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ATI Medical Surgical Proctored Exam 2019 Quizlet
1. A 38-year-old male client collapsed at his outside construction job in Texas in July. His admitting vital signs to ICU are, BP 82/70, heart rate 140 beats/minute, urine output 10 ml/hr, skin cool to the touch. Pulmonary artery (PA) pressures are, PAWP 1, PAP 8/2, RAP -1, SVR 1600. What nursing action has the highest priority?
- A. Apply a hypothermia unit to stabilize core temperature.
- B. Increase the client's IV fluid rate to 200 ml/hr.
- C. Call the hospital chaplain to counsel the family.
- D. Draw blood cultures x3 to detect infection.
Correct answer: B
Rationale: The correct answer is to increase the client's IV fluid rate to 200 ml/hr. The client's vital signs indicate signs of shock and hypovolemia, making fluid resuscitation the priority to address these conditions. Improving intravascular volume is crucial to stabilize the client's blood pressure, heart rate, and urine output, ultimately improving organ perfusion and addressing the underlying issue of hypovolemia.
2. The client has acute kidney injury (AKI). Which assessment finding requires immediate intervention?
- A. Urine output of 50 ml in the last hour.
- B. Serum potassium of 6.2 mEq/L.
- C. Blood pressure of 150/90 mm Hg.
- D. Serum creatinine of 2.5 mg/dL.
Correct answer: B
Rationale: An elevated serum potassium level of 6.2 mEq/L in a client with AKI can lead to life-threatening cardiac arrhythmias, necessitating immediate intervention. Hyperkalemia is a serious complication in AKI as impaired kidney function can result in the accumulation of potassium in the blood, posing a risk of cardiac arrest. Prompt treatment to lower potassium levels is crucial to prevent cardiac complications in this situation.
3. A healthcare professional is interested in studying the incidence of infant death in a particular city and wants to compare that city's rate to the state's rate. What state resource is most likely to provide this information?
- A. Disease registry.
- B. Department of Health.
- C. Bureau of Vital Statistics.
- D. Census data.
Correct answer: C
Rationale: The Bureau of Vital Statistics collects data on births and deaths, including infant mortality rates. This data is crucial for healthcare professionals to analyze and compare rates between different regions.
4. A 60-year-old male client is admitted to the hospital with the complaint of right knee pain for the past week. His right knee and calf are warm and edematous. He has a history of diabetes and arthritis. Which neurological assessment action should the nurse perform for this client?
- A. Glasgow Coma Scale
- B. Assess pulses, paresthesia, and paralysis distal to the right knee
- C. Assess pulses, paresthesia, and paralysis proximal to the right knee
- D. Optic nerve using an ophthalmoscope
Correct answer: B
Rationale: In this scenario, the nurse should assess pulses, paresthesia, and paralysis distal to the right knee to evaluate for neurovascular compromise. This assessment helps determine the perfusion and sensation of the lower extremity, which is crucial in identifying potential vascular or nerve damage that may be causing the client's symptoms.
5. An elderly client with congestive heart failure (CHF) is admitted to the hospital. Which laboratory test result should the nurse expect to find?
- A. Elevated serum sodium level.
- B. Decreased brain natriuretic peptide (BNP) level.
- C. Increased serum creatinine level.
- D. Elevated hemoglobin and hematocrit levels.
Correct answer: C
Rationale: In clients with congestive heart failure (CHF), impaired cardiac function can lead to decreased renal perfusion, resulting in elevated serum creatinine levels. Therefore, an increased serum creatinine level is a common laboratory finding in CHF clients, indicating possible renal impairment.
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