ATI RN
ATI Med Surg Pharm Comprehensive Exam 1 Questions
Extract:
Question 1 of 5
An older adult client is scheduled to have an elective surgical procedure and informs the nurse that she wants to be designated as a 'do not resuscitate' (DNR) case. Which of the following responses should the nurse provide?
Correct Answer: D
Rationale: The provider should directly discuss the client's wishes regarding a DNR order to ensure understanding and documentation.
Question 2 of 5
A nurse is monitoring a client who is on telemetry. Which of the following findings on the ECG strip should the nurse recognize as normal sinus rhythm?
Correct Answer: B
Rationale: The P wave falling before the QRS complex is characteristic of normal sinus rhythm.
Question 3 of 5
A nurse is observing a newly licensed nurse prepare a sterile field. For which of the following actions should the nurse intervene?
Correct Answer: C
Rationale: Holding a bottle of solution with the label away from the palm of the hand is incorrect; the label should be held toward the palm to protect it from damage caused by spills.
Question 4 of 5
A nurse is assessing a client to identify risk factors for disease. Which of the following findings is a risk factor for metabolic syndrome?
Correct Answer: B
Rationale: A large waist size (abdominal obesity) is a significant risk factor for metabolic syndrome, which includes a cluster of conditions such as increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels.
Extract:
Vital Signs
1200:
Temperature 38.6° C (10.5° F)
Heart rate 109/min
Respiratory rate 28/min
Blood pressure 106/54 mm Hg
Oxygen saturation 94% on room air
Nurses' Notes
Client presents to ED with report of shortness of breath for 2 days, with headache, chills, fever, sore throat, and cough. States they went to a music concert recently "and probably picked up some kind of virus." Oriented to person, place, and time. Appears lethargic, difficulty answering questioning due to shortness of breath. Follows simple commands, moves all extremities with weakness.
Client's face is flushed, sinus tachycardia, rate of 109/min, S152 heart sounds heard on auscultation. Pulses palpable.
Breath sounds with crackles to right lower lobe, tachypnea, rate of 28/min. Frequent productive cough with thick yellow sputum. Client denies hemoptysis. Unable to lie down, states they are "more comfortable sitting up."
Bowel sounds active x 4 quadrants. Denies diarrhea, last bowel movement yesterday. States "no appetite since I've been sick."
Reports decreased urination over past 24 hr. "Haven't been drinking as much water as I should because my throat hurts."
Client reports they have not had a pneumococcal vaccine and does not get annual influenza vaccinations. States, "I just hate needles."
Diagnostic Results
1230:
Chest x-ray:
Areas of increased density and white infiltrates to lower right lobe indicative of pneumonia
Medical History
1215:
70 years of age
No significant medical history other than primary concern
Well nourished
Home Medications:
Daily multi-vitamin
Vitamin D
Social History.
Lives alone, partner died 5 years ago
Drinks 1 to 2 glasses of red wine daily
Has never smoked
Walks 2 to 3 miles 6 days/week
Question 5 of 5
Select 4 findings in the client's medical record that place them at risk for pneumonia.
Correct Answer: A,C,E,F
Rationale: The client has not received pneumococcal vaccine, which increases susceptibility to pneumococcal pneumonia. The client has not received influenza vaccine, which increases susceptibility to influenza-related pneumonia. The client's fluid intake seems to be reduced, as indicated by their decreased urination and reports of not drinking much water due to a sore throat, which can contribute to the risk of infection. Being 70 years old increases susceptibility to respiratory infections like pneumonia.