Medical Surgical ATI Proctored Exam

Medical Surgical ATI Proctored Exam Related

Review Medical Surgical ATI Proctored Exam related questions and content

During assessment, a healthcare provider is evaluating a client with chronic bronchitis. Which of the following percussion sounds should the healthcare provider expect?

  • A. Dullness
  • B. Resonance
  • C. Tympany
  • D. Flatness
Correct Answer: B

Rationale: The correct answer is B: Resonance. When assessing a client with chronic bronchitis, the healthcare provider should expect to hear resonant percussion sounds. This is because chronic bronchitis is characterized by inflammation and excess mucus production in the bronchial tubes, leading to airway obstruction. Resonance indicates normal lung tissue and air-filled spaces. Dullness (A) may suggest consolidation or fluid in the lungs, which is not typically associated with chronic bronchitis. Tympany (C) is a drum-like sound that can be heard over air-filled structures like the stomach, not typically expected in a lung assessment. Flatness (D) is heard over solid structures like the liver and would not be expected in a lung assessment for chronic bronchitis.

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A client in the emergency department is being cared for by a nurse and has cardiogenic pulmonary edema. The client's assessment findings include anxiousness, dyspnea at rest, crackles, blood pressure 110/79 mm Hg, and apical heart rate 112/min. What is the nurse's priority intervention?

  • A. Provide the client with supplemental oxygen at 5 L/min via facemask.
  • B. Place the client in high-Fowler's position with their legs in a dependent position
  • C. Give the client sublingual nitroglycerin
  • D. Administer morphine sulfate IV
Correct Answer: A

Rationale: The correct answer is A: Provide the client with supplemental oxygen at 5 L/min via facemask. In cardiogenic pulmonary edema, the priority intervention is to improve oxygenation. Supplemental oxygen helps increase oxygen levels and alleviate respiratory distress, reducing the workload on the heart. This intervention addresses the client's dyspnea and anxiousness by improving oxygen delivery.

Choice B is incorrect as placing the client in high-Fowler's position with legs in a dependent position can help with breathing but does not address the immediate need for oxygenation.

Choice C is incorrect as sublingual nitroglycerin is typically used for angina and not the priority intervention for cardiogenic pulmonary edema.

Choice D is incorrect as morphine sulfate IV may be indicated for pain relief and anxiety, but it is not the priority intervention to address the client's oxygenation needs in cardiogenic pulmonary edema.

Match the following types of pain in the left column with a category of pain from the upper right column and an example of the source of the pain from the lower right column.

  • A. Pain from loss of afferent input
  • B. Pain persisting from sympathetic nervous system (SNS) activity
  • C. Pain caused by dysfunction in the central nervous system (CNS)
  • D. Pain arising from muscles and bones; localized or diffuse and radiating
Correct Answer: D

Rationale: Pain felt along the distribution of peripheral nerve(s) from nerve damage

A home health nurse visits a client who has COPD and receives oxygen at 2 L/min via nasal cannula. The client reports difficulty breathing. Which of the following actions is the nurse's priority?

  • A. Increase the oxygen flow to 3 L/min.
  • B. Assess the client's respiratory status.
  • C. Call emergency services for the client.
  • D. Have the client cough and expectorate secretions.
Correct Answer: B

Rationale: The correct answer is B: Assess the client's respiratory status. This is the priority because the client is experiencing difficulty breathing, which could indicate a worsening of their condition. By assessing the respiratory status, the nurse can gather vital information to determine the appropriate next steps, such as adjusting the oxygen flow rate, providing respiratory treatments, or seeking further medical intervention. Increasing the oxygen flow without assessing the client's condition could potentially exacerbate the issue. Calling emergency services (choice C) may be necessary based on the assessment findings but should not be the immediate priority. Having the client cough and expectorate secretions (choice D) is important for airway clearance but is not the priority when the client is in distress.

Systolic hypertension and stroke are due to:

  • A. Increased vascular stiffness related to structural changes
  • B. Loss of peripheral vascular tone
  • C. Buildup of soft plaque within the veins
  • D. Changes within the basement membrane
Correct Answer: A

Rationale: As people age, arteries lose elasticity and become stiffer, leading to increased systolic blood pressure and higher risk of stroke.

The World Health Organization (WHO) recommends the use of three-step analgesic ladder when deciding on pain management. In order of first choice to second choice to third choice, the following drug categories are used:

  • A. NSAIDs,nonopioids and opioids
  • B. Nonopioids opioid antagonists and opioids
  • C. Nonopioids opioids and adjuvant agents
  • D. NSAIDs opioids and adjuvant agent
Correct Answer: C

Rationale: The WHO analgesic ladder starts with nonopioid analgesics (e.g., acetaminophen), progresses to weak opioids if needed, and finally includes strong opioids along with adjuvant therapies for severe pain.

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