ATI RN
ATI Rn 46 Med Surg Exam Questions
Extract:
Question 1 of 5
Which of the following are risk factors for abdominal aortic aneurysm (AAA)? (Select all that apply.)
Correct Answer: A,B
Rationale: Smoking and family history increase AAA risk by weakening arterial walls and genetic predisposition. High HDL and normal total cholesterol are protective. Diabetes is not a direct risk factor.
Question 2 of 5
A nurse is teaching several newly licensed nurses about cardiac valve replacement. Which of the following should the nurse include in the teaching?
Correct Answer: A
Rationale: Among the four heart valves (aortic, mitral, tricuspid, and pulmonary), the aortic and mitral valves are indeed the most commonly replaced valves. Aortic stenosis and mitral valve regurgitation are frequent indications for valve replacement. Aortic stenosis primarily affects the left ventricle, not the right. Mitral valve insufficiency primarily causes problems on the left side of the heart. The tricuspid valve is on the right side of the heart and its inadequate closure affects the right side, not the left ventricle.
Extract:
History and Physical
0900:
History of present illness:
Client presents to the emergency department reporting acute onset of back pain that started this morning. Client reports pain as 8 on a scale of Oto 10. Client also reports feeling dizzy and weak.
Past medical history: Diabetes mellitus type 2, hypertension
Surgical history: Appendectomy at age 23 years
Family history:
Father: History of prostate cancer Mother: Died of "old age"
Social history: Smokes 1 pack of cigarette
Vital Signs
0900:
Blood pressure 136/84 mm Hg
Heart rate 111/min
Respiratory rate 20/min
Temperature 37° C (98.6" F)
0920:
Blood pressure 150/86 mm Hg
Heart rate 120/min
Respiratory rate 24/min
Temperature 37° C (98.6° F)
Provider Prescriptions
Metoprolol succinate ER 100 mg PO x 1 dose
Diagnostic results
0915:
CT scan of the abdomen and pelvis: 4 cm infrarenal abdominal aortic aneurysm (AAA) Hemoglobin 11 g/dL (14 to 18 g/dL)
Hematocrit 40% (42% to 52%)
Question 3 of 5
A nurse is caring for a client in the emergency department. Which of the following interventions should the nurse expect when planning care for this client? (Select All that Apply)
Correct Answer: B,C,E,F
Rationale: Analyzing CBC monitors for bleeding, preparing for surgery addresses symptomatic AAA, antihypertensives control rupture risk, and arterial line aids monitoring. Back pain monitoring, transfusion, and education are secondary in the acute phase.
Extract:
Question 4 of 5
The nurse is caring for a client who had a resection of an abdominal aortic aneurysm yesterday. The client has an IV infusion of maintenance fluid at a rate of 150 mL/hr, unchanged from the last 10 hours. The client's urine output for the last 3 hours has been 90ml, 50mL, and 24mL. Which nursing action is the priority?
Correct Answer: B
Rationale: A significant drop in urine output post-AAA resection may indicate acute renal failure, requiring immediate provider notification. Monitoring, specific gravity, and albumin checks are secondary.
Question 5 of 5
What effect does valvular regurgitation have on a patient?
Correct Answer: B
Rationale: Valvular regurgitation causes backward blood flow, leading to volume overload in the prior chamber. Fever, autoimmune reactions, and vessel narrowing are not direct effects.