ATI RN
ATI Medical Surgical Proctored Exam
1. A client presents to the emergency department with an acute myocardial infarction (MI) at 1500 (3:00 PM). The facility has 24-hour catheterization laboratory capabilities. To meet The Joint Commission's Core Measures set, by what time should the client have a percutaneous coronary intervention performed?
- A. 1530 (3:30 PM)
- B. 1600 (4:00 PM)
- C. 1630 (4:30 PM)
- D. 1700 (5:00 PM)
Correct answer: C
Rationale: The Joint Commission's Core Measures set for MI includes percutaneous coronary intervention within 90 minutes of the diagnosis of myocardial infarction. Since the client presented at 1500 (3:00 PM), the percutaneous coronary intervention should be performed no later than 1630 (4:30 PM), to adhere to the 90-minute timeline for optimal outcomes.
2. A male patient with benign prostatic hyperplasia (BPH) is prescribed finasteride (Proscar). What should the nurse include in the patient education?
- A. The medication is expected to reduce the size of the prostate, which should improve urinary symptoms over time.
- B. The medication will improve symptoms within a few days.
- C. The medication will cure BPH after treatment is complete.
- D. The medication may cause erectile dysfunction as a side effect.
Correct answer: A
Rationale: Finasteride is expected to reduce the size of the prostate, which should improve urinary symptoms over time, although the effects may take several weeks or months to become noticeable.
3. When classmates are asked to rate each other's likability, __________ children get many positive votes, whereas __________ children are seldom mentioned.
- A. popular; neglected
- B. neglected; rejected
- C. popular; rejected
- D. controversial; neglected
Correct answer: A
Rationale: The correct answer is A: 'popular; neglected.' Popular children are well-liked by their peers, hence they receive many positive votes. Neglected children, on the other hand, are often overlooked or ignored, resulting in them being seldom mentioned. Choice B is incorrect because neglected and rejected have different meanings. Choice C is incorrect as popular and rejected do not align with the likability context provided in the question. Choice D is incorrect as controversial does not directly relate to likability in the context of the question.
4. Why does multiple sclerosis manifest as asymmetrical and in different parts of the body?
- A. Autoreactive lymphocytes are causing diffuse patchy damage to the myelin sheath in the central nervous system.
- B. Acetylcholine receptors are destroyed by immunoglobulin G.
- C. Autoreactive T lymphocytes cause progressive loss of neurons in the substantia nigra.
- D. Cortical motor cells degenerate.
Correct answer: Autoreactive lymphocytes are causing diffuse patchy damage to the myelin sheath in the central nervous system.
Rationale: Multiple sclerosis is characterized by the immune system mistakenly attacking the myelin sheath in the central nervous system. This results in the formation of lesions that can occur in different parts of the central nervous system, leading to varied symptoms depending on the location of the damage. Choice A is the correct answer because it accurately describes the pathophysiology of multiple sclerosis. Choices B, C, and D are incorrect because they describe mechanisms or locations that are not associated with the pathogenesis of multiple sclerosis.
5. A patient with a history of breast cancer is being prescribed tamoxifen (Nolvadex). The nurse should educate the patient about what potential side effect of this medication?
- A. Increased risk of venous thromboembolism
- B. Increased risk of hot flashes
- C. Increased risk of cataracts
- D. Increased risk of bone fractures
Correct answer: A
Rationale: The correct answer is A: Increased risk of venous thromboembolism. Tamoxifen is known to increase the risk of venous thromboembolism, a serious side effect. Patients should be educated about the signs and symptoms of blood clots such as swelling, redness, warmth, or pain in the affected limb. Choices B, C, and D are incorrect because tamoxifen is not associated with an increased risk of hot flashes, cataracts, or bone fractures.
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