ATI RN
ATI RN Adult Medical Surgical 2023 V Questions
Extract:
Question 1 of 5
A nurse is teaching a client who has Graves' disease about recognizing the manifestations of thyroid storm. Which of the following findings should the nurse include in the teaching?
Correct Answer: B
Rationale: Thyroid storm causes hyperthermia due to excessive thyroid hormone, leading to increased temperature as a key manifestation.
Question 2 of 5
A nurse is preparing to obtain a guaiac smear sample from a client for fecal occult blood testing. Which of the following actions should the nurse plan to take?
Correct Answer: D
Rationale: Urine can contaminate the sample, leading to inaccurate fecal occult blood test results.
Extract:
Medical History
• Dehydration
• Hyperlipidemia
• Hypertension
• Coronary artery disease (CAD)
Diagnostic Results
• WBC count 14,000/mm3 (5,000 to 10,000/mm3)
• Hgb 14 g/dL (12 to 16 g/dL)
• Hct 40% (34 to 47%)
• Sodium 132 mEq/L (136 to 146 mEq/L)
• Potassium 6.2 mEq/L (3.5 to 5 mEq/L)
• Calcium 10 mg/dL (9 to 10.5 mg/dL)
• BUN 20 mg/dL (10 to 20 mg/dL)
• Albumin 2.8 g/dL (3.5 to 5 g/dL)
• Fasting blood glucose 140 mg/dL (74 to 106 mg/dL)
• Triglycerides 134 mg/dL (34 to 160 mg/dL)
Nurses' Notes
Client is lying in bed. Awake, alert, and oriented to time, place, and person. Client is febrile and reports weakness. Receiving TPN via central line in left antecubital. Client is NPO and has had diarrhea x3 in past 4 hr. Crackles auscultated in posterior lobes. Client has a productive cough and sputum is yellow in color. Client receiving 2 U/min oxygen via nasal cannula with an oxygen saturation of 90%. Abdomen is distended and tender. Active range of motion to all extremities. Denies pain at this time.
Question 3 of 5
A nurse is caring for a client who is receiving TPN. Which of the following actions should the nurse take? For each potential nursing intervention, click to specify if the potential intervention is anticipated, nonessential, or contraindicated for the client.
| Options | Anticipated | Nonessential | Contraindicated |
|---|---|---|---|
| Notify provider to increase TPN rate/hr. | |||
| Decrease the client's oxygen to 1.5 L/min oxygen via nasal cannula. | |||
| Obtain client weight twice daily. | |||
| Request a prescription for insulin. | |||
| Request an antibiotic to be administered. | |||
| Have 3 nurses verify the TPN solution prescription. |
Correct Answer: C,D,E
Rationale: Weight monitoring ensures nutritional adequacy, insulin corrects hyperglycemia, and antibiotics address infection signs (crackles, yellow sputum).
Extract:
Question 4 of 5
A nurse is assessing a client who has skeletal traction for a femoral fracture. The nurse notes that the weights are resting on the floor. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: Elevating the extremity ensures weights hang freely, maintaining traction alignment.
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.
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
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)
• Sodium 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)
Question 5 of 5
A nurse is caring for a client in the emergency department. For each assessment finding, click to specify if the assessment finding is consistent with diabetic ketoacidosis (DKA) or hyperglycemic-hyperosmolar state (HHS). Each finding may support more than 1 disease process.
Correct Answer: A,B,C,D
Rationale: Poor skin turgor, high glucose, and elevated creatinine are common in both DKA and HHS; ketones are specific to DKA.