ATI RN
ATI Medical Surgical Proctored Exam
1. When interviewing a client recently diagnosed with lung cancer and having a 60-pack-year smoking history, what is the most important action for the nurse to take?
- A. Educate the client about the importance of quitting smoking to halt cancer progression.
- B. Encourage the client to disclose both tobacco and marijuana use openly.
- C. Maintain a nonjudgmental attitude to promote honest communication with the client.
- D. Provide realistic information about cancer treatment and prognosis without giving false hope.
Correct answer: C
Rationale: Maintaining a nonjudgmental attitude during the interview is crucial to create a safe environment where the client feels comfortable and open about disclosing their smoking history and other relevant information. This approach helps establish trust and facilitates an honest conversation which is essential for providing appropriate care and support to the client.
2. A client with cirrhosis is experiencing ascites. Which dietary instruction should the nurse provide?
- A. Increase protein intake.
- B. Limit fluid intake to 1500 mL/day.
- C. Consume a low-sodium diet.
- D. Take a daily multivitamin.
Correct answer: C
Rationale: For a client with cirrhosis experiencing ascites, the nurse should instruct them to consume a low-sodium diet. This dietary modification helps reduce fluid retention and manage ascites by decreasing the amount of sodium in the body, which helps prevent fluid accumulation in the abdomen. Limiting sodium intake is crucial in managing ascites and preventing further complications in clients with cirrhosis.
3. A client with asthma presents with bilateral wheezing, decreased pulse oxygen saturation, and suprasternal retraction on inhalation. Which actions should the nurse take? (SATA)
- A. Administer prescribed salmeterol (Serevent) inhaler.
- B. Assess the client for a tracheal deviation.
- C. Administer oxygen to maintain saturations above 94%.
- D. Perform peak expiratory flow measurements.
Correct answer: C
Rationale: Suprasternal retraction during inhalation suggests the client is using accessory muscles due to difficulty in moving air into the respiratory passages caused by airway narrowing. The presence of bilateral wheezing and decreased pulse oxygen saturation further support airway narrowing. In this situation, immediate intervention is necessary to improve oxygenation. Administering oxygen to maintain saturations above 94% is crucial to support oxygenation. While administering a rescue inhaler may be warranted, the priority in this scenario is ensuring adequate oxygenation to address the respiratory distress.
4. A student asks the faculty to explain best practices when communicating with a person from the LGBTQ community. What answer by the faculty is most accurate?
- A. Avoid embarrassing the individual by asking questions.
- B. Don't make assumptions about their health needs.
- C. Most LGBTQ individuals do not want to share information.
- D. No differences exist in communicating with this group.
Correct answer: B
Rationale: It is essential not to make assumptions about the health needs of individuals from the LGBTQ community. Each person is unique, and assuming their needs based on their sexual orientation or gender identity can lead to incorrect care and communication. By being open-minded and avoiding assumptions, healthcare providers can create a safe and supportive environment for LGBTQ individuals to discuss their health needs openly and honestly.
5. A client had a total hip arthroplasty. Which of the following prescriptions should the nurse verify with the provider?
- A. Administer enoxaparin 30 mg subcutaneously every 12 hr
- B. Place a wedge or pillow between the client's legs when turning.
- C. Instruct the client to restrict flexion of the hip past 120�.
- D. Encourage the client to perform foot and calf exercises every 2 hr
Correct answer: C
Rationale: Following a total hip arthroplasty, the client should be instructed to restrict hip flexion past 90 degrees to prevent dislocation of the prosthesis. Restricting flexion past 120 degrees is excessive and could lead to complications. Therefore, the nurse should verify this prescription with the provider to ensure the client's safety and proper postoperative care.
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