ATI Medical Surgical Proctored Exam 2019 Quizlet

ATI Medical Surgical Proctored Exam 2019 Quizlet Related

Review ATI Medical Surgical Proctored Exam 2019 Quizlet related questions and content

The nurse is caring for four clients: Client A, who has emphysema and an oxygen saturation of 94%; Client B, with a postoperative hemoglobin of 8.7 g/dL; Client C, newly admitted with a potassium level of 3.8 mEq/L; and Client D, scheduled for an appendectomy with a white blood cell count of 15,000/mm3. What intervention should the nurse implement?

  • A. Increase Client A's oxygen to 4 liters per minute via nasal cannula.
  • B. Determine if Client B has two units of packed cells available in the blood bank.
  • C. Ask the dietitian to add a banana to Client C's breakfast tray.
  • D. Inform Client D that surgery is likely to be delayed until the infection is treated.
Correct Answer: D

Rationale: The correct answer is D because a white blood cell count of 15,000/mm3 indicates an infection, which can be a contraindication for surgery. The nurse should inform Client D that surgery is likely to be delayed until the infection is treated to prevent complications.

Choice A is incorrect as increasing oxygen for Client A may not be necessary based on the oxygen saturation level of 94%, which is within the normal range.

Choice B is incorrect because determining if packed cells are available in the blood bank for Client B with a hemoglobin of 8.7 g/dL does not address the immediate concern of the possible surgical delay due to infection.

Choice C is incorrect as adding a banana to Client C's breakfast tray for a potassium level of 3.8 mEq/L is not a priority compared to addressing the potential surgical delay for Client D.

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A client diagnosed with major depressive disorder refuses to get out of bed, eat, or participate in group therapy. Which intervention is most important for the nurse to implement?

  • A. Offer the client high-calorie snacks and frequent small meals.
  • B. Ask the client why they are not participating in therapy.
  • C. Sit with the client and offer support without demanding participation.
  • D. Encourage the client to discuss their feelings of hopelessness.
Correct Answer: C

Rationale: The correct answer is C because sitting with the client and offering support without demanding participation is crucial in building trust and rapport. This approach respects the client's autonomy and allows them to feel supported without pressure. It also creates a safe space for the client to open up when they are ready.

Explanation for why the other choices are incorrect:
A: Offering high-calorie snacks and frequent small meals does not address the core issue of the client's refusal to participate in therapy.
B: Asking the client why they are not participating in therapy may come off as confrontational and could further discourage them from opening up.
D: Encouraging the client to discuss their feelings of hopelessness may be overwhelming for them at this stage and could lead to resistance.

In which situation is it most important for the registered nurse (RN) working on a medical unit to provide direct supervision?

  • A. A graduate nurse needs to access a client's implanted port to start an infusion of Ringer's Lactate.
  • B. A postpartum nurse pulled to the unit needs to start a transfusion of packed red blood cells.
  • C. A practical nurse is preparing to assist the healthcare provider with a lumbar puncture at the bedside.
  • D. An unlicensed assistive personnel is preparing to weigh an obese bedfast client using a bed scale.
Correct Answer: A

Rationale: The correct answer is A because accessing an implanted port for infusion is a specialized skill that requires direct supervision to ensure the safety and accuracy of the procedure. Step 1: A graduate nurse may not have sufficient experience with accessing ports. Step 2: The RN needs to ensure proper technique and prevent complications. Step 3: Direct supervision allows for immediate intervention if any issues arise. Other choices are incorrect because B: starting a transfusion is within the scope of practice for a nurse, C: assisting with a lumbar puncture can be done under indirect supervision, and D: weighing a client is a task that can be delegated to unlicensed personnel with proper training.

Following a CVA, the nurse assesses that a client developed dysphagia, hypoactive bowel sounds, and a firm, distended abdomen. Which prescription for the client should the nurse question?

  • A. Continuous tube feeding at 65 ml/hr via gastrostomy.
  • B. Total parenteral nutrition to be infused at 125 ml/hour.
  • C. Nasogastric tube connected to low intermittent suction.
  • D. Metoclopramide (Reglan) intermittent piggyback.
Correct Answer: A

Rationale: The correct answer is A: Continuous tube feeding at 65 ml/hr via gastrostomy. Dysphagia, hypoactive bowel sounds, and a distended abdomen indicate a potential risk for aspiration or impaired gastrointestinal motility. Continuous tube feeding may worsen these conditions. The nurse should question this prescription to prevent further complications. Choices B, C, and D are not immediate concerns for dysphagia and bowel issues. Total parenteral nutrition, nasogastric tube connected to suction, and metoclopramide can be appropriate interventions for nutritional support and bowel motility in this scenario.

A male client in the day room becomes increasingly angry and aggressive when denied a day-pass. Which action should the nurse implement?

  • A. Tell him he can have a day pass if he calms down.
  • B. Put the client's behavior on extinction.
  • C. Decrease the volume on the television set.
  • D. Instruct the client to sit down and be quiet.
Correct Answer: D

Rationale: The correct answer is D because instructing the client to sit down and be quiet is a non-confrontational and calming approach to de-escalate the situation. It helps redirect the client's focus and encourages self-regulation. Choice A may reinforce the aggressive behavior by rewarding it. Choice B (putting behavior on extinction) may escalate the situation further. Choice C (decreasing TV volume) does not address the client's behavior directly.

What instruction should be provided to a client with a history of myocardial infarction (MI) who is prescribed nitroglycerin?

  • A. Take nitroglycerin with food to avoid stomach upset.
  • B. Store nitroglycerin tablets in a dark, glass container.
  • C. Swallow nitroglycerin tablets whole without chewing.
  • D. Discontinue the medication if a headache occurs.
Correct Answer: B

Rationale: The correct answer is B because nitroglycerin tablets should be stored in a dark, glass container to protect them from light and moisture, which could decrease their effectiveness. Storing them in any other container could lead to degradation of the medication.

Choice A is incorrect because nitroglycerin should be taken sublingually, not with food. Choice C is incorrect because nitroglycerin should be placed under the tongue to be absorbed quickly, not swallowed whole. Choice D is incorrect because experiencing a headache is a common side effect of nitroglycerin and does not indicate that the medication should be discontinued.

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