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 4
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:
Medical History
Conditions:
• Dehydration
• Hyperlipidemia
• Hypertension
• Coronary artery disease (CAD)
Diagnostic Results
• WBC Count: 14,000/mm³ (Normal: 5,000 to 10,000/mm³)
• Hemoglobin (Hgb): 14 g/dL (Normal: 12 to 16 g/dL)
• Hematocrit (Hct): 40% (Normal: 34 to 47%)
• Sodium: 132 mEq/L (Normal: 136 to 146 mEq/L)
• Potassium: 6.2 mEq/L (Normal: 3.5 to 5 mEq/L)
• Calcium: 10 mg/dL (Normal: 9 to 10.5 mg/dL)
• BUN: 20 mg/dL (Normal: 10 to 20 mg/dL)
• Albumin: 2.8 g/dL (Normal: 3.5 to 5 g/dL)
• Fasting Blood Glucose: 140 mg/dL (Normal: 74 to 106 mg/dL)
• Triglycerides: 134 mg/dL (Normal: 34 to 160 mg/dL)
Nurses' Notes
Client is lying in bed. Awake, alert, and oriented to time, place, and person. Client is febrile and reports weakness. Receiving TPN via central line in left antecubital. Client is NPO and has had diarrhea x3 in past 4 hr. Crackles auscultated in posterior lobes.
Client has a productive cough and sputum is yellow in color. Client receiving 2 L/min oxygen via nasal cannula with an oxygen saturation of 90%. Abdomen is distended and tender. Active range of motion to all extremities. Denies pain at this time.
Question 2 of 4
Which of the following actions should the nurse take? For each potential nursing intervention, click to specify if the potential intervention is anticipated, nonessential, or contraindicated for the client.
| Options | Anticipated | Nonessential | Contraindicated |
|---|---|---|---|
| Obtain client weight twice daily. | |||
| Have 3 nurses verify the TPN solution prescription. | |||
| Request a prescription for insulin. | |||
| Request an antibiotic to be administered. | |||
| Decrease the client's oxygen to 1.5 L/min oxygen via nasal cannula. | |||
| Notify provider to increase TPN rate/hr. |
Correct Answer: (See rationale)
Rationale: Weight monitoring and insulin are anticipated for CAD and dehydration; TPN verification is nonessential; antibiotics and oxygen reduction are contraindicated without indication.
Extract:
Medical History
HIV
Diagnostic Results
On Diagnosis:
Total WBC: 6,000/mm³ (Normal: 5,000 to 10,000/mm³)
Platelet Count: 154,000/mm³ (Normal: 150,000 to 400,000/mm³)
Sodium: 139 mEq/L (Normal: 136 to 145 mEq/L)
Potassium: 4.2 mEq/L (Normal: 3.5 to 5 mEq/L)
BUN: 16 mg/dL (Normal: 10 to 20 mg/dL)
3 Month Visit:
Total WBC: 5,500/mm³ (Normal: 5,000 to 10,000/mm³)
Platelet Count: 112,000/mm³ (Normal: 150,000 to 400,000/mm³)
Sodium: 136 mEq/L (Normal: 136 to 145 mEq/L)
Potassium: 3.8 mEq/L (Normal: 3.5 to 5 mEq/L)
BUN: 18 mg/dL (Normal: 10 to 20 mg/dL)
Question 3 of 4
The client is at risk for developing……. due to.....
Correct Answer: A,G
Rationale: Low platelet count in HIV increases bleeding risk due to impaired clotting.
Extract:
Medical History
Type 2 Diabetes Mellitus
Hypertension: Controlled by diuretic and ACE-inhibitor therapy
Osteoarthritis
Diagnostic Results
Preoperative Laboratory Results:
Basic Metabolic Profile (BMP):
Glucose: 190 mg/dL (Normal: 74 to 106 mg/dL)
BUN: 16 mg/dL (Normal: 10 to 20 mg/dL)
Creatinine: 0.8 mg/dL (Normal: 0.5 to 1 mg/dL)
Hemoglobin A1C: 9.5% (Poor diabetic control: >9%)
Current Laboratory Results:
Basic Metabolic Profile (BMP):
Glucose: 280 mg/dL (Normal: 74 to 106 mg/dL)
BUN: 15 mg/dL (Normal: 10 to 20 mg/dL)
Creatinine: 0.7 mg/dL (Normal: 0.5 to 1 mg/dL)
Medication Administration Record
Home Medications:
Metformin: 1,000 mg PO BID
Lisinopril: 20 mg PO daily
Celecoxib: 100 mg PO BID
Vital Signs
Preoperative:
Temperature: 36.4°C (97.6°F)
Heart Rate: 82/min
Respiratory Rate: 20/min
Blood Pressure: 126/74 mm Hg
Oxygen Saturation: 95% on room air
Current:
Temperature: 37.2°C (99°F)
Heart Rate: 92/min
Respiratory Rate: 22/min
Blood Pressure: 136/85 mm Hg
Oxygen Saturation: 98% on 2 L/min nasal cannula
Question 4 of 4
The client is at highest risk for…... as evidenced by the....
Correct Answer: B,E
Rationale: Post-knee arthroplasty, elevated blood glucose increases infection risk due to impaired healing.
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 4
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.