ATI RN
ATI Medsurg Proctored Final Exam Questions
Extract:
Question 1 of 5
A nurse on a medical-surgical unit is performing an admission assessment of a client who has COPD with emphysema. The client reports that he has a frequent productive cough and is short of breath. The nurse should anticipate which of the following assessment findings for this client?
Correct Answer: B
Rationale: The correct answer is B: Increased anteroposterior diameter of the chest. In COPD with emphysema, there is air trapping leading to hyperinflation of the lungs, causing the chest to expand more in the front-to-back direction (increased anteroposterior diameter). This is known as barrel chest.
A: Fine crackles are not typically associated with COPD/emphysema, they are more common in conditions like heart failure or pneumonia.
C: Increased tactile fremitus is not typically seen in COPD/emphysema, it may be present in conditions like pneumonia.
D: Fever and chills are not typical findings in COPD/emphysema unless there is an infection present.
Question 2 of 5
A nurse is evaluating teaching on a client who has a new prescription for montelukast to treat asthma. Which of the following statements by the client indicates an understanding of the teaching?
Correct Answer: A
Rationale:
Correct
Answer: A. "I'll take this medication once a day in the evening."
Rationale:
1. Montelukast is usually taken once daily in the evening to provide optimal control of asthma symptoms.
2. Taking it consistently at the same time every day helps maintain a steady level of the medication in the body.
3. This statement shows the client understands the prescribed dosing schedule and is likely to adhere to it.
Summary of other choices:
B. Incorrect: Waiting to take the medication only during an asthma attack is not the correct way to manage asthma as montelukast is meant for daily maintenance.
C. Incorrect: Taking the medication before exercise is not the recommended timing for montelukast administration.
D. Incorrect: Stopping the medication when feeling better can lead to a worsening of asthma symptoms as montelukast helps prevent asthma attacks.
Question 3 of 5
A nurse is caring for a client who has asthma and is taking fluticasone. The nurse should monitor the client for which of the following adverse effects?
Correct Answer: A
Rationale: The correct answer is A: Oral candidiasis. Fluticasone is a corticosteroid inhaler commonly used to manage asthma. Corticosteroids can suppress the immune system locally, leading to oral candidiasis. The nurse should monitor for white patches in the mouth. Hypertension (
B), increased appetite (
C), and weight loss (
D) are not commonly associated with fluticasone use.
Question 4 of 5
A nurse is providing discharge teaching to a client who has asthma and new prescriptions for cromolyn and albuterol, both by nebulizer. Which of the following statements by the client indicates an understanding of the teaching?
Correct Answer: A
Rationale: The correct answer is A: "I will be sure to take the albuterol before taking the cromolyn." This is because albuterol is a bronchodilator that helps to open up the airways quickly, providing immediate relief during an asthma attack. Cromolyn, on the other hand, is a mast cell stabilizer that helps to prevent asthma attacks but does not provide immediate relief. Taking albuterol first allows for quick relief, followed by cromolyn for long-term prevention.
Choice B is incorrect as taking both medications at the same time may not allow for the full effectiveness of each drug.
Choice C is incorrect as cromolyn should be taken before albuterol to allow time for it to take effect.
Choice D is incorrect as there is a specific order in which these medications should be taken for optimal results.
Question 5 of 5
A nurse is discharging a child who has sickle cell anemia after an acute crisis episode. Which of the following instructions should the nurse include in the teaching?
Correct Answer: A
Rationale: The correct answer is A: Offer fluids to your child multiple times every day. This is important in sickle cell anemia to prevent dehydration and promote good blood flow, reducing the risk of sickling and subsequent crisis episodes. Adequate hydration helps maintain the flexibility of red blood cells and prevents them from clumping together. Options B, C, and D are incorrect because limiting fluid intake can lead to dehydration and worsen the symptoms of sickle cell anemia during and after a crisis episode. It is essential to encourage regular fluid intake to keep the child well-hydrated and prevent complications.