ATI RN
ATI RN Adult Medical Surgical 2023 V Questions
Extract:
Question 1 of 5
A nurse is teaching a client who has asthma about how to use a metered-dose inhaler with a spacer. Which of the following information should the nurse include in the teaching?
Correct Answer: B
Rationale: Holding the breath for 10 seconds allows medication to deposit in the lungs, maximizing effectiveness.
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.
1400:
Client admitted to the medical-surgical unit at 1200 today. Alert and orientated x4, heart and lung sounds clear. Client urinating 100 mL/hour. Client is tolerating soft diet and oral fluids. Bowel sounds are hyperactive in all 4 quadrants. Bilateral pedal pulses 2+. Blood glucose 310 mg/dL (74 to 106 mg/dL)
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
1400:
• Temperature 36.8° C (98.2" F) Pulse rate 84/min
• Respiratory rate 16/min
• Blood pressure 106/76 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) S
• odium 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)
Provider Prescriptions
0930:
• Administer 0.9% sodium chloride at 15 ml/kg/hr for 1 hr and then reduce to 10 ml/kg/hr.
• Potassium chloride 20 mEq/L intravenous PRN potassium less than 5.0 mEq/L
• Regular insulin continuous infusion, titrate per DKA protocol once potassium is greater than 3.3 mEq/L.
• ondansetron 4mg intravenous bolus every 4 hr PRN nausea
• Acetaminophen 650 mg every 4 hr. PRN pain
• Magnesium sulfate 2 g intravenously over 2 hr for hypomagnesemia
• Strict I & O
• Blood glucose level hourly
• Initiate cardiac monitoring
Question 2 of 5
A nurse is caring for a client in the emergency department. Select the findings that indicate that the client's condition is improving.
Correct Answer: C,D,E
Rationale: Improved pulses, lower pulse rate, higher blood pressure, and reduced glucose indicate DKA resolution.
Extract:
Question 3 of 5
A nurse is caring for a client who is receiving a 0.9% sodium chloride via IV infusion. The client has become dyspneic with a blood pressure of 140/100 mm Hg, a fluid intake of 960 mL, and an output of 300 mL in the past 12 hr. Which of the following actions should the nurse take?
Correct Answer: C
Rationale: Dyspnea and fluid overload signs suggest slowing the infusion and notifying the provider to prevent worsening heart failure.
Question 4 of 5
A nurse is admitting a client who has meningitis. Which of the following findings should the nurse expect?
Correct Answer: A
Rationale: Photophobia is a common symptom of meningitis due to meningeal irritation affecting the eyes.
Question 5 of 5
A nurse in the emergency department is evaluating a young adult client for bacterial meningitis. Which of the following actions should the nurse take as part of the focused assessment?
Correct Answer: C
Rationale: Nuchal rigidity is a classic sign of meningitis, assessed by resistance or pain when flexing the neck, indicating meningeal irritation.