ATI RN
ATI Detailed Answer Key Medical Surgical
1. A healthcare professional is assessing a client who has a fracture of the femur. Vital signs are obtained on admission and again in 2 hours. Which of the following changes in assessment should indicate to the healthcare professional that the client could be developing a serious complication?
- A. Increased respiratory rate from 18 to 44/min
- B. Increased oral temperature from 36.6° C (97.8° F) to 37° C (98.6° F)
- C. Increased blood pressure from 112/68 to 120/72 mm Hg
- D. Increased heart rate from 68 to 72/min
Correct answer: Increased respiratory rate from 18 to 44/min
Rationale: An increased respiratory rate from 18 to 44/min is a significant change that should alert the healthcare professional to a potential serious complication. Such a drastic increase in respiratory rate may indicate respiratory distress or hypoxia, which are critical conditions requiring immediate attention. The other options show minor changes in vital signs that are within normal limits and are less likely to indicate a serious complication.
2. Natasha's husband died suddenly two months ago, and she has been overwhelmed with grief. When Natasha is subsequently diagnosed with major depressive disorder, her daughter, Nadia, makes which true statement?
- A. Depression often begins after a major loss. Losing dad was a major loss.
- B. Bereavement and depression are the same problem.
- C. Mourning is pathological and not normal behavior.
- D. Antidepressant medications will not help this type of depression.
Correct answer: A
Rationale: When individuals experience a significant loss, such as the death of a loved one, it can trigger major depressive disorder. This is because the intense grief and sadness associated with the loss can lead to the development of depressive symptoms. Therefore, Nadia's statement that 'Depression often begins after a major loss' is accurate in this context.
3. A newly graduated nurse in the hospital states that, since she is so new, she cannot participate in quality improvement (QI) projects. What response by the precepting nurse is best?
- A. All staff nurses are required to participate in quality improvement projects.
- B. Even as a new nurse, you can implement activities designed to improve care.
- C. It's easy to identify which indicators should be used to measure quality improvement.
- D. You should ask to be assigned to the research and quality committee.
Correct answer: B
Rationale: The best response is to encourage the newly graduated nurse to actively participate in quality improvement initiatives. Being new does not preclude one from contributing to improving care processes and outcomes. By engaging in small activities focused on quality improvement, the new nurse can start making a positive impact and learn valuable skills early in their career.
4. When auscultating an infant's lungs, the nurse detects diminished breath sounds. What should the nurse interpret this as?
- A. Suggestive of chronic pulmonary disease
- B. Suggestive of impending respiratory failure
- C. An abnormal finding warranting investigation
- D. A normal finding in infants younger than 1 year of age
Correct answer: C
Rationale: Diminished breath sounds in an infant are an abnormal finding and warrant further investigation to rule out conditions like atelectasis or pneumonia.
5. The client is on dobutamine. Adverse effects of Dobutrex (dobutamine) include the following: Select all that apply.
- A. Heart failure
- B. Bradycardia
- C. Tachycardia
- D. Respiratory distress
Correct answer: C
Rationale: The correct answer is C: Tachycardia. Dobutamine is a medication that primarily increases heart rate (tachycardia) and blood pressure. Therefore, the adverse effects of dobutamine include tachycardia. Choices A, B, and D are incorrect. Heart failure is not an adverse effect of dobutamine; in fact, it is used to treat heart failure by increasing heart contractility. Bradycardia (slow heart rate) is not an expected adverse effect of dobutamine, as it usually increases heart rate. Respiratory distress is not a common adverse effect of dobutamine.
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