ATI RN
ATI RN Adult Medical Surgical 2023 III Questions
Extract:
Diagnostic Results
Day of Admission:
Brain Natriuretic Peptide (BNP): 450 pg/mL (Normal: <100 pg/mL)
Potassium: 4.8 mEq/L (Normal: 3.5-5 mEq/L)
Sodium: 132 mEq/L (Normal: 136-145 mEq/L)
BUN: 10 mg/dL (Normal: 10-20 mg/dL)
Day 2 of Hospitalization:
Brain Natriuretic Peptide (BNP): 110 pg/mL (Normal: <100 pg/mL)
Potassium: 3.3 mEq/L (Normal: 3.5-5 mEq/L)
Sodium: 135 mEq/L (Normal: 136-145 mEq/L)
BUN: 20 mg/dL (Normal: 10-20 mg/dL)
Medical Administration Record
Day of Admission:
• Medication: Furosemide 80 mg IV, 3 times per day
Vital Signs
Day of Admission:
Temperature: 36.6°C (97.8°F)
Heart Rate: 112/min
Respiratory Rate: 24/min
Blood Pressure: 186/84 mmHg
Oxygen Saturation: 93% on room air
Weight: 97.5 kg (215 lb)
Day 2 of Hospitalization:
Temperature: 36.6°C (97.8°F)
Heart Rate: 78/min
Respiratory Rate: 18/min
Blood Pressure: 102/78 mmHg
Oxygen Saturation: 98% on 2 L/min oxygen via nasal cannula
Weight: 90.7 kg (200 lb)
Question 1 of 5
The client is at risk for developing……. and……...
Correct Answer: B,D
Rationale: Heart failure increases the risk of fluid volume deficit and dysrhythmias due to cardiac strain and electrolyte imbalances.
Extract:
Question 2 of 5
A nurse is caring for a client who is experiencing an increase in intracranial pressure (ICP). The nurse should expect which of the following as an early manifestation of increased ICP?
Correct Answer: C
Rationale: Restlessness is an early sign of increased ICP due to cerebral irritation before more severe symptoms appear.
Question 3 of 5
A nurse is caring for a client following a cardiac catheterization who has hives and urticaria following administration of IV contrast dye. Which of the following medications should the nurse plan to administer?
Correct Answer: A
Rationale: Diphenhydramine is an antihistamine used to treat allergic reactions, such as hives and urticaria caused by contrast dye.
Question 4 of 5
A nurse is planning the discharge of a client who had an ischemic stroke. The nurse should ensure that the client is discharged with which of the following types of pharmacologic therapy?
Correct Answer: D
Rationale: Antithrombotic therapy is essential post-ischemic stroke to prevent further clot formation and reduce the risk of recurrent stroke.
Extract:
Nurses' Notes
Day 1:
1000:
Client is alert to person, place, and time. Client is short of breath and leans forward to breathe easier. Lung sounds are diminished in bilateral bases with occasional wheezes. Nonproductive cough. Heart rate is regular. +2 pulses in all extremities.
1500:
Client is tachypneic, cough is productive, and mucous is yellow in color. Wheezes and crackles heard upon auscultation. Heart rate is regular. +2 pulses in all extremities. Client is oriented to person, place and time. Client is restless. Pupils are reactive to light. Client is diaphoretic with cyanotic mucous membranes
Vital Signs
1000:
Temperature: 37.1°C (98.8°F)
Heart Rate: 100/min
Respiratory Rate: 22/min (irregular)
Blood Pressure: 164/80 mm Hg
Oxygen Saturation: 92% on room air
1500:
Temperature: 37.3°C (100.3°F)
Heart Rate: 110/min
Respiratory Rate: 26/min (irregular)
Blood Pressure: 110/58 mm Hg
Oxygen Saturation: 87% on room air
Question 5 of 5
A nurse is caring for a client who has COPD. Select the findings below that require immediate follow-up.
Correct Answer: B,C,E,F
Rationale: Restlessness, tachypnea, yellow mucous, and wheezes/crackles indicate worsening COPD requiring intervention.