ATI RN
ATI Medical Surgical Proctored Exam 2023
1. A client is experiencing an acute exacerbation of asthma. Which medication should the nurse administer first?
- A. Albuterol (Proventil)
- B. Ipratropium (Atrovent)
- C. Salmeterol (Serevent)
- D. Fluticasone (Flovent)
Correct answer: A
Rationale: During an acute exacerbation of asthma, the priority is to administer a short-acting beta2-agonist like Albuterol (Proventil) first. Albuterol acts quickly to dilate the airways and provide immediate relief of bronchospasm. Ipratropium (Atrovent) is an anticholinergic that can be used as an adjunct therapy. Salmeterol (Serevent) is a long-acting beta2-agonist intended for maintenance therapy, not for acute exacerbations. Fluticasone (Flovent) is a corticosteroid used for long-term asthma control and should not be the initial medication given during an acute exacerbation.
2. Kevin has a history of peptic ulcer disease and vomits coffee-ground emesis. What does this indicate?
- A. He has fresh, active upper GI bleeding.
- B. He needs immediate saline gastric lavage.
- C. His gastric bleeding occurred 2 hours earlier.
- D. He needs a transfusion of packed RBC’s.
Correct answer: C
Rationale: Coffee-ground emesis indicates that the gastric bleeding occurred 2 hours earlier.
3. The nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to:
- A. restrict fluid intake to 1 qt (1,000 ml)/day.
- B. drink liquids only with meals.
- C. don't drink liquids 2 hours before meals.
- D. drink liquids only between meals.
Correct answer: D
Rationale: A client who experiences dumping syndrome after a subtotal gastrectomy should be advised to ingest liquids between meals rather than with meals. Taking fluids between meals allows for adequate hydration, reduces the amount of bulk ingested with meals, and aids in preventing rapid gastric emptying. There is no need to restrict the amount of fluids, just the time when the client drinks fluids. Drinking liquids with meals increases the risk of dumping syndrome by increasing the amount of bulk and stimulating rapid gastric emptying. Small amounts of water are allowable before meals.
4. A client is prescribed Propranolol for dysrhythmia. Which action should the nurse plan to take?
- A. Hold Propranolol if the client's apical pulse is greater than 100/min.
- B. Monitor the client's blood pressure after administering Propranolol.
- C. Assist the client when transitioning to a sitting or standing position after taking Propranolol.
- D. Monitor the client's potassium levels for signs of Propranolol toxicity.
Correct answer: C
Rationale: The correct action the nurse should plan to take when administering Propranolol to a client with dysrhythmia is to assist the client when transitioning to a sitting or standing position. Propranolol can cause orthostatic hypotension, leading to dizziness during position changes, so it is essential to help the client move slowly to prevent falls or injuries. Choices A, B, and D are incorrect because holding Propranolol based on pulse rate, monitoring blood pressure after administration, and monitoring potassium levels are not directly related to the common side effect of orthostatic hypotension associated with Propranolol.
5. A nurse is developing a care plan for a client with Alzheimer's disease. Which of the following interventions should the nurse include?
- A. Provide reality orientation throughout the day.
- B. Limit the client's choices to prevent decision fatigue.
- C. Encourage the client to participate in group therapy.
- D. Engage the client in sensory stimulation activities.
Correct answer: A
Rationale: The correct intervention the nurse should include in the care plan for a client with Alzheimer's disease is to provide reality orientation throughout the day. Reality orientation involves helping clients with Alzheimer's disease stay connected to the present, reducing confusion and disorientation. This intervention can help the client maintain a sense of time, place, and person. Choices B, C, and D are incorrect because limiting choices may lead to frustration, group therapy may not always be suitable for clients with Alzheimer's disease, and sensory stimulation activities may not address the core issue of disorientation in Alzheimer's disease.
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