ATI RN
ATI Medical Surgical Proctored Exam
1. When working as a professional nurse, what is the priority for a new nurse working on an inpatient medical-surgical unit with a preceptor?
- A. Attending to holistic client needs
- B. Ensuring client safety
- C. Avoiding medication errors
- D. Providing client-focused care
Correct answer: B
Rationale: The priority for a nurse working on an inpatient medical-surgical unit is to ensure client safety. This is crucial as errors in hospital care can lead to preventable deaths. While attending to holistic client needs and providing client-focused care are important aspects of nursing, ensuring client safety takes precedence to prevent harm and promote positive patient outcomes.
2. A client with end-stage renal disease (ESRD) is receiving hemodialysis. Which assessment finding indicates a need for immediate action?
- A. Weight gain of 1 kg since the last dialysis session
- B. Blood pressure of 150/90 mm Hg
- C. Potassium level of 6.5 mEq/L
- D. Hemoglobin level of 10 g/dL
Correct answer: C
Rationale: A potassium level of 6.5 mEq/L is critically high and can lead to life-threatening cardiac dysrhythmias, requiring immediate intervention. Hyperkalemia is a common complication in clients with ESRD due to the kidneys' inability to excrete potassium effectively. High potassium levels can result in serious cardiac consequences such as arrhythmias, cardiac arrest, and death. Prompt action is necessary to prevent these severe complications.
3. A client tests positive for alpha1-antitrypsin (AAT) deficiency and asks the nurse, What does this mean? How should the nurse respond?
- A. Your children may be at high risk for developing chronic obstructive pulmonary disease.
- B. I will arrange for a genetic counselor to discuss your condition.
- C. Your risk for chronic obstructive pulmonary disease is higher, particularly if you smoke.
- D. This is a recessive gene that should not affect your health.
Correct answer: C
Rationale: Alpha1-antitrypsin (AAT) deficiency is associated with a higher risk of chronic obstructive pulmonary disease (COPD), especially if the individual smokes. This condition is caused by a recessive gene. Individuals with one allele typically produce enough AAT to prevent COPD unless they smoke. However, those with two alleles are at high risk for COPD even without exposure to smoke or other irritants. Being a carrier of AAT deficiency does not guarantee that one's children will develop the disease; it depends on the AAT levels of the partner. While involving a genetic counselor may be beneficial in the long run, the immediate concern of the client's question should be addressed first.
4. When teaching a group of clients about emergency care for a snake bite, which of the following information should the nurse include?
- A. Raise the affected extremity above the level of the heart.
- B. Immobilize the affected extremity with a splint
- C. Apply ice to the bite area
- D. Apply a tourniquet to the affected extremity.
Correct answer: B
Rationale: In cases of snake bites, it is essential to immobilize the affected extremity with a splint to prevent the spread of venom throughout the body. Raising the extremity above the heart level can promote venom spread, and applying ice or a tourniquet can worsen the condition. Immobilization helps reduce movement and slows the circulation of venom, aiding in the prevention of further complications.
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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