ATI RN
ATI Medical Surgical Proctored Exam 2023
1. A nurse collaborates with a respiratory therapist to complete pulmonary function tests (PFTs) for a client. Which statements should the nurse include in communications with the respiratory therapist prior to the tests? (Select all that apply)
- A. I held the client's morning bronchodilator medication.
- B. The client is ready to go down to radiology for this examination.
- C. Physical therapy states the client can run on a treadmill.
- D. I advised the client not to smoke for 6 hours prior to the test.
Correct answer: B
Rationale: Communication between the nurse and respiratory therapist is crucial before pulmonary function tests (PFTs). It is important to inform the respiratory therapist that the client is ready for the examination. The nurse should not administer bronchodilator medication before the test as it may affect the results, and the client should not smoke for 6 to 8 hours prior to the test to ensure accurate results. Additionally, PFTs do not involve running on a treadmill; instead, the client may be required to perform specific breathing maneuvers as instructed by the respiratory therapist.
2. When teaching a client with chronic obstructive pulmonary disease (COPD) about nutrition, what information should be included? (Select all that apply)
- A. Avoid drinking fluids just before and during meals.
- B. Rest before meals if experiencing dyspnea.
- C. Have about six small meals a day.
- D. Eat high-fiber foods to promote gastric emptying.
Correct answer: D
Rationale: When educating a client with COPD about nutrition, it is important to consider factors that can impact breathing and digestion. Avoiding drinking fluids just before and during meals can help prevent bloating, which may impede breathing. Resting before meals if experiencing dyspnea can aid in reducing respiratory effort during eating. Having about six small meals a day can help prevent overeating and decrease the feeling of fullness, promoting easier breathing. However, it is crucial to be cautious with high-fiber foods as they can produce gas, leading to abdominal bloating and increased shortness of breath. Clients with COPD should focus on increasing calorie and protein intake to prevent malnourishment. It is advisable not to increase carbohydrate intake as this can elevate carbon dioxide production and exacerbate breathing difficulties.
3. A client is interested in smoking cessation. Which statements should the nurse include in this client's teaching? (Select ONE that does not apply)
- A. Find an activity that you enjoy and will keep your hands busy.
- B. Make a list of reasons you want to stop smoking.
- C. Identify a punishment for yourself in case you backslide.
- D. Drink at least eight glasses of water each day.
Correct answer: D
Rationale: When educating a client on smoking cessation, the nurse should include several strategies. Finding an activity to keep hands busy helps distract from smoking urges. Making a list of reasons to quit smoking reinforces motivation. Identifying a consequence for backsliding can serve as a deterrent. Drinking water is beneficial for overall health but is not directly related to smoking cessation. It's crucial to support the client, encourage healthy habits, and address challenges without punitive measures.
4. A client who received benzocaine spray before a recent bronchoscopy presents with continuous cyanosis despite oxygen therapy. What action should the nurse take next?
- A. Administer albuterol treatment.
- B. Notify Rapid Response Team.
- C. Assess the client's peripheral pulses.
- D. Obtain blood and sputum cultures.
Correct answer: B
Rationale: Cyanosis unresponsive to oxygen therapy suggests methemoglobinemia, an adverse effect of benzocaine spray. Methemoglobinemia can lead to death if not managed promptly. The nurse should notify the Rapid Response Team to provide immediate advanced care. Administering albuterol would not address the underlying cause of cyanosis. Assessing peripheral pulses and obtaining cultures are not the priority as they do not directly address the urgent need to manage methemoglobinemia.
5. A client with chronic obstructive pulmonary disease (COPD) is being assessed by a nurse. Which finding should the nurse expect?
- A. Increased anterior-posterior (AP) chest diameter
- B. Decreased respiratory rate
- C. Weight gain
- D. Productive cough with yellow sputum
Correct answer: A
Rationale: In COPD, the client often develops a barrel chest, characterized by an increased anterior-posterior diameter of the chest. This change is due to air trapping and hyperinflation of the lungs. Decreased respiratory rate, weight gain, and productive cough with yellow sputum are not typically associated with COPD. Weight loss is more common due to increased work of breathing and decreased energy expenditure in individuals with COPD.
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