ATI RN
ATI Medical Surgical Proctored Exam
1. When working as a professional nurse, what is the priority for a new nurse working on an inpatient medical-surgical unit with a preceptor?
- A. Attending to holistic client needs
- B. Ensuring client safety
- C. Avoiding medication errors
- D. Providing client-focused care
Correct answer: B
Rationale: The priority for a nurse working on an inpatient medical-surgical unit is to ensure client safety. This is crucial as errors in hospital care can lead to preventable deaths. While attending to holistic client needs and providing client-focused care are important aspects of nursing, ensuring client safety takes precedence to prevent harm and promote positive patient outcomes.
2. The client is prescribed a long-acting beta2 agonist and expresses concerns about the cost, stating they only use the inhaler during asthma attacks. How should the nurse respond?
- A. Explain the importance of using the inhaler daily to prevent asthma attacks.
- B. Suggest identifying community services to help with the cost and encourage daily use of the inhaler.
- C. Explore the client's fears regarding breathlessness.
- D. Emphasize the necessity of using this inhaler daily and discuss potential community services for financial assistance.
Correct answer: B
Rationale: The correct response should address the client's concern about the cost of using the inhaler daily. While emphasizing the importance of daily use is crucial, it is also essential to acknowledge and offer support for the financial burden. Identifying community resources can help the client access affordable medications. Exploring fears related to breathlessness does not directly address the client's financial concerns.
3. A client who had coronary artery bypass grafting yesterday needs care. What actions can the nurse delegate to the unlicensed assistive personnel (UAP)? (SATA)
- A. administer antibiotics every 4 hrs
- B. Encourage the client to use the spirometer every 4 hours.
- C. Ensure the client wears TED hose or sequential compression devices.
- D. Have the client rate pain on a 0-to-10 scale and report to the nurse.
Correct answer: C
Rationale: The nurse can delegate tasks such as assisting the client to get up in the chair or ambulate to the bathroom, applying TED hose or sequential compression devices, and taking/recording vital signs to the unlicensed assistive personnel (UAP). Using the spirometer should be encouraged every hour the day after surgery by the nurse. Assessing pain using a 0-to-10 scale is a nursing assessment. However, if the client reports pain, the UAP should inform the nurse for a more detailed assessment.
4. A client with acute respiratory distress syndrome (ARDS) requires care planning. Which of the following interventions should be included in the plan?
- A. Administer low-flow oxygen continuously via nasal cannula.
- B. Encourage oral intake of at least 3,000 mL of fluids per day.
- C. Offer high-protein and high-carbohydrate foods frequently.
- D. Place in a prone position
Correct answer: D
Rationale: In acute respiratory distress syndrome (ARDS), placing the client in a prone position helps improve ventilation-perfusion matching and oxygenation. This position can optimize lung function and is a beneficial intervention for clients with ARDS. Administering low-flow oxygen via nasal cannula, encouraging oral intake of excess fluids, or offering high-protein and high-carbohydrate foods are not primary interventions for ARDS and may not directly address the respiratory distress experienced by the client.
5. A client with heart failure expresses feelings of burden and thoughts of death to a nurse. How should the nurse respond?
- A. Would you like to talk more about this?
- B. You are lucky to have such a devoted daughter.
- C. It is normal to feel as though you are a burden.
- D. Would you like to meet with the chaplain?
Correct answer: A
Rationale: Depression can occur in clients with heart failure, especially in older adults. When a client expresses thoughts of being a burden and death, it is crucial for the nurse to address these concerns. Offering to talk more about the client's feelings provides an opportunity for open communication and a deeper understanding of the client's emotions. Open-ended questions like the one in choice A encourage the client to express themselves freely, leading to better assessment and client-centered care. Choices B and C fail to address the client's emotional distress directly, and choice D diverts the focus without addressing the client's immediate concerns.
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