ATI RN
ATI Nursing Specialty
1. A nurse at a provider's office receives a phone call from a client who reports unrelieved chest pain after taking a nitroglycerin (Nitrostat) tablet 5 minutes ago. Which of the following is an appropriate response by the nurse?
- A. Tell the client to take an aspirin.
- B. Instruct the client to call 911.
- C. Have the client take another nitroglycerin tablet in 15 minutes.
- D. Advise the client to come to the office.
Correct answer: B
Rationale: In this scenario, the client reporting unrelieved chest pain after taking a nitroglycerin tablet could be indicative of a serious cardiac event. Instructing the client to call 911 is the most appropriate response because immediate medical attention is necessary for chest pain that is not relieved by nitroglycerin. Telling the client to take an aspirin (Choice A) may not address the urgency of the situation, and aspirin might not be appropriate depending on the client's medical history. Having the client take another nitroglycerin tablet (Choice C) without relief could lead to overdosage. Advising the client to come to the office (Choice D) is not the best course of action when dealing with a potential cardiac emergency that requires immediate intervention.
2. A client prescribed home oxygen therapy is receiving discharge teaching from a nurse. Which statement by the client indicates a need for further teaching?
- A. I will be able to tell the amount of oxygen being delivered by looking at the flowmeter.
- B. I should contact my doctor if I notice a decrease in my ability to concentrate.
- C. I will ensure that visitors smoke outside.
- D. I should see a frosty buildup on the tank when I refill my portable oxygen.
Correct answer: A
Rationale: The correct answer is A. The client's statement indicates a need for further teaching because the flowmeter indicates the flow rate of oxygen, not the total amount of oxygen being delivered. Choices B, C, and D demonstrate understanding of safety measures and indications for seeking medical attention in relation to home oxygen therapy, making them appropriate statements.
3. A nurse is caring for a client who came to the emergency department reporting chest pain. The provider suspects a myocardial infarction. While waiting for the laboratory to report the client's troponin levels, the client asks what this blood test will show. The nurse should explain that troponin is
- A. an enzyme that indicates damage to brain, heart, and skeletal muscle tissues.
- B. a protein whose levels reflect the risk for coronary artery disease.
- C. a heart muscle protein that appears in the bloodstream when there is damage to the heart.
- D. a protein that helps transport oxygen throughout the body.
Correct answer: C
Rationale: The correct answer is that troponin is a heart muscle protein that appears in the bloodstream when there is damage to the heart. Troponin is a specific marker for heart muscle damage, particularly seen in conditions like myocardial infarction. Choice A is incorrect as troponin is not an enzyme that indicates damage to brain and skeletal muscle tissues. Choice B is incorrect as troponin is not a protein whose levels reflect the risk for coronary artery disease; it indicates heart muscle damage. Choice D is incorrect as troponin is not a protein that helps transport oxygen throughout the body; its presence in the bloodstream is specific to heart muscle damage.
4. A client with chronic obstructive pulmonary disease (COPD expresses difficulty in bringing up bronchial secretions. Which action should the nurse take to help the client with tenacious bronchial secretions?
- A. Maintaining a semi-Fowler's position as much as possible
- B. Administering oxygen via nasal cannula at 2 L per min
- C. Helping the client select a low-salt diet
- D. Encouraging the client to drink eight glasses of water daily
Correct answer: D
Rationale: Encouraging the client to drink eight glasses of water daily is the most appropriate action to help with tenacious bronchial secretions in COPD. Increased fluid intake can help in thinning the mucus, making it easier for the client to cough up and clear secretions. This addresses the client's difficulty in bringing up bronchial secretions. Maintaining a semi-Fowler's position can aid in breathing but does not directly address the issue of clearing secretions. Administering oxygen may be necessary for COPD, but it does not specifically target the tenacious secretions. Selecting a low-salt diet can be helpful in managing COPD in general, but it does not directly address the client's current concern of clearing bronchial secretions.
5. A client with peripheral arterial disease (PAD) is experiencing muscle pain or cramping during physical activity that resolves with rest. Which of the following symptoms is typically the initial reason clients with PAD seek medical attention?
- A. Intermittent claudication
- B. Dependent rubor
- C. Rest pain
- D. Foot ulcers
Correct answer: A
Rationale: The correct answer is Intermittent claudication. Intermittent claudication, which manifests as muscle pain or cramping during physical activity that improves with rest, is typically the initial reason clients with PAD seek medical attention. Dependent rubor, rest pain, and foot ulcers are more advanced symptoms of PAD and are not usually the initial reasons for seeking medical care.
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