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ATI-Med-Surg Exam Questions &Answers

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Course
Nursing (ATIMEDICALSURG)

Institution
Thompson River University (TRU )

diffcult to breathe. Risk factors: genetics, immune response, allergens, exercise, air pollution, occupational hazards, respiratory tract infections, nose and sinus issues, drug and food allergens/additives, GERD, psychological factors (extreme emotion can cause an episode). Types of trigge...

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Exam 2 Blueprint

Content Number of
questions
Respiratory 17
GI 17
Biliary 5
Pancreas 5
Anemia 6

diffcult to breathe. Risk factors: genetics, immune response, allergens,
exercise, air pollution, occupational hazards, respiratory tract infections,
nose and sinus issues, drug and food allergens/additives, GERD,
psychological factors (extreme emotion can cause an episode).
Types of triggers: strong odors, pollution, anger, stress, pets, exercise,
pollen, bugs, chemicals, cold air, spores, dust and smoke. There are di6erent
triggers from person to person.
Peak ow meter: used to see where they are at, to plan for their cares. FEV1
– forced expiratory volume for 1 second. Aerochamber: seals the medication
in the chamber – helpful when patient is coughing while trying to take
medication so they don't lose it.
Asthma classi$cations (Per the lecture, we don't need to know
speci$cs, but we need to be aware of them):
Intermittent – symptoms are less than 2 days a week, 0-1 exacerbations per
year. No limitations.
Persistent mild – Symptoms are greater than 2 days a week, not daily.
Exacerbations 2x a year. FEV1 = >80% predicted.
Persistent moderate – daily symptoms, night >1/week. SABA usage daily.
Some limitations. FEV1 = 60-80% predicted.
Persistent severe – symptoms are continuous, nighttime often. SABA several
times a day. FEV1 = <80% predicted.

Goal of asthma tx: achieve and maintain control. Monitoring the disease
and assess at severity.
Asthma medications (Meds are the examples mentioned in the
lecture).
LONG TERM MEDS: Anti-in0ammatories (Singulair) such as
corticosteroids (inhaled or oral), leukotriene modi'ers, Anti-igE.
Bronchodilators (Atrovent, Serovent) such as long-acting B2-adrenergic
agonists and methylxanthines (rarely used).
QUICK RELIEF MEDS: Bronchodilators (Albuterol, Proventil) such as
short acting inhaled B2 adrenergic agonists, anticholinergic drugs. Anti-
in0ammatories (Solumedrol) such as systemic corticosteroids by IV pus

, Exam 2 Blueprint

patient education on asthma:
Identi'cation and avoidance of known
personal triggers. Premedication if triggers can't be avoided and you know
prior to exposure. Acute management – ASSESSMENT is crucial. Listen to
their lungs, what are their sats, etc. Be aggressive with breathing
treatments, medications. Provide a calm environment. Discharge teaching:
review their meds, have patient demo the technique. Develop an action plan
– when to call doc, when to take meds.

Pneumonia: inammatory response in lungs – something is irritating the
lining. Then alveoli 'lls with uids and debris, increase production in mucous
Leads to a decrease in gas exchange, air can't get through to the alveoli.
Antibiotic medications needed.
Diagnostic: CBC draw – elevated WBC, neutrophils, temperature. If it involves
a substantial portion of one or more lobes, it's lobar pneumonia.
Bronchopneumonia is more common, and it is distributed in a patchy
fashion.
Community acquired pneumonia is the 6
th
leading cause of death in people
over 65. It is community acquired if happened to patient who has not been
hospitalized or residing in a long-term care facility within 14 days of onset.
Risk factors: abdominal/thoracic surgery, > 65 years old, air pollution,
altered LOC, chronic disease, immunosuppressed, LTC resident, smoking,
tracheal intubation, URI, NGT, COPD
community acquired PNa is caused by Streptococcus pneumoniae.
healthcare associated/hospital acquired
Hospital acquired occurs 48 hours or longer after hospital
admission.
Aspiration pneumonia, opportunistic pneumonia: route of entry.
Penicillin resistant pneumonia risk factors: >65 years, alcoholism,
immunosuppressed.
Enteric gram negative bacteria risk factors: LTC resident, underlying
cardiopulmonary disease, recent antibiotics.
ventilator associated pmeumonia.
Pseudomonas risk factors: structural lung disease, corticosteroid
treatment, malnutrition, broad spectrum antibiotics >7 days in the last month.

Clinical manifestations: elevated WBC, sudden onset of chills, rapidly rising
fever, pleuritic chest pain that is aggravated by coughing and deep
breathing, low SPO2. Tachypnea, signs of respiratory distress, orthopnea,
leaning forward, poor appetite, diaphoresis, easily tired.
Diagnostic and assessment $ndings: recent respiratory infection,
physical examination, chest xray, blood culture, sputum examination

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