ATI RN
ATI Medical Surgical Proctored Exam
1. 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.
2. Kai and Ken received their Christmas gifts from their parents. Although their gifts vary in many characteristics, the two compared their gifts based on size. This tendency among children is known as:
- A. Semiotic
- B. Abstraction
- C. Preoperational
- D. Overextension
Correct answer: D
Rationale: The correct answer is D, Overextension. Overextension happens when children compare objects or experiences based on one characteristic, such as size. Choices A, B, and C are incorrect. Semiotic refers to the study of signs and symbols; Abstraction is the process of thinking about something as a general concept rather than a specific example; Preoperational is a stage in Piaget's theory of cognitive development, not related to comparing gifts based on size.
3. A healthcare provider is assessing a client who has been using beclomethasone for 2 weeks to manage her asthma. What is the priority to report to the provider?
- A. Sore throat
- B. Cough
- C. Chest tightness
- D. Bronchospasms
Correct answer: D
Rationale: The correct answer is D: Bronchospasms. Bronchospasms can indicate worsening asthma and are considered a severe side effect that requires immediate attention. While sore throat, cough, and chest tightness are also possible side effects of beclomethasone, bronchospasms are of higher concern due to their association with significant respiratory distress and potential exacerbation of asthma symptoms.
4. A client with multiple sclerosis (MS) is frustrated by tremors associated with the disease. How should the nurse explain why these tremors occur? Due to the demyelination of neurons that occurs in MS:
- A. there is an imbalance in acetylcholine and dopamine, leading to tremors.
- B. there is a disruption in nerve impulse conduction, causing tremors.
- C. muscles are unable to receive impulses, resulting in tremors.
- D. the reflex arc is disrupted, leading to muscle tremors.
Correct answer: B
Rationale: In multiple sclerosis (MS), demyelination of neurons disrupts nerve impulse conduction. This disruption in nerve impulses can lead to tremors, explaining why the client experiences tremors in MS. Choice A is incorrect because tremors in MS are primarily due to nerve conduction issues, not an imbalance in acetylcholine and dopamine. Choice C is incorrect as it oversimplifies the process; the issue lies in nerve impulses, not the muscle's ability to receive them. Choice D is incorrect as the primary cause of tremors in MS is the disruption in nerve impulse conduction, not the reflex arc being disrupted.
5. A nurse at a provider’s office is providing teaching to a client who is taking chemotherapy and losing weight. Which of the following should the nurse recommend to increase calorie and protein intake? (Select one that does not apply.)
- A. Top yogurt with fruits.
- B. Add cream to soups.
- C. Use milk instead of water in recipes.
- D. Increase fluids during meals.
Correct answer: Increase fluids during meals.
Rationale: The correct recommendation to increase calorie and protein intake for a client taking chemotherapy and losing weight is to add cream to soups (choice B), as it provides additional calories and proteins. Using milk instead of water in recipes (choice C) can also increase the calorie and protein content. Topping yogurt with fruits (choice A) can be a healthy choice but may not significantly increase calorie and protein intake. Increasing fluids during meals (choice D) may fill up the stomach, potentially reducing the intake of solid foods, which is not ideal when trying to increase calorie and protein consumption.
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