ATI RN
ATI Medical Surgical Proctored Exam
1. A client with diabetes is experiencing symptoms of hypoglycemia. What should the nurse administer first?
- A. 10 units of regular insulin subcutaneously
- B. 50 mL of 50% dextrose solution intravenously
- C. 1 mg of glucagon intramuscularly
- D. 15-20 grams of fast-acting carbohydrate orally
Correct answer: D
Rationale: The correct first intervention for a client experiencing hypoglycemia is administering 15-20 grams of fast-acting carbohydrate orally. If the client is conscious and able to swallow, providing quick-acting carbohydrates helps raise blood glucose levels rapidly and effectively. This approach is preferred over other options like administering insulin, dextrose solution intravenously, or glucagon, which are not the initial interventions for hypoglycemia.
2. A student learns about modifiable risk factors for coronary artery disease. Which factors does this include? (Select one that does not apply)
- A. Age
- B. Hypertension
- C. Obesity
- D. Smoking
Correct answer: A
Rationale: Hypertension, obesity, smoking, and excessive stress are all modifiable risk factors for coronary artery disease, as they can be changed or controlled through interventions. Age, on the other hand, is a nonmodifiable risk factor, meaning it cannot be altered. Understanding the difference between modifiable and nonmodifiable risk factors is essential in preventive healthcare strategies.
3. A client presents to the emergency department with an acute myocardial infarction (MI) at 1500 (3:00 PM). The facility has 24-hour catheterization laboratory capabilities. To meet The Joint Commission's Core Measures set, by what time should the client have a percutaneous coronary intervention performed?
- A. 1530 (3:30 PM)
- B. 1600 (4:00 PM)
- C. 1630 (4:30 PM)
- D. 1700 (5:00 PM)
Correct answer: C
Rationale: The Joint Commission's Core Measures set for MI includes percutaneous coronary intervention within 90 minutes of the diagnosis of myocardial infarction. Since the client presented at 1500 (3:00 PM), the percutaneous coronary intervention should be performed no later than 1630 (4:30 PM), to adhere to the 90-minute timeline for optimal outcomes.
4. During a call to the on-call physician about a client who had a hysterectomy 2 days ago & has unrelieved pain from prescribed narcotic medication, which statement is part of the SBAR format for communication?
- A. I suggest ordering a different pain medication.
- B. This client has allergies to morphine & codeine.
- C. Dr. Smith does not prefer nonsteroidal anti-inflammatory meds.
- D. The client had a vaginal hysterectomy 2 days ago.
Correct answer: B
Rationale: SBAR is a structured form of communication used in healthcare settings. It stands for Situation, Background, Assessment, and Recommendation. In this scenario, informing the on-call physician about the client's allergies to morphine & codeine falls under the 'Background' component of the SBAR format, making choice B the correct answer.
5. When teaching a group of clients about emergency care for a snake bite, which of the following information should the nurse include?
- A. Raise the affected extremity above the level of the heart.
- B. Immobilize the affected extremity with a splint
- C. Apply ice to the bite area
- D. Apply a tourniquet to the affected extremity.
Correct answer: B
Rationale: In cases of snake bites, it is essential to immobilize the affected extremity with a splint to prevent the spread of venom throughout the body. Raising the extremity above the heart level can promote venom spread, and applying ice or a tourniquet can worsen the condition. Immobilization helps reduce movement and slows the circulation of venom, aiding in the prevention of further complications.
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