ATI RN
ATI Medical Surgical Proctored Exam
1. Prior to a thoracentesis, what intervention should the nurse complete?
- A. Measure oxygen saturation before and after the procedure.
- B. Verify that the client has given informed consent.
- C. Explain the procedure briefly to the client and their family.
- D. Ensure informed consent has been obtained from the client.
Correct answer: D
Rationale: Before a thoracentesis procedure, it is crucial to ensure that the client has given informed consent. This process involves explaining the procedure, its risks, benefits, and alternatives to the client, and obtaining their signature on the consent form. Verifying informed consent is a vital legal and ethical step to protect the client's autonomy and ensure they have made an informed decision about the procedure.
2. A client is interested in smoking cessation. Which statements should the nurse include in this client's teaching? (Select ONE that does not apply)
- A. Find an activity that you enjoy and will keep your hands busy.
- B. Make a list of reasons you want to stop smoking.
- C. Identify a punishment for yourself in case you backslide.
- D. Drink at least eight glasses of water each day.
Correct answer: D
Rationale: When educating a client on smoking cessation, the nurse should include several strategies. Finding an activity to keep hands busy helps distract from smoking urges. Making a list of reasons to quit smoking reinforces motivation. Identifying a consequence for backsliding can serve as a deterrent. Drinking water is beneficial for overall health but is not directly related to smoking cessation. It's crucial to support the client, encourage healthy habits, and address challenges without punitive measures.
3. A client with Parkinson's disease is prescribed carbidopa-levodopa (Sinemet). What should the nurse include in the teaching about this medication?
- A. Take the medication without a high-protein meal.
- B. Expect the medication to take several weeks to reach full effectiveness.
- C. The medication may cause urine to turn light.
- D. You may experience a rapid heartbeat as a common side effect.
Correct answer: B
Rationale: Patients prescribed carbidopa-levodopa should be informed that it may take several weeks for the medication to reach its full therapeutic effectiveness in managing Parkinson's disease symptoms. This delayed onset of action is important for patients to be aware of to prevent premature discontinuation of the medication due to perceived lack of efficacy.
4. A client with a pleural effusion is being assessed by a nurse. Which clinical manifestation does the nurse expect to find?
- A. Decreased breath sounds on the affected side
- B. Hyperresonance on percussion of the affected side
- C. Increased tactile fremitus on the affected side
- D. Tracheal deviation toward the affected side
Correct answer: A
Rationale: In a client with pleural effusion, decreased breath sounds on the affected side are common due to the presence of fluid in the pleural space. Hyperresonance is not expected; dullness on percussion is more likely. Tactile fremitus is typically decreased, not increased, in pleural effusion cases. Tracheal deviation away from the affected side, not toward it, can be seen with large effusions.
5. A healthcare professional assesses a client who is experiencing an acute asthma attack. Which assessment finding requires immediate intervention?
- A. Loud wheezing
- B. Increased respiratory rate
- C. Use of accessory muscles
- D. Silent chest
Correct answer: D
Rationale: A silent chest in a client experiencing an acute asthma attack indicates severe airway obstruction and impending respiratory failure. It is a critical finding that requires immediate intervention as it signifies a lack of airflow and ventilation. Loud wheezing, increased respiratory rate, and use of accessory muscles are common signs of an asthma attack and indicate the body's attempt to compensate. However, a silent chest suggests a dangerous lack of airflow that necessitates urgent medical attention to prevent respiratory arrest.
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