ATI RN
ATI Med Surg Nursing 300 Day Exam Questions
Extract:
Question 1 of 5
A patient is ordered 20 unit/kg IV bolus of Heparin. The patient weighs 154 lbs. Heparin is supplied 25,000 units/250 mL. How many mL will the nurse administer? (round to the nearest whole number)
Correct Answer: 14 mL
Rationale: 154 lbs ÷ 2.2 = 70 kg; 20 units/kg × 70 kg = 1400 units; 1400 units ÷ (25,000 units/250 mL) = 14 mL.
Question 2 of 5
The client problem of Activity Intolerance related to decrease in cardiac reserve is identified for a client with chronic heart failure. Which intervention should the nurse include in the plan of care related to this problem?
Correct Answer: C
Rationale: Alternating activity and rest periods helps manage energy demands and prevents overexertion in heart failure.
Question 3 of 5
The nurse is caring for a patient who is about to have a lumbar puncture to obtain cerebrospinal fluid for lab analysis. The patient is anxious about damage to the spinal cord. What is the best response by the nurse?
Correct Answer: C
Rationale: Explaining the needle placement below the spinal cord addresses the patient's fear of damage.
Question 4 of 5
The nurse is assessing the client with a recent pacemaker placement. The client's monitor is displaying what type of rhythm?
Correct Answer: D
Rationale: A dual-chamber (DD
D) pacemaker paces both the atrium and ventricle, as indicated by the rhythm strip showing pacing spikes for both chambers.
Question 5 of 5
The nurse notes that the client's rhythm strip indicates a PR-interval of 0.28 seconds. What is the nurse's analysis of this problem?
Correct Answer: D
Rationale: In 1st degree AV block, the PR interval is consistently prolonged, usually more than 0.20 seconds, but it is a constant, non-variable delay in the conduction between the atria and ventricles. A PR interval of 0.28 seconds is characteristic of a first-degree AV block.