ATI RN
ATI RN Adult Medical Surgical 2023 III Questions
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 1 of 5
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:
Patient Summary
Presenting Complaint:
Time of Arrival: 0900 hours
Symptoms: Client reports not feeling well for the past 12 hours, with increasing blood glucose levels. Client has a history of type 1 diabetes mellitus and hypertension. Recent treatment for bronchitis and pneumonia. Reports nausea, decreased appetite, frequent urination, and extreme thirst.
Medical History:
Conditions: Type 1 diabetes mellitus, hypertension.
Recent Illnesses: Bronchitis, pneumonia.
Nurses' Notes
0900 Hours:
Client presents with a history of type 1 diabetes mellitus and hypertension. The client is alert and oriented x4. Heart and lung sounds are clear. The client reports frequent urination, extreme thirst, nausea, and decreased appetite. Bowel sounds are hyperactive in all 4 quadrants. Bilateral pedal pulses are 1+. Slight tenting of skin noted. Peripheral IV established, and labs drawn.
Vital Signs
0900 Hours:
Temperature: 36.8°C (98.2°F)
Pulse Rate: 110/min
Respiratory Rate: 18/min
Blood Pressure: 96/65 mm Hg
Oxygen Saturation: 96% on room air
1400 Hours:
Temperature: 36.8°C (98.2°F)
Pulse Rate: 84/min
Respiratory Rate: 16/min
Blood Pressure: 106/76 mm Hg
Laboratory Results
0915 Hours:
Blood Glucose: 468 mg/dL (Normal: 74-106 mg/dL)
pH: 7.30 (Normal: 7.35-7.45)
Potassium: 5.5 mEq/L (Normal: 3.5-5.0 mEq/L)
Sodium: 138 mEq/L (Normal: 136-145 mEq/L)
Chloride: 101 mEq/L (Normal: 98-106 mEq/L)
BUN: 21 mg/dL (Normal: 10-20 mg/dL)
Creatinine: 1.7 mg/dL (Normal: 0.5-1.1 mg/dL)
Urine Dipstick: Positive for ketones (Normal: Negative)
Provider's Prescriptions
Fluids: Administer 0.9% sodium chloride at 15 ml/kg/hr for 1 hr, then reduce to 10 ml/kg/hr.
Potassium: Potassium chloride 20 mEq/L IV PRN if potassium is less than 5.0 mEq/L.
Insulin: Regular insulin continuous infusion, titrate per DKA protocol once potassium is greater than 3.3 mEq/L.
Anti-nausea: Ondansetron 4 mg IV bolus every 4 hr PRN for nausea.
Pain Relief: Acetaminophen 650 mg every 4 hr PRN for pain.
Magnesium: Magnesium sulfate 2 g IV over 2 hr for hypomagnesemia.
Monitoring: Strict intake and output, blood glucose level hourly.
Question 2 of 5
The nurse should plan to first administer….. followed by……
Correct Answer: D,E
Rationale: Sodium chloride corrects dehydration in DKA, followed by insulin to lower blood glucose.
Extract:
Question 3 of 5
A nurse is planning care for a client who is 12 hr postoperative following a kidney transplant. Which of the following actions should the nurse include in the plan of care?
Correct Answer: C
Rationale: Hourly urine output monitoring is critical post-kidney transplant to assess graft function and detect complications early.
Question 4 of 5
A nurse is preparing a teaching plan for a client who has mucositis related to chemotherapy treatment. Which of the following instructions should the nurse include?
Correct Answer: D
Rationale: Gentle flossing helps maintain oral hygiene without irritating mucositis lesions caused by chemotherapy.
Question 5 of 5
A nurse is caring for a client who has skeletal traction applied to the left leg. Which of the following actions should the nurse take?
Correct Answer: B
Rationale: A trapeze bar assists the client in repositioning without disrupting the traction, promoting comfort and mobility.