ATI RN
ATI Medical Surgical Proctored Exam
1. A client tests positive for alpha1-antitrypsin (AAT) deficiency and asks the nurse, What does this mean? How should the nurse respond?
- A. Your children may be at high risk for developing chronic obstructive pulmonary disease.
- B. I will arrange for a genetic counselor to discuss your condition.
- C. Your risk for chronic obstructive pulmonary disease is higher, particularly if you smoke.
- D. This is a recessive gene that should not affect your health.
Correct answer: C
Rationale: Alpha1-antitrypsin (AAT) deficiency is associated with a higher risk of chronic obstructive pulmonary disease (COPD), especially if the individual smokes. This condition is caused by a recessive gene. Individuals with one allele typically produce enough AAT to prevent COPD unless they smoke. However, those with two alleles are at high risk for COPD even without exposure to smoke or other irritants. Being a carrier of AAT deficiency does not guarantee that one's children will develop the disease; it depends on the AAT levels of the partner. While involving a genetic counselor may be beneficial in the long run, the immediate concern of the client's question should be addressed first.
2. A nurse assesses a client who has a history of heart failure. Which question should the nurse ask to assess the extent of the client's heart failure?
- A. Do you have trouble breathing or chest pain?
- B. Are you able to walk upstairs without fatigue?
- C. Do you awake with breathlessness during the night?
- D. Do you have new-onset heaviness in your legs?
Correct answer: B
Rationale: Clients with a history of heart failure generally have negative findings, such as shortness of breath. The nurse needs to determine whether the client's activity is the same or worse, or whether the client identifies a decrease in activity level. Trouble breathing, chest pain, breathlessness at night & peripheral edema are symptoms of heart failure, but do not provide data that can determine the extent of the client's heart failure.
3. A client has a pleural chest tube. Which action should the nurse take to ensure safe use of this equipment?
- A. Never strip the tubing to maintain patency.
- B. Secure tubing junctions with tape to prevent accidental disconnections.
- C. Set wall suction at the level recommended by the device manufacturer.
- D. Keep padded clamps at the bedside for use if the drainage system is interrupted.
Correct answer: D
Rationale: To ensure safe use of a pleural chest tube, the nurse should keep padded clamps at the bedside for use if the drainage system becomes dislodged or is interrupted. Stripping the tubing should never be done to maintain patency. Tubing junctions should be secured with tape, not clamps. Wall suction should be set at the level recommended by the device manufacturer, not the provider.
4. Prior to a cardiac catheterization, what is the most important action for the nurse to take?
- A. Ensure that the client has been NPO for 6 hours before the procedure.
- B. Administer pre-procedure medications as ordered.
- C. Verify that informed consent has been obtained.
- D. Assess the client for any allergies, especially to iodine or shellfish.
Correct answer: D
Rationale: Assessing the client for allergies, particularly to iodine or shellfish, is crucial before a cardiac catheterization because the contrast dye used during the procedure can lead to allergic reactions. Identifying any allergies beforehand allows the healthcare team to take necessary precautions to prevent potential adverse reactions and ensure the client's safety.
5. A client with deep vein thrombosis (DVT) is receiving heparin therapy. What is the priority assessment for the nurse?
- A. Monitoring blood pressure
- B. Checking the activated partial thromboplastin time (aPTT)
- C. Assessing for signs of bleeding
- D. Measuring calf circumference
Correct answer: C
Rationale: Assessing for signs of bleeding is the priority when caring for a client with deep vein thrombosis (DVT) receiving heparin therapy. Heparin therapy increases the risk of bleeding complications, so monitoring for signs of bleeding is crucial to ensure patient safety and timely intervention if needed.
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