ATI RN
Medical Surgical ATI Proctored Exam
1. While assessing a client with pulmonary tuberculosis, which of the following findings should the nurse expect?
- A. Lethargy
- B. High-grade fever
- C. Weight gain
- D. Dry cough
Correct answer: Lethargy
Rationale: When assessing a client with pulmonary tuberculosis, the nurse should expect lethargy as a common finding. Tuberculosis can cause fatigue and weakness due to the body's efforts to fight the infection. High-grade fever is another common symptom of tuberculosis, not weight gain or dry cough. Weight loss is more typical in tuberculosis due to decreased appetite and systemic effects of the infection. A persistent productive cough with sputum is more characteristic of tuberculosis rather than a dry cough.
2. How does the pain of a myocardial infarction (MI) differ from stable angina? (SATA)
- A. Accompanied by shortness of breath
- B. Feelings of fear or anxiety
- C. Lasts longer than 15 minutes
- D. Relieved by taking nitroglycerin
Correct answer: A, C
Rationale: The pain of an MI is often accompanied by shortness of breath and feelings of fear or anxiety. It typically lasts longer than 15 minutes and is not relieved by nitroglycerin. Unlike stable angina, the pain of an MI occurs without a known cause such as exertion.
3. A healthcare provider collaborates with a respiratory therapist to complete pulmonary function tests (PFTs) for a client. Which statements should the healthcare provider include in communications with the respiratory therapist prior to the tests? (Select ONE that does not apply)
- A. I ensured the client did not use bronchodilator medication within the specified timeframe.
- B. The client is prepared to undergo the examination in radiology.
- C. Physical therapy has approved the client for treadmill exercise.
- D. I instructed the client not to smoke for the required duration before the test.
Correct answer: C
Rationale: For accurate pulmonary function tests (PFTs), it is essential to communicate that the client did not use bronchodilators within the specified timeframe, did not smoke for the required duration before the test, and can comply with different breathing maneuvers. The use of a treadmill is not part of the PFT procedure and is unrelated to the testing process. Therefore, communicating about the client's ability to run on a treadmill is not relevant to the pulmonary function tests being conducted by the respiratory therapist.
4. When teaching a client with chronic obstructive pulmonary disease who will start using fluticasone via MDI twice daily, which instruction should the nurse include?
- A. Monitor your heart rate before each dose.
- B. Inspect your mouth for lesions daily.
- C. Do not use this medication to relieve an acute attack.
- D. Do not skip the morning dose even if symptom-free.
Correct answer: B: "Inspect your mouth for lesions daily."
Rationale: It is crucial for clients using inhaled corticosteroids like fluticasone to inspect their mouths daily for signs of oral thrush, a common side effect. Checking the mouth can help identify lesions early, allowing for timely intervention to prevent worsening of the condition. Monitoring heart rate is not specifically required for this medication. Fluticasone is a maintenance medication used to manage COPD, not to relieve acute attacks. Skipping doses, especially in the morning, can lead to inadequate control of COPD symptoms.
5. A healthcare professional is interested in making interdisciplinary work a high priority. Which actions by the professional best demonstrate this skill? (SATA)
- A. Consulting with other disciplines on client care
- B. Coordinating discharge planning for home safety
- C. Participating in comprehensive client rounding
- D. Sharing the care plans with other disciplines
Correct answer: A, C, D
Rationale: Interdisciplinary work in healthcare involves effective communication and collaboration between different disciplines for holistic client care. Consulting with other disciplines allows for sharing expertise, insights, and perspectives to enhance client outcomes. Participating in comprehensive client rounding involves a team-based approach to discuss and plan client care collectively. Sharing nursing care plans with other disciplines ensures that all team members are informed and can contribute to the client's overall well-being. Coordinating discharge planning is important but may not directly demonstrate interdisciplinary collaboration as the other actions do.
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