ATI RN
ATI Medical Surgical Proctored Exam 2023
1. A client who is interested in smoking cessation receives teaching from a nurse. Which statements should the nurse include in this teaching? (Select ONE that does not apply)
- A. Find an activity that you enjoy and that will keep your hands busy.
- B. Keep healthy snacks on hand to nibble on.
- C. Identify reasons for quitting smoking.
- D. Make a list of reasons for quitting smoking.
Correct answer: C
Rationale: When teaching a client interested in smoking cessation, the nurse should include advice to find an activity that keeps hands busy to help distract from smoking urges, keep healthy snacks on hand to manage oral cravings, and drink at least 8 glasses of water daily to aid in flushing out toxins. Making a list of reasons for quitting smoking is also beneficial to reinforce motivation. It is important to avoid punitive measures or punishments for relapses as this can negatively impact the client's progress.
2. A client with chronic obstructive pulmonary disease is being taught by a nurse about ways to facilitate eating. Which of the following statements indicates a need for further teaching?
- A. I will rest for at least 30 minutes before eating.
- B. I will take my bronchodilators after meals.
- C. I will eat five or six small meals each day.
- D. I will choose foods that are not gas-forming.
Correct answer: B
Rationale: Option B, 'I will take my bronchodilators after meals,' indicates a need for further teaching. Bronchodilators should be taken before meals to help open the airways and make breathing easier before eating. This statement suggests a misunderstanding of the timing for optimal bronchodilator effectiveness. Options A, C, and D are all appropriate strategies for facilitating eating for a client with chronic obstructive pulmonary disease.
3. A client is wearing a Venturi mask to receive oxygen, and the dinner tray has arrived. What action by the nurse is best?
- A. Assess the client's oxygen saturation and, if normal, turn off the oxygen.
- B. Determine if the client can switch to a nasal cannula during the meal.
- C. Have the client lift the mask off the face when taking bites of food.
- D. Turn off the oxygen while the client eats the meal and then restart it.
Correct answer: B
Rationale: In this scenario, the nurse should determine if the client can safely switch to a nasal cannula during meals. It is crucial to ensure that the provider has approved this change. Oxygen is considered a medication and should be delivered continuously. Turning off the oxygen or lifting the mask while eating can lead to a decrease in the FiO2 delivered, potentially compromising the client's oxygenation status. Therefore, the best course of action is to ascertain if transitioning to a nasal cannula is appropriate for the client during the meal.
4. When preparing a client for transfer to the ICU for placement of a pulmonary artery catheter, the nurse should explain that this catheter is used to monitor which of the following conditions?
- A. Intracranial pressure
- B. Spinal cord perfusion
- C. Renal function
- D. Hemodynamic status
Correct answer: D
Rationale: A pulmonary artery catheter is primarily used to monitor hemodynamic status. It provides essential information on cardiac output, preload, afterload, and overall cardiovascular function. This data helps healthcare providers manage the client's fluid status, cardiac function, and guide treatment interventions in critically ill patients. Monitoring intracranial pressure, spinal cord perfusion, or renal function would require different monitoring devices and techniques, not a pulmonary artery catheter.
5. A client with tuberculosis is starting medication therapy with isoniazid, rifampin, and pyrazinamide. Which of the following instructions should the nurse include?
- A. Take isoniazid with an antacid.
- B. Provide a sputum specimen every 2 weeks to the clinic for testing.
- C. Expect your sputum cultures to be negative after 6 months of therapy.
- D. Drink at least 8 ounces of water when you take the pyrazinamide tablet.
Correct answer: D
Rationale: Pyrazinamide can cause gastrointestinal upset and is best taken with a full glass of water to minimize irritation to the stomach lining. This instruction helps reduce the risk of adverse effects associated with pyrazinamide. Options A and C are not directly related to the medication regimen for tuberculosis. While sputum testing is important, the frequency mentioned in option B is not required every two weeks.
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