ATI RN
Adult Medical Surgical ATI
1. When performing tracheostomy care, which intervention should the nurse implement?
- A. Use aseptic technique.
- B. Clean the inner cannula with mild soap and water.
- C. Secure new tracheostomy ties before removing old ones.
- D. Apply suction when inserting the catheter.
Correct answer: Secure new tracheostomy ties before removing old ones.
Rationale: When caring for a client with a tracheostomy, it is essential to ensure that the airway is maintained and secured at all times. Securing new tracheostomy ties before removing the old ones helps prevent accidental decannulation and ensures continuous airway patency. Aseptic technique is crucial to prevent infections but is not directly related to securing the tracheostomy ties. Cleaning the inner cannula with mild soap and water is important for maintaining hygiene but does not address the immediate need for securing the airway. Applying suction when inserting the catheter is not a standard practice during tracheostomy care.
2. A client experiencing alcohol withdrawal is being cared for by a nurse. Which symptom should the nurse identify as a priority to address?
- A. Insomnia
- B. Nausea and vomiting
- C. Increased heart rate
- D. Tremors
Correct answer: C
Rationale: Increased heart rate is a critical symptom to address in a client experiencing alcohol withdrawal as it can indicate potential cardiovascular complications. Monitoring and managing the increased heart rate promptly is essential to prevent adverse outcomes.
3. A nurse is assessing a client who has chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse report to the provider?
- A. Oxygen saturation of 91%
- B. Use of pursed-lip breathing
- C. Productive cough with green sputum
- D. Decreased breath sounds in the right lower lobe
Correct answer: D
Rationale: The correct finding the nurse should report to the provider is decreased breath sounds in the right lower lobe. This can indicate a respiratory infection or atelectasis in clients with COPD, requiring further evaluation and intervention. Choice A, an oxygen saturation of 91%, although slightly lower than normal, does not necessarily require immediate reporting unless the client's baseline is significantly higher. Choice B, the use of pursed-lip breathing, is actually a beneficial technique for clients with COPD to improve oxygenation and reduce shortness of breath, so it does not need reporting. Choice C, a productive cough with green sputum, can be common in clients with COPD and may indicate an infection, but it is not as concerning as decreased breath sounds in a specific lung lobe which may signify a more acute issue.
4. A healthcare professional is preparing to administer IV Dantrolene to a client who has developed Malignant Hyperthermia during surgery. Which of the following actions should the healthcare professional take?
- A. Dilute the medication with sterile water and administer it rapidly.
- B. Store the medication in a refrigerator until use.
- C. Administer the medication through a large-bore IV catheter.
- D. Administer the medication via an infusion pump over 60 minutes.
Correct answer: C
Rationale: Dantrolene should be administered through a large-bore IV catheter because it is highly irritating to tissues and can cause vein irritation or thrombophlebitis if administered through a small vein. Using a large-bore IV catheter helps to minimize the risk of tissue damage and ensures proper and safe administration of the medication in emergency situations like Malignant Hyperthermia. Choices A, B, and D are incorrect because diluting the medication with sterile water and administering it rapidly can lead to tissue damage, storing the medication in a refrigerator is not necessary, and administering the medication via an infusion pump over 60 minutes is not appropriate in emergency situations like Malignant Hyperthermia where rapid administration is crucial.
5. In managing cystic fibrosis, which nutrition therapy is crucial for patients with pancreatic insufficiency?
- A. A low-fat diet to prevent steatorrhea
- B. A low-sodium diet to normalize fluid status
- C. A high-fiber diet to normalize bowel function
- D. Pancreatic enzyme replacement therapy to help digestion
Correct answer: D
Rationale: In cystic fibrosis patients with pancreatic insufficiency, pancreatic enzyme replacement therapy is vital for aiding digestion. This therapy helps compensate for the decreased production of digestive enzymes by the pancreas, enabling the proper breakdown and absorption of nutrients. Options A, B, and C are not the primary focus of nutrition therapy for cystic fibrosis patients with pancreatic insufficiency.
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