ATI Medical Surgical Proctored Exam

ATI Medical Surgical Proctored Exam Related

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During a call to the on-call physician about a client who had a hysterectomy 2 days ago & has unrelieved pain from prescribed narcotic medication, which statement is part of the SBAR format for communication?

  • A. I suggest ordering a different pain medication.
  • B. This client has allergies to morphine & codeine.
  • C. Dr. Smith does not prefer nonsteroidal anti-inflammatory meds.
  • D. The client had a vaginal hysterectomy 2 days ago.
Correct Answer: B

Rationale: The correct answer is B because it provides relevant information regarding the client's allergies to morphine and codeine, which is crucial for the physician to know when considering alternative pain medication options. This aligns with the "Background" component of the SBAR format, which includes pertinent patient history.

Choice A is incorrect because it jumps to a solution without providing necessary background information. Choice C is irrelevant to the current situation as it does not address the client's pain management issue. Choice D is also incorrect as it only provides historical information about the type of hysterectomy performed, which is not directly related to the client's current pain management concern.

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Priority Decision: Upon admission of a patient to the PACU, the nurse's priority assessment is

  • A. vital signs.
  • B. surgical site.
  • C. respiratory adequacy.
  • D. level of consciousness.
Correct Answer: C

Rationale: Respiratory adequacy is critical immediately postoperatively to ensure oxygenation and ventilation.

For a patient on the chemotherapeutic drug vincristine (Oncovin), which of the following side effects should be reported to the physician?

  • A. Fatigue.
  • B. Nausea and vomiting.
  • C. Paresthesia.
  • D. Anorexia.
Correct Answer: C

Rationale: Paresthesia is a serious neurotoxic side effect of vincristine and requires immediate medical attention.

Consider the differences between primary and secondary prevention. Fill in the blanks.

  • A. Secondary
  • B. Primary
  • C. None
  • D. All
Correct Answer: B

Rationale: Secondary prevention focuses on early detection and intervention to halt disease progression, while primary prevention aims to prevent disease onset through healthy behaviors like diet, exercise, and immunizations.

Following a gastric resection, a 70-year-old male client is admitted to the Post-Anesthesia Care Unit (PACU). The client was extubated prior to leaving the OR suite. Upon arrival at the PACU, the nurse should first:

  • A. check the client's airway to feel for the amount of air exchange, noting the rate, depth, and quality of respirations.
  • B. obtain pulse and blood pressure readings, noting the rate and quality of the client's pulse.
  • C. reassure the client that his surgery is over and that he is in the recovery room.
  • D. review the doctor's orders to administer any medications ordered.
Correct Answer: A

Rationale: Adequate air exchange and tissue oxygenation depends upon competent respiratory function. Checking the airway is the nurse's priority action. Obtaining the vital signs is an important action, but is secondary to airway management. Re-orienting a client to time, place, and person and knowing that their surgery is over is important, but is secondary to airway management and taking vital signs. Airway management takes precedence over the physician's orders, unless the orders specifically relate to airway management.

You are reviewing the drug list of an elderly client who is on several medications prescribed by different specialists for various health problems. The client reports 'lately there has been a roaring sound in my ears.' You notify the prescriber of which medication?

  • A. gentamicin sulfate (Garamycin)
  • B. metoprolol (Lopressor)
  • C. amoxicillin (Amoxil)
  • D. warfarin (Coumadin)
Correct Answer: A

Rationale: Gentamicin is an ototoxic medication that can cause tinnitus or hearing loss, warranting notification of the prescriber.

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