ATI RN
ATI Medical Surgical Proctored Exam
1. The provider requests the nurse to start an infusion of an inotropic agent on a client. How should the nurse explain the action of these drugs to the client and spouse?
- A. It constricts vessels, improving blood flow.
- B. It dilates vessels, which lessens the work of the heart.
- C. It increases the force of the heart's contractions.
- D. It slows the heart rate down for better filling.
Correct answer: C
Rationale: An inotropic agent is a medication that increases the force of the heart's contractions, which helps improve cardiac output. Choice A and B are incorrect as inotropic agents do not constrict or dilate vessels. Choice D is also incorrect as inotropic agents do not slow down the heart rate but rather enhance the heart's contractility.
2. A client is admitted with a pulmonary embolism (PE). The client is young, healthy, and active, and has no known risk factors for PE. What action by the nurse is most appropriate?
- A. Encourage the client to walk for 5 minutes each hour.
- B. Refer the client for smoking cessation classes.
- C. Teach the client about factor V Leiden testing.
- D. Explain to the client that sometimes no cause for the disease is found.
Correct answer: C
Rationale: The most appropriate action for the nurse in this scenario is to teach the client about factor V Leiden testing. Factor V Leiden is an inherited thrombophilia that can lead to abnormal clotting events, including pulmonary embolism (PE). In a case where a client has no known risk factors for PE, testing for this genetic disorder is crucial to determine if it is a contributing factor. Encouraging the client to walk or referring them to smoking cessation classes, while beneficial for overall health, are not directly relevant to the development of a PE in this specific case. While it is true that sometimes no cause for a disease is found, prematurely assuming this without appropriate investigations may lead to missed opportunities for preventive measures or treatments.
3. Prior to a thoracentesis, what intervention should the nurse complete?
- A. Measure oxygen saturation before and after the procedure.
- B. Verify that the client has given informed consent.
- C. Explain the procedure briefly to the client and their family.
- D. Ensure informed consent has been obtained from the client.
Correct answer: D
Rationale: Before a thoracentesis procedure, it is crucial to ensure that the client has given informed consent. This process involves explaining the procedure, its risks, benefits, and alternatives to the client, and obtaining their signature on the consent form. Verifying informed consent is a vital legal and ethical step to protect the client's autonomy and ensure they have made an informed decision about the procedure.
4. The client with a chest tube after a coronary artery bypass graft has significantly slowed drainage. What action is most important for the nurse to take?
- A. Increase the setting on the suction.
- B. Notify the provider immediately.
- C. Re-position the chest tube.
- D. Take the tubing apart to assess for clots.
Correct answer: B
Rationale: If the drainage from the chest tube decreases significantly, it may indicate a blockage by a clot, potentially leading to cardiac tamponade. The nurse's priority action should be to notify the healthcare provider immediately for further evaluation and intervention. Increasing suction, re-positioning the chest tube, or disassembling the tubing independently are not appropriate actions without healthcare provider guidance in this situation.
5. When planning care, what factors should the nurse consider when utilizing evidence-based practice (EBP)? (Select ONE that does not apply)
- A. Cost-saving measures
- B. Nurse's expertise
- C. Client preferences
- D. Research findings
Correct answer: A
Rationale: In evidence-based practice (EBP), nurses should consider the current evidence (research findings), client preferences, and the nurse's expertise when planning care. By integrating these factors, nurses can provide individualized, effective, and patient-centered care that aligns with the best available evidence, the patient's values, and the nurse's clinical knowledge and experience.
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