ATI RN
ATI Medical Surgical Proctored Exam 2023
1. What instruction should be included when teaching a client with asthma about using a metered-dose inhaler (MDI)?
- A. Shake the inhaler well before use.
- B. Inhale rapidly while administering the medication.
- C. Administer the medication while lying down.
- D. Hold the inhaler 2 inches away from the mouth while inhaling.
Correct answer: A
Rationale: Shaking the inhaler well before use ensures that the medication is properly mixed, allowing for an accurate dose with each administration. Inhaling slowly and deeply, not rapidly, helps the medication reach the lungs effectively. The medication should be administered while sitting or standing to facilitate proper lung expansion and airflow. Holding the inhaler 2 inches away from the mouth can lead to medication loss; it should be placed directly in the mouth or used with a spacer to optimize delivery to the airways.
2. A client is scheduled to have a tracheostomy placed in an hour. What action by the nurse is the priority?
- A. Administer prescribed anxiolytic medication.
- B. Ensure informed consent is on the chart.
- C. Reinforce any teaching done previously.
- D. Start the preoperative antibiotic infusion.
Correct answer: B
Rationale: The priority action for the nurse is to ensure that informed consent is on the chart. Before any surgical procedure, it is essential to have the client's informed consent documented. While administering anxiolytics, starting antibiotic infusion, and reinforcing teaching may also be necessary, obtaining informed consent takes precedence to ensure the client's understanding and agreement to proceed with the tracheostomy.
3. A client with chronic obstructive pulmonary disease (COPD) receives oxygen therapy. Which finding requires immediate intervention by the nurse?
- A. Oxygen saturation of 91%
- B. Respiratory rate of 10 breaths per minute
- C. Client reports shortness of breath
- D. Use of accessory muscles
Correct answer: B
Rationale: A respiratory rate of 10 breaths per minute in a client with COPD receiving oxygen therapy may indicate respiratory depression, necessitating immediate intervention. An oxygen saturation of 91%, client reports of shortness of breath, and use of accessory muscles are expected in COPD clients.
4. A client has a tracheostomy tube in place. When the nurse suctions the client, food particles are noted. What action by the nurse is best?
- A. Elevate the head of the client's bed.
- B. Measure and compare cuff pressures.
- C. Place the client on NPO status.
- D. Request a swallow study for the client.
Correct answer: B
Rationale: When food particles are noted during suctioning of a client with a tracheostomy tube, it can indicate tracheomalacia due to constant pressure from the tracheostomy cuff. This condition may lead to dilation of the tracheal passage. To address this issue, the nurse should measure and compare cuff pressures. By monitoring these pressures and comparing them to previous readings, the nurse can identify trends and potential complications. Elevating the head of the bed, placing the client on NPO status, and requesting a swallow study will not directly address the cuff pressure issue causing food particles in the secretions.
5. A nurse collaborates with a respiratory therapist to complete pulmonary function tests (PFTs) for a client. Which statements should the nurse include in communications with the respiratory therapist prior to the tests? (Select all that apply)
- A. I held the client's morning bronchodilator medication.
- B. The client is ready to go down to radiology for this examination.
- C. Physical therapy states the client can run on a treadmill.
- D. I advised the client not to smoke for 6 hours prior to the test.
Correct answer: B
Rationale: Communication between the nurse and respiratory therapist is crucial before pulmonary function tests (PFTs). It is important to inform the respiratory therapist that the client is ready for the examination. The nurse should not administer bronchodilator medication before the test as it may affect the results, and the client should not smoke for 6 to 8 hours prior to the test to ensure accurate results. Additionally, PFTs do not involve running on a treadmill; instead, the client may be required to perform specific breathing maneuvers as instructed by the respiratory therapist.
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