ATI RN
ATI Medical Surgical Proctored Exam 2023
1. When assessing a client with pneumonia, which clinical manifestation should the nurse expect to find?
- A. Fremitus
- B. Hyperresonance
- C. Dullness on percussion
- D. Decreased tactile fremitus
Correct answer: C
Rationale: In pneumonia, lung tissue consolidation occurs, leading to dullness on percussion. This is a typical finding in pneumonia. Fremitus and decreased tactile fremitus are more commonly associated with conditions like pleural effusion or pneumothorax. Hyperresonance is typically seen in conditions causing air trapping, such as emphysema.
2. What instruction should be included when teaching a client with asthma about using a metered-dose inhaler (MDI)?
- A. Shake the inhaler well before use.
- B. Inhale rapidly while administering the medication.
- C. Administer the medication while lying down.
- D. Hold the inhaler 2 inches away from the mouth while inhaling.
Correct answer: A
Rationale: Shaking the inhaler well before use ensures that the medication is properly mixed, allowing for an accurate dose with each administration. Inhaling slowly and deeply, not rapidly, helps the medication reach the lungs effectively. The medication should be administered while sitting or standing to facilitate proper lung expansion and airflow. Holding the inhaler 2 inches away from the mouth can lead to medication loss; it should be placed directly in the mouth or used with a spacer to optimize delivery to the airways.
3. A client with chronic obstructive pulmonary disease (COPD) is being taught by a nurse. What nutrition information should the nurse include in the teaching?
- A. Avoid drinking fluids just before and during meals.
- B. Rest before meals if experiencing dyspnea.
- C. Consume about six small meals a day.
- D. Consume high-fiber foods to promote gastric emptying.
Correct answer: D
Rationale: While some of the other options may be helpful, the most appropriate advice for a client with COPD is to consume high-fiber foods to promote gastric emptying. Avoiding fluids just before and during meals can help prevent bloating, resting before meals can assist with dyspnea, and having several small meals a day can help reduce bloating. However, fibrous foods can lead to gas production, causing abdominal bloating and potentially worsening shortness of breath. Increasing calorie and protein intake is essential to prevent malnourishment. It is also important to avoid excessive carbohydrate intake, as it can increase carbon dioxide production and the risk of acidosis in COPD patients.
4. A client is prescribed albuterol (Proventil) via a metered-dose inhaler. Which action should the nurse take to ensure effective use of this medication?
- A. Instruct the client to inhale quickly while administering the medication.
- B. Have the client hold their breath for 10 seconds after inhaling the medication.
- C. Tell the client to exhale immediately after inhaling the medication.
- D. Encourage the client to use the inhaler as needed only when experiencing symptoms.
Correct answer: B
Rationale: To ensure effective use of albuterol via a metered-dose inhaler, the nurse should have the client hold their breath for 10 seconds after inhaling the medication. This action allows the medication to reach deeper into the airways. Inhaling slowly and deeply, not quickly, is recommended for optimal drug delivery. Exhaling immediately after inhaling the medication would expel it before it can take effect. It's essential for the client to follow the prescribed regimen of medication usage, not just using the inhaler when symptoms are present.
5. A client with asthma is being taught about peak flow meter use. Which statement by the client indicates understanding of the teaching?
- A. I will use my peak flow meter every morning.
- B. I will use my peak flow meter when I feel short of breath.
- C. I will use my peak flow meter before using my inhaler.
- D. I will use my peak flow meter after using my inhaler.
Correct answer: A
Rationale: The correct answer is A. Using the peak flow meter every morning is crucial for monitoring asthma control and making timely treatment adjustments. While using the meter when feeling short of breath or before using an inhaler can also be beneficial, the daily morning routine helps in consistent management of asthma symptoms.
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