ATI RN
ATI Medical Surgical Proctored Exam 2023
1. A client who is interested in smoking cessation receives teaching from a nurse. Which statements should the nurse include in this teaching? (Select ONE that does not apply)
- A. Find an activity that you enjoy and that will keep your hands busy.
- B. Keep healthy snacks on hand to nibble on.
- C. Identify reasons for quitting smoking.
- D. Make a list of reasons for quitting smoking.
Correct answer: C
Rationale: When teaching a client interested in smoking cessation, the nurse should include advice to find an activity that keeps hands busy to help distract from smoking urges, keep healthy snacks on hand to manage oral cravings, and drink at least 8 glasses of water daily to aid in flushing out toxins. Making a list of reasons for quitting smoking is also beneficial to reinforce motivation. It is important to avoid punitive measures or punishments for relapses as this can negatively impact the client's progress.
2. The healthcare provider is caring for a client who has heart failure and a history of asthma. The provider reviews the orders and recognizes that clarification is needed for which of the following medications?
- A. Carvedilol
- B. Fluticasone
- C. Captopril
- D. Isosorbide dinitrate
Correct answer: B
Rationale: The correct answer is Fluticasone. Carvedilol, Captopril, and Isosorbide dinitrate are commonly used in heart failure management and do not typically pose significant risks for clients with a history of asthma. However, Fluticasone is a corticosteroid used to manage asthma but can potentially worsen heart failure symptoms due to its anti-inflammatory effects. Therefore, the nurse should seek clarification regarding the prescription of Fluticasone for a client with heart failure and a history of asthma.
3. A nurse in an emergency room is caring for a client who sustained partial-thickness burns to both lower legs, chest, face, and both forearms. Which of the following is the priority action the nurse should take?
- A. Insert an indwelling urinary catheter.
- B. Inspect the mouth for signs of inhalation injuries.
- C. Administer intravenous pain medication.
- D. Draw blood for a complete blood cell (CBC) count.
Correct answer: B
Rationale: When caring for a client with burns, especially burns to the face and chest, the priority action for the nurse is to inspect the mouth for signs of inhalation injuries. Inhalation injuries can be life-threatening and may not be immediately apparent. Identifying these injuries early allows for prompt intervention and can significantly impact the client's outcomes. While other actions such as pain management and blood tests are important, assessing for inhalation injuries takes precedence due to its critical nature.
4. A client in the emergency department is being cared for by a nurse and has cardiogenic pulmonary edema. The client's assessment findings include anxiousness, dyspnea at rest, crackles, blood pressure 110/79 mm Hg, and apical heart rate 112/min. What is the nurse's priority intervention?
- A. Provide the client with supplemental oxygen at 5 L/min via facemask.
- B. Place the client in high-Fowler's position with their legs in a dependent position
- C. Give the client sublingual nitroglycerin
- D. Administer morphine sulfate IV
Correct answer: A
Rationale: In cardiogenic pulmonary edema, the priority intervention is to improve oxygenation and reduce the workload on the heart. Providing supplemental oxygen at 5 L/min via facemask helps increase oxygen levels and alleviate respiratory distress. This intervention can help improve oxygen saturation, alleviate dyspnea, and support the client's respiratory function. Placing the client in a high-Fowler's position with legs dependent can also help with respiratory effort, but ensuring adequate oxygenation takes precedence. Sublingual nitroglycerin and IV morphine sulfate are commonly used interventions for cardiac-related conditions, but in this case, addressing oxygenation is the priority to prevent further deterioration.
5. A client with a long history of smoking is being assessed by a nurse. Which finding is a common complication of chronic obstructive pulmonary disease (COPD)?
- A. Decreased anteroposterior chest diameter
- B. Increased breath sounds
- C. Prolonged expiratory phase
- D. Increased chest expansion
Correct answer: C
Rationale: In COPD, a prolonged expiratory phase is a typical finding caused by airway obstruction and air trapping. This results in difficulty expelling air from the lungs, leading to the characteristic prolonged exhalation in individuals with COPD.
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