
Nurses' Notes
1000:
Client presents with reports of shortness of breath, dizziness, and "feelings of pressure" in jaw, neck, and left arm. Was mowing the lawn when feelings of discomfort began.
Denies chest pain, nausea, palpitations.
Provider updated, prescriptions received.
1010:
Nitroglycerin sublingual tablet administered x 3, 5 min apart. Updated provider on diagnostic results. Prescriptions received.
1025:
Client states relief from discomfort, no further shortness of breath, dizziness, or feelings of pressure, continues to deny chest pain.
Provider updated, prescriptions received.
Vital signs
Temperature 36.4°C (97.6°F)
Heart rate 112/min
Respiratory rate 28/min
Blood pressure 146/74 mm Hg
SaO2 93% on room air
1015:
Temperature 36.4°C (97.6°F)
Heart rate 92/min
Respiratory rate 24/min
Blood pressure 126/64 mm Hg
SaO, 96% on oxygen @ 2L/min via nasal cannula
Provider Prescriptions
1005:
12 Lead EKG
Serum cardiac enzymes
Nitroglycerin 0.3 mg sublingual now, may repeat every 5 min for 2 additional doses
Diagnostic Results
1010:
12 Lead EKG:
ST depression and T-wave inversion
Question 3 of 5
For each of the following findings in the client's medical record, click to specify if they are consistent with angina or a myocardial infarction (MI). Each finding may support more than one disease process.
| Options | Angina | Myocardial infarction |
|---|---|---|
| Provider consult | ||
| Client's initial report of manifestations | ||
| Treadmill stress test | ||
| Result of nitroglycerin therapy | ||
| 12 Lead EKG report |
Correct Answer: B,D,E
Rationale: Client's initial manifestations, nitroglycerin relief, and EKG changes are consistent with both angina and MI, though MI requires further confirmation.
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 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.