ATI RN
ATI Med Surg Pharm Comprehensive Exam 1 Questions
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 1 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.
Extract:
Question 2 of 5
A nurse is preparing to administer penicillin G benzathine 1.2 million units IM now. The amount available is penicillin G benzathine 600,000 units/mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Correct Answer: 2
Rationale:
To administer the correct dose of penicillin G benzathine, which is 1.2 million units, and given that the available concentration is 600,000 units per mL, the nurse should calculate the volume to administer based on these values. By dividing the prescribed dose by the concentration available, the nurse can determine the volume needed for injection. In this case, 1.2 million units divided by 600,000 units per mL results in 2 mL.
Question 3 of 5
A nurse is caring for a client who has a cardiopulmonary arrest. The nurse anticipates the emergency response team will administer which of the following medications if the client's restored rhythm is symptomatic bradycardia?
Correct Answer: B
Rationale: Atropine is the first-line treatment for symptomatic bradycardia as it increases heart rate by blocking the vagus nerve's effect on the heart.
Question 4 of 5
A nurse is teaching a client who has chronic obstructive pulmonary disease and is to start using fluticasone by MDI twice daily. Which of the following instructions should the nurse include?
Correct Answer: D
Rationale: Inspecting the mouth for lesions daily is important to detect oral thrush, a potential side effect of inhaled corticosteroids.
Question 5 of 5
A nurse is caring for a young female adult client who reports weakness, fatigue, and heavy menstrual periods. The client has a hemoglobin level of 8 g/dL and a hematocrit level of 28 g/dL. The nurse suspect which of the following types of anemia?
Correct Answer: D
Rationale: Iron-deficiency anemia commonly presents with weakness, fatigue, and heavy menstrual bleeding due to inadequate iron for red blood cell production.