Medical Surgical ATI Proctored Exam

Medical Surgical ATI Proctored Exam Related

Review Medical Surgical ATI Proctored Exam related questions and content

A client with long-standing obesity has been prescribed phentermine/topiramate-ER. What statement by the client suggests that further health education is necessary?

  • A. I'm so relieved to start this medication. I really don't like having to exercise or change what I eat.
  • B. It's hard to believe that there are actually medications that can treat obesity.
  • C. I'm a bit nervous to start this medication because I know I'll need blood tests sometimes.
  • D. I'm going to have to do some rearranging of my finances to make sure I can afford this medication.
Correct Answer: A

Rationale: The correct answer is A because the client's statement indicates a lack of understanding about the comprehensive approach needed to address obesity. Phentermine/topiramate-ER is not a standalone solution; it is most effective when used in conjunction with lifestyle changes like exercise and dietary modifications. By expressing a dislike for exercise and dietary changes, the client demonstrates a reliance solely on the medication, which is not conducive to long-term weight management. This suggests a need for further education on the importance of holistic lifestyle modifications in conjunction with medication therapy.

Choice B is incorrect because the client expressing disbelief at medications for obesity is not necessarily indicative of a need for further education; it may simply reflect surprise or lack of awareness. Choice C is incorrect as the client's nervousness about blood tests is a common concern and does not necessarily indicate a need for more education. Choice D is also incorrect as financial concerns are valid but do not directly relate to the need for additional health education.

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A 45-year-old obese man arrives at a clinic reporting daytime sleepiness, difficulty falling asleep at night, and snoring. The nurse should recognize the manifestations of what health problem?

  • A. Adenoiditis
  • B. Chronic tonsillitis
  • C. Obstructive sleep apnea
  • D. Laryngeal cancer
Correct Answer: C

Rationale: The correct answer is C: Obstructive sleep apnea. The patient's symptoms of daytime sleepiness, difficulty falling asleep, and snoring are classic signs of obstructive sleep apnea, a condition where the upper airway collapses during sleep, leading to pauses in breathing. This results in poor sleep quality and daytime fatigue. Adenoiditis (choice A) and chronic tonsillitis (choice B) typically present with symptoms like sore throat and difficulty swallowing, which are not seen in this patient. Laryngeal cancer (choice D) would present with hoarseness, persistent cough, and difficulty swallowing, which are not mentioned in the patient's symptoms. Therefore, based on the patient's presentation, the most likely diagnosis is obstructive sleep apnea.

A client with liver failure is at an increased risk of bleeding due to the inability to synthesize prothrombin in the liver. What factor most likely contributes to this loss of function?

  • A. Alterations in glucose metabolism
  • B. Retention of bile salts
  • C. Inadequate production of albumin by hepatocytes
  • D. Inability of the liver to use vitamin K
Correct Answer: D

Rationale: The correct answer is D: Inability of the liver to use vitamin K. Vitamin K is essential for the synthesis of clotting factors, including prothrombin. In liver failure, impaired function leads to reduced production of bile, which is necessary for the absorption of fat-soluble vitamins like vitamin K. This results in inadequate activation of clotting factors and increased risk of bleeding. Choices A, B, and C are incorrect as alterations in glucose metabolism, retention of bile salts, and inadequate albumin production do not directly impact the synthesis and activation of clotting factors like prothrombin in liver failure.

A client with a newly created ileostomy has not had ostomy output for the past 12 hours and reports worsening nausea. What is the nurse's priority action?

  • A. Facilitate a referral to the wound-ostomy-continence (WOC) nurse
  • B. Report signs and symptoms of obstruction to the health care provider
  • C. Encourage the client to mobilize to enhance mobility
  • D. Contact the health care provider to obtain a swab of the stoma for culture
Correct Answer: B

Rationale: The correct answer is B: Report signs and symptoms of obstruction to the health care provider. The priority action in this scenario is to address the possibility of an obstruction, which could be a life-threatening complication. Reporting to the healthcare provider allows for prompt assessment and intervention to prevent further complications. A: Referring to the WOC nurse may be necessary but is not the priority when obstruction is suspected. C: Encouraging mobilization is important for overall health but not the priority in this urgent situation. D: Obtaining a swab for culture is not the priority when obstruction is suspected.

A 55-year-old woman presents with fatigue, pruritus, and jaundice. Laboratory tests reveal elevated bilirubin and alkaline phosphatase levels. Imaging shows dilated intrahepatic bile ducts and a normal common bile duct. What is the most likely diagnosis?

  • A. Primary biliary cirrhosis
  • B. Primary sclerosing cholangitis
  • C. Gallstones
  • D. Pancreatic cancer
Correct Answer: A

Rationale: The most likely diagnosis is A: Primary biliary cirrhosis. This is supported by the patient's symptoms of fatigue, pruritus, jaundice, elevated bilirubin and alkaline phosphatase levels, and dilated intrahepatic bile ducts. Primary biliary cirrhosis is an autoimmune liver disease that primarily affects middle-aged women, leading to destruction of intrahejson hepatic bile ducts. The normal common bile duct rules out obstruction from gallstones or pancreatic cancer. Primary sclerosing cholangitis typically presents with strictures in the bile ducts, which is not seen in this case. Therefore, the combination of symptoms, lab findings, and imaging results point towards primary biliary cirrhosis as the most likely diagnosis.

The healthcare provider is providing care to a client with a tracheostomy. Which action should the healthcare provider take to prevent tracheostomy complications?

  • A. Use sterile technique when performing tracheostomy care.
  • B. Suction the tracheostomy tube every hour.
  • C. Keep the tracheostomy tube cuff inflated at all times.
  • D. Change the tracheostomy ties daily.
Correct Answer: A

Rationale: The correct answer is A: Use sterile technique when performing tracheostomy care. This is crucial to prevent infections that can lead to complications. Sterile technique helps minimize the risk of introducing harmful pathogens into the tracheostomy site. Using clean rather than sterile technique can increase the client's risk of infection.

Choice B is incorrect because suctioning the tracheostomy tube every hour can lead to mucosal damage and increase the risk of infection. Choice C is incorrect because keeping the tracheostomy tube cuff inflated at all times can cause pressure ulcers and damage the trachea. Choice D is incorrect because changing the tracheostomy ties daily is unnecessary and can increase the risk of dislodging the tracheostomy tube, leading to complications.

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