ATI RN
ATI Detailed Answer Key Medical Surgical
1. A client is 1-day postoperative following a left lower lobectomy and has a chest tube in place. When assessing the client's three-chamber drainage system, the nurse notes that there is no bubbling in the suction control chamber. Which of the following actions should the nurse take?
- A. Continue to monitor the client as this is an expected finding.
- B. Add more water to the suction control chamber of the drainage system.
- C. Verify that the suction regulator is on and check the tubing for leaks.
- D. Milk the chest tube and dislodge any clots in the tubing that are occluding it.
Correct answer: C
Rationale: In a three-chamber chest drainage system, the absence of bubbling in the suction control chamber indicates that no suction is being applied to the chest tube. The nurse should first verify that the suction regulator is on and check the tubing for any leaks that may be causing the lack of suction. Adding more water to the chamber or milking the chest tube are inappropriate actions and could potentially harm the client. Monitoring the client without taking action could lead to complications if the chest tube is not functioning properly.
2. A nurse is teaching a patient about the use of raloxifene (Evista) for the prevention of osteoporosis. What is the primary therapeutic action of this medication?
- A. It decreases the absorption of calcium from the intestines.
- B. It decreases bone resorption and increases bone density.
- C. It increases the excretion of calcium through the kidneys.
- D. It stimulates the formation of new bone.
Correct answer: B
Rationale: The correct answer is B. Raloxifene, a selective estrogen receptor modulator (SERM), works by decreasing bone resorption and increasing bone density. This action helps in preventing osteoporosis by maintaining bone strength. Choice A is incorrect as raloxifene does not affect the absorption of calcium from the intestines. Choice C is incorrect as raloxifene does not increase the excretion of calcium through the kidneys. Choice D is incorrect as raloxifene does not directly stimulate the formation of new bone; instead, it primarily works by reducing bone loss.
3. 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.
4. A lack of social skills, poor school performance, and moodiness have all been associated with which of the following parenting styles?
- A. Authoritarian
- B. Permissive/indulgent
- C. Authoritative
- D. Neglectful/uninvolved
Correct answer: D
Rationale: The correct answer is D, Neglectful/uninvolved. This parenting style is associated with a lack of social skills, poor school performance, and moodiness due to the lack of parental involvement and emotional support. Authoritarian parenting (choice A) is characterized by strict rules and high demands, not necessarily linked to these issues. Permissive/indulgent parenting (choice B) involves few rules and high responsiveness, which may not directly lead to these problems. Authoritative parenting (choice C) combines high demands with emotional support and is actually linked to positive outcomes such as good school performance and social skills.
5. When preparing to administer parenteral acyclovir (Zovirax) to an 80-year-old patient with chronic renal failure and herpes simplex, what would the nurse expect in regard to the dose?
- A. The dose is smaller due to the herpes simplex infection.
- B. The dose is smaller based on the patient's kidney function.
- C. The dose is higher in treating genital herpes.
- D. The dose is higher if the creatinine clearance is above 4.0 mg/dL.
Correct answer: B
Rationale: In patients with chronic renal failure, especially in older adults, dosages of medications excreted renally need to be adjusted based on kidney function. Acyclovir is primarily eliminated by the kidneys, so in a patient with chronic renal failure, the dose would need to be smaller to prevent drug accumulation and toxicity. Choice A is incorrect because the dose adjustment is more related to the patient's kidney function than the presence of herpes simplex. Choice C is incorrect because the type of herpes infection does not determine the dose adjustment for acyclovir. Choice D is incorrect as the creatinine clearance is a more accurate measure of kidney function compared to creatinine levels.
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