ATI RN
ATI Medical Surgical Proctored Exam 2023
1. A client with asthma presents with bilateral wheezing, decreased pulse oxygen saturation, and suprasternal retraction on inhalation. Which actions should the nurse take? (SATA)
- A. Administer prescribed salmeterol (Serevent) inhaler.
- B. Assess the client for a tracheal deviation.
- C. Administer oxygen to maintain saturations above 94%.
- D. Perform peak expiratory flow measurements.
Correct answer: C
Rationale: Suprasternal retraction during inhalation suggests the client is using accessory muscles due to difficulty in moving air into the respiratory passages caused by airway narrowing. The presence of bilateral wheezing and decreased pulse oxygen saturation further support airway narrowing. In this situation, immediate intervention is necessary to improve oxygenation. Administering oxygen to maintain saturations above 94% is crucial to support oxygenation. While administering a rescue inhaler may be warranted, the priority in this scenario is ensuring adequate oxygenation to address the respiratory distress.
2. What laboratory finding should the nurse expect in a child with an excess of water?
- A. Decreased hematocrit
- B. High serum osmolality
- C. High urine specific gravity
- D. Increased blood urea nitrogen (BUN)
Correct answer: A
Rationale: Water excess typically leads to hemodilution, resulting in a decreased hematocrit. High serum osmolality and specific gravity would indicate dehydration, while elevated BUN could suggest renal impairment or dehydration, not fluid overload.
3. One characteristic that centenarians share is
- A. a high level of exercise throughout life
- B. long-lived relatives
- C. following the Mediterranean diet
- D. never having smoked
Correct answer: never having smoked
Rationale: The correct answer is 'never having smoked.' Research suggests that one of the common characteristics among centenarians is that they have never smoked. Smoking is a well-known risk factor for various diseases and can significantly reduce lifespan. Choice A, 'a high level of exercise throughout life,' is not a universal characteristic among centenarians, although exercise can contribute to a healthy lifestyle. Choice B, 'long-lived relatives,' while genetics can play a role in longevity, not all centenarians have long-lived relatives. Choice C, 'following the Mediterranean diet,' is a healthy dietary choice but not a defining characteristic shared by all centenarians.
4. A client had a total hip arthroplasty. Which of the following prescriptions should the nurse verify with the provider?
- A. Administer enoxaparin 30 mg subcutaneously every 12 hr
- B. Place a wedge or pillow between the client's legs when turning.
- C. Instruct the client to restrict flexion of the hip past 120°.
- D. Encourage the client to perform foot and calf exercises every 2 hr
Correct answer: Instruct the client to restrict flexion of the hip past 120°.
Rationale: Following a total hip arthroplasty, the client should be instructed to restrict hip flexion past 90 degrees to prevent dislocation of the prosthesis. Restricting flexion past 120 degrees is excessive and could lead to complications. Therefore, the nurse should verify this prescription with the provider to ensure the client's safety and proper postoperative care.
5. A male patient is concerned about the risk of prostate cancer while receiving finasteride (Proscar) for benign prostatic hyperplasia (BPH). What should the nurse explain about this risk?
- A. Finasteride has been shown to lower the risk of developing prostate cancer.
- B. Finasteride has no effect on the risk of developing prostate cancer.
- C. Finasteride may increase the risk of developing prostate cancer, so regular screening is important.
- D. Finasteride does not affect the risk of prostate cancer, so regular screening is unnecessary.
Correct answer: A
Rationale: The correct answer is A. Finasteride has been shown to lower the risk of developing prostate cancer. Studies have demonstrated that finasteride can reduce the incidence of prostate cancer. However, it is still recommended to have regular screening to monitor for any potential issues. Choice B is incorrect as finasteride has shown to have a positive effect on reducing prostate cancer risk. Choice C is inaccurate because finasteride decreases, not increases, the risk of prostate cancer. Choice D is incorrect as regular screening is still necessary despite the risk reduction associated with finasteride.
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