ATI Medical Surgical Proctored Exam

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A client is hospitalized with a second episode of pulmonary embolism (PE). Recent genetic testing reveals the client has an alteration in the gene CYP2C19. What action by the nurse is best?

  • A. Instruct the client to eliminate all vitamin K from the diet.
  • B. Prepare preoperative teaching for an inferior vena cava (IVC) filter.
  • C. Refer the client to a chronic illness support group.
  • D. Teach the client to use a soft-bristled toothbrush.
Correct Answer: B

Rationale: The correct answer is B: Prepare preoperative teaching for an inferior vena cava (IVC) filter. In the context of a client with an alteration in the gene CYP2C19 and recurrent pulmonary embolism, the use of an IVC filter helps prevent blood clots from traveling to the lungs. This intervention is crucial in managing the risk of further pulmonary embolism. Teaching the client about the purpose, care, and potential complications of the IVC filter is essential for their understanding and cooperation in the treatment plan.

Incorrect Choices:
A: Instruct the client to eliminate all vitamin K from the diet. This choice is not relevant to the management of recurrent pulmonary embolism associated with a genetic alteration.
C: Refer the client to a chronic illness support group. While support is important, it is not the immediate priority in this case of managing a recurrent PE.
D: Teach the client to use a soft-bristled toothbrush. This recommendation is not directly

You may also like to solve these questions

What nursing action is most important initially for Ms. Jenkins with pneumococcal pneumonia?

  • A. Administer humidified oxygen, as ordered
  • B. Obtain an order for aspirin
  • C. Auscultate the posterior basal segments for rales and rhonchi
  • D. Explain the diagnosis to the patient
Correct Answer: A

Rationale: Oxygen therapy addresses hypoxemia, a primary concern in pneumonia.

A patient with a history of asthma is scheduled for an appendectomy. Because of her asthma, you would include as part of the preoperative teaching the need to perform postoperatively

  • A. Coughing and deep breathing exercises.
  • B. Leg exercises.
  • C. Wound dressing changes.
  • D. All of these.
Correct Answer: A

Rationale: Deep breathing exercises help prevent postoperative complications in asthmatic patients.

During an acute asthma attack in a client with asthma, what medication should the nurse administer first?

  • A. Oral corticosteroids
  • B. Short-acting beta agonist
  • C. Leukotriene receptor antagonist
  • D. Long-acting beta agonist
Correct Answer: B

Rationale: The correct answer is B: Short-acting beta agonist. During an acute asthma attack, the priority is to quickly relieve bronchoconstriction and improve airflow. Short-acting beta agonists like albuterol are the first-line medications for acute asthma exacerbations as they act rapidly to relax smooth muscles in the airways, providing immediate relief of symptoms. Oral corticosteroids (A) are important for long-term management but do not provide immediate relief. Leukotriene receptor antagonists (C) and long-acting beta agonists (D) are not appropriate for acute asthma attacks as they have slower onset of action and are used for maintenance therapy.

Which postoperative complication results from saliva, mucus, vomitus, or blood making its way into the lungs as a result of difficulty in swallowing or a client’s inability to rid himself/herself of oral secretions?

  • A. Aspiration
  • B. Hypoxia
  • C. Shock
  • D. Hemorrhage
Correct Answer: A

Rationale: The correct answer is A because aspiration occurs when foreign material enters the lungs.

Why are older adults more likely to develop hypovolemic shock?

  • A. Low-activity lifestyle
  • B. Altered cardiac function
  • C. Decreased percentage of body water
  • D. Decline in muscle strength and bone mass
Correct Answer: C

Rationale: Older adults have less total body water, making them more susceptible to fluid losses and hypovolemic shock.

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