ATI RN
ATI Medical Surgical Proctored Exam 2023
1. A client is scheduled to have a tracheostomy placed in an hour. What action by the nurse is the priority?
- A. Administer prescribed anxiolytic medication.
- B. Ensure informed consent is on the chart.
- C. Reinforce any teaching done previously.
- D. Start the preoperative antibiotic infusion.
Correct answer: B
Rationale: The priority action for the nurse is to ensure that informed consent is on the chart. Before any surgical procedure, it is essential to have the client's informed consent documented. While administering anxiolytics, starting antibiotic infusion, and reinforcing teaching may also be necessary, obtaining informed consent takes precedence to ensure the client's understanding and agreement to proceed with the tracheostomy.
2. A patient is starting on atorvastatin (Lipitor) for hyperlipidemia. What critical instruction should the nurse provide?
- A. Take the medication at night to reduce the risk of muscle pain and other side effects.
- B. Avoid consuming grapefruit juice while taking this medication.
- C. Take the medication in the morning with breakfast to improve absorption.
- D. Take the medication with a high-fat meal to increase its effectiveness.
Correct answer: A
Rationale: The correct answer is to take the medication at night to reduce the risk of muscle pain and other side effects. Atorvastatin, like other statins, is more effective when taken in the evening as the body produces more cholesterol at night. Taking it with a high-fat meal (choice D) is not recommended as it may reduce the drug's absorption. Grapefruit juice (choice B) should be avoided with atorvastatin as it can increase the risk of side effects. Taking the medication in the morning with breakfast (choice C) is not as effective as taking it at night.
3. A nurse is caring for a client who has a chest tube following thoracic surgery. Which of the following actions should the nurse take?
- A. Clamp the chest tube when assisting the client out of bed.
- B. Empty the drainage system every 8 hours.
- C. Keep the collection device below the client's chest.
- D. Strip the chest tube every 4 hours.
Correct answer: C
Rationale: The correct action for the nurse to take is to keep the collection device below the client's chest. This positioning ensures proper drainage of fluid from the chest, preventing backflow of fluids. Clamping the chest tube when assisting the client out of bed is incorrect as it can lead to fluid accumulation and potential complications. Emptying the drainage system every 8 hours is necessary but not the priority over maintaining proper positioning. Stripping the chest tube every 4 hours is an outdated practice and can cause damage to the tissue and should be avoided.
4. A teen with asthma asks the nurse why it is hard to breathe during an asthma attack. The nurse explains that exposure to a “trigger” results in which of these manifestations?
- A. Bronchodilation, muscle relaxation, and decreased mucus production
- B. Air trapping and hypo-inflation of the alveoli
- C. Air trapping and decreased blood flow to the upper airway
- D. Bronchoconstriction, airway inflammation, and excess mucus production
Correct answer: D
Rationale: The correct answer is D. Asthma triggers cause bronchoconstriction, airway inflammation, and increased mucus production, leading to difficulty breathing. This combination of manifestations results in narrowing of the airways, making it hard for the individual to breathe effectively. Choices A, B, and C are incorrect because during an asthma attack, bronchodilation, muscle relaxation, and decreased mucus production do not occur. Instead, the airways constrict, become inflamed, and produce excess mucus, contributing to the breathing difficulties experienced by individuals with asthma.
5. A 5-year-old has patient-controlled analgesia (PCA) for pain management after abdominal surgery. What information does the nurse include in teaching the parents about the PCA?
- A. The child may not be pain-free.
- B. The parents or nurse may push the button for a bolus if needed.
- C. The pump allows for a continuous basal rate to deliver a constant amount of medication for pain control.
- D. Monitoring is required every 1 to 2 hours to assess patient response.
Correct answer: C
Rationale: The correct answer is C because the PCA pump can be programmed to deliver a continuous basal rate of pain medication to maintain pain control. While the goal of PCA is effective pain relief, it does not guarantee a pain-free state. In the case of a 5-year-old child, the parents or nurse can administer boluses if necessary since the child may not fully comprehend using the PCA button. Monitoring every 1 to 2 hours for patient response is adequate and there is no need for monitoring every 15 minutes, as stated in choice D, unless specific circumstances dictate more frequent monitoring.
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