ATI RN
ATI Medical Surgical Proctored Exam 2023
1. A client with a tracheostomy experienced a coughing spell during a meal that was being fed by an unlicensed assistive personnel (UAP). What action by the nurse takes priority?
- A. Assess the client's lung sounds.
- B. Assign a different UAP to the client.
- C. Report the UAP to the manager.
- D. Request thicker liquids for meals.
Correct answer: A
Rationale: The priority action for the nurse is to assess the client's lung sounds to check for signs of aspiration, which can compromise the client's oxygenation. This is crucial to ensure the client's immediate safety and respiratory status. Once the client has been assessed, the nurse can then consider consulting with the registered dietitian regarding appropriate thickened liquids for future meals. Assigning a different UAP or reporting the UAP to the manager may be necessary steps but not the immediate priority in this situation.
2. A recent ethical issue has resulted in uneasiness and discomfort for several nurses on a unit. The unit manager has decided to discuss the issues at the next team meeting. The situation has resulted in which of the following for some of the nurses?
- A. Moral suffering
- B. Moral distress
- C. Ethical dilemma
- D. Veracity
Correct answer: B
Rationale: The correct answer is B, moral distress. Moral distress occurs when one knows the ethically correct action to take but feels constrained in their ability to take that action due to institutional, hierarchical, or other constraints. In this scenario, the nurses are experiencing uneasiness and discomfort due to an ethical issue, which aligns with the definition of moral distress. Choice A, moral suffering, is not the most appropriate term in this context as moral distress better describes the situation. Choice C, ethical dilemma, refers to a situation where a person is faced with two equally undesirable alternatives, which does not fully capture the nurses' current experience. Choice D, veracity, is unrelated to the nurses' situation and does not fit the context of the scenario.
3. Which lab value is most critical to monitor in a patient receiving digoxin?
- A. Monitor potassium levels
- B. Monitor sodium levels
- C. Monitor calcium levels
- D. Monitor magnesium levels
Correct answer: A
Rationale: The correct answer is to monitor potassium levels in a patient receiving digoxin. Hypokalemia can potentiate the toxic effects of digoxin, leading to serious cardiac arrhythmias. Monitoring potassium levels helps prevent toxicity. Monitoring sodium levels (Choice B), calcium levels (Choice C), and magnesium levels (Choice D) are also important aspects of patient care, but potassium levels are most critical in patients on digoxin therapy.
4. A client has a chest tube in place connected to a closed chest drainage system. Which of the following findings should indicate to the nurse that the client's lung has re-expanded?
- A. Oxygen saturation of 95%
- B. No fluctuations in the water seal chamber
- C. No reports of pleuritic chest pain
- D. Occasional bubbling in the water-seal chamber
Correct answer: No fluctuations in the water seal chamber
Rationale: The absence of fluctuations in the water seal chamber indicates that the client's lung has re-expanded. This finding suggests that the negative pressure in the pleural space is restored, preventing air from entering the system. Oxygen saturation, absence of pleuritic chest pain, and occasional bubbling in the water-seal chamber are important assessments but do not specifically indicate lung re-expansion.
5. Why does a nurse on an oncology unit verify a client's current cumulative lifetime dose of doxorubicin before administering it to a client with breast cancer?
- A. Excessive doxorubicin can result in myelosuppression.
- B. Exceeding the lifetime cumulative dose limit of doxorubicin may lead to extravasation.
- C. An excess amount of doxorubicin can lead to cardiomyopathy.
- D. Exceeding the lifetime cumulative dose limit of doxorubicin may cause red-tinged urine and sweat.
Correct answer: C
Rationale: Verifying the client's current cumulative lifetime dose of doxorubicin is necessary because excessive amounts of the medication can lead to cardiomyopathy, a serious and potentially life-threatening side effect. By monitoring the cumulative dose, healthcare providers can help prevent cardiotoxicity and ensure patient safety during treatment.
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