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ATI Medical Surgical Proctored Exam 2019 Quizlet
1. The healthcare provider is planning care for a non-potty-trained child with nephrotic syndrome. Which intervention provides the best means of determining fluid retention?
- A. Weigh the child daily.
- B. Observe the lower extremities for pitting edema.
- C. Measure the child's abdominal girth weekly.
- D. Weigh the child's wet diapers.
Correct answer: A
Rationale: Daily weighing is the most accurate method to monitor fluid retention in a child with nephrotic syndrome. Changes in weight can indicate fluid retention or loss, which is crucial in managing nephrotic syndrome. Observing for pitting edema and measuring abdominal girth are also important assessments, but daily weighing provides more immediate and precise information about fluid status.
2. The nurse is caring for four clients: Client A, who has emphysema and an oxygen saturation of 94%; Client B, with a postoperative hemoglobin of 8.7 g/dL; Client C, newly admitted with a potassium level of 3.8 mEq/L; and Client D, scheduled for an appendectomy with a white blood cell count of 15,000/mm3. What intervention should the nurse implement?
- A. Increase Client A's oxygen to 4 liters per minute via nasal cannula.
- B. Determine if Client B has two units of packed cells available in the blood bank.
- C. Ask the dietitian to add a banana to Client C's breakfast tray.
- D. Inform Client D that surgery is likely to be delayed until the infection is treated.
Correct answer: D
Rationale: A high white blood cell count, as seen in Client D, indicates infection, which may require postponing surgery to treat the infection adequately. It is crucial to address the underlying infection before proceeding with the appendectomy to prevent complications and ensure a successful surgical outcome.
3. A healthcare provider is preparing to administer a scheduled dose of intravenous (IV) metoprolol (Lopressor) to a client. The client's apical pulse is 58 beats/minute. What action should the healthcare provider take?
- A. Administer the medication as prescribed.
- B. Hold the medication and notify the healthcare provider.
- C. Give half the prescribed dose and recheck the pulse in 30 minutes.
- D. Administer the medication and then recheck the pulse in 30 minutes.
Correct answer: B
Rationale: In the scenario described, with the client's apical pulse being 58 beats/minute, holding the medication and notifying the healthcare provider is the correct action. A low pulse rate may indicate bradycardia and may necessitate dose adjustment or further evaluation by the healthcare provider to prevent potential complications.
4. The healthcare provider prescribes naproxen (Naprosyn) 500 mg PO twice a day for a client with osteoarthritis. During a follow-up visit one month later, the client tells the nurse, 'The pills don't seem to be working. They are not helping the pain at all.' Which factor should influence the nurse's response?
- A. Noncompliance is probably affecting optimal medication effectiveness.
- B. Drug dosage is inadequate and needs to be increased to three times a day.
- C. The drug needs 4 to 6 weeks to reach therapeutic levels in the bloodstream.
- D. NSAID response is variable, and trying another NSAID may be more effective.
Correct answer: D
Rationale: Different NSAIDs work differently in individuals. If a patient is not experiencing relief with one NSAID, switching to a different one may provide better pain management. This variability in response is common among NSAIDs due to individual differences in drug metabolism and efficacy.
5. What instruction should be provided to a client with a history of myocardial infarction (MI) who is prescribed nitroglycerin?
- A. Take nitroglycerin with food to avoid stomach upset.
- B. Store nitroglycerin tablets in a dark, glass container.
- C. Swallow nitroglycerin tablets whole without chewing.
- D. Discontinue the medication if a headache occurs.
Correct answer: B
Rationale: Nitroglycerin is a medication that should be stored in a dark, glass container to protect it from light and moisture. Exposure to light and moisture can reduce its effectiveness. Storing it in a dark, glass container helps maintain the medication's stability and potency, ensuring that it remains safe and effective for use in emergencies, such as angina attacks.
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