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ATI MED SURG / NURSING 250 PROCTORED EXAM 2019 GUIDE - 111 Correct Questions & Answers with Rationales

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  • Chamberlain College Of Nursing

ATI MED SURG PROCTORED EXAM 2019 GUIDE 1. A nurse is assessing a client who is 12hr postoperative following a colon resection. Which of the following findings should the nurse report to the surgeon? 1. Heart rate 90/min 2. Absent bowel sounds 3. Hgb 8.2 g/dl 4. Gastric pH of 3.0 Rationale: No...

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  • 9 de febrero de 2022
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  • ati med surg proctored exam 2019 guide 1 a nurse is assessing a client who is 12hr postoperative following a colon resection which of the following findings should the nurse report to the surgeon 3

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ATI MED SURG PROCTORED EXAM 2019 GUIDE
1. A nurse is assessing a client who is 12hr postoperative following a colon resection. Which
of the following findings should the nurse report to the surgeon?
1. Heart rate 90/min
2. Absent bowel sounds
3. Hgb 8.2 g/dl
4. Gastric pH of 3.0
Rationale: Normal Hgb is 13-18M g/dl, 12-16 g/dl. This may indicate a possible
hemorrhaging.

2. A nurse is caring for a client who has diabetes insipidus. Which of the
following medications should the nurse plan to administer?
a. Desmopressin
b. Regular insulin
c. Furosemide
d. Lithium carbonate
Rationale: Diabetes Insipidus has decreased ADH. Administer Desmopressin/Vasopressin
increase ADH and to stop patient on urinating.

3. A nurse is admitting a client who has arthritic pain and reports taking ibuprofen
several times daily for 3 years. Which of the following test should the nurse monitor?
a. Fasting blood glucose
b. Stool for occult blood
c. Urine for white blood cells
d. Serum calcium
Rationale: ATI Pharm 16. Pg. 485 Ibuprofen (NSAIDs) monitor for GI bleed
(bloody, tarry stools, abdominal pain).

4. A nurse in the emergency department is assessing a client. Which of the following
actions should the nurse take first (Click on the “Exhibit” button for additional
information about the client. There are three tabs that contain separate categories of
data.)
a. Obtain a sputum sample for culture
b. Prepare the client for a chest x-ray
c. Initiate airborne precautions
d. Administer ondansertron.
Rationale: No idea what the Exhibit is all about; wont be able to answer it.

5. A nurse is contacting the provider for a client who has cancer and is experiencing
breakthrough pain. Which of the following prescriptions should the nurse
anticipate?
a. Transmucosal fentanyl
b. Intramuscular meperidine
c. Oral acetaminophen
d. Intravenous dexamethasone
Rationale: ATI pg. 27 Morphine sulfate and fentanyl are opioid agents used to treat
moderate to severe pain. A short-acting pain medication is administered for breakthrough pain.

6. A nurse is admitting a client who reports chest pain and has been placed on a telemetry
monitor. Which of the following should the nurse analyze to determine whether the
client is experiencing a myocardial infarction?
a. PR interval

, b. QRS duration
c. T wave
d. ST segment
Rationale: ST elevation indicates MI. ST depression indicates ischemia

7. A nurse is teaching a client who has ovarian cancer about skin care following
radiation treatment. Which of the following instructions should the nurse include?
a. Pat the skin on the radiation site to dry it
b. Apply OTC moisturizer to the radiation site
c. Cover the radiation site loosely with a gauze wrap before dressing
d. Use a soft washcloth to clean the area around the radiation
site Rationale: pg. 584. Dry the area thoroughly using patting motions.

8. A nurse is caring for a client who is receiving a blood transfusion. The nurse observes
that the client has bounding peripheral pulses, hypertension, and distended jugular
veins. The nurse should anticipate administering which of the following prescribed
medications?
a. Diphenhydramine
b. Acetaminophen
c. Pantoprazole
d. Furosemide
Rationale: S/S may indicate fluid retention or heart failure. It is important to administer
diuretics to prevent cardiovascular/respiratory distress.

9. A nurse is assessing a client who is receiving magnesium sulfate IV for the treatment of
hypomagnesemia. Which of the following findings indicates effectiveness of the
medication?
a. Lungs clear
b. Apical pulse 82/min
c. Hyperactive bowel sounds
d. Blood pressure 90/50 mm Hg
Rationale: pg. 278 Confirmed on answer
sheet

10. A nurse is reviewing a client’s ABG results pH 7.42, PaC02 30 mm Hg, and HCO3 21
mEq/L. The nurse should recognize these findings as indication of which of the
following conditions?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Compensated respiratory alkalosis
d. Uncompensated respiratory acidosis
Rationale: because the HCO3 21 trying to compensate for respiratory alkalosis.

11. A nurse is caring for a client who has a deep partial thickness burns over 15% of her
body which of the following labs should the nurse expect during the first 24 hours
A. Decreased BUN (elevated due to fluid loss)
B. Hypoglycemia (High due to stress)
C. Hypoalbuminemia (Low due to fluid loss)
D. Decreased Hematocrit (Elevated due to 3rd spacing during resuscitation
phase) Rationale: Pg. 481 ATI. Total protein and albumin- low due to fluid loss.

, 12. A nurse is caring for a client who has dumping syndrome following a gastrectomy,
which of the following actions should the nurse takes?
a. Offer the client high carbohydrate meal options (High fat, high protein, low fiber,
low to moderate carbs page 317, chapter 49 Peptic ulcer disease med surge ATI
PDF 10.0)
b. Provide the client with four full meals a day (Small frequent meals)
c. Encourage the client to drink at least 360 ml of fluids with meals (Eliminate liquids
with meals for 1 hr. prior and following a meal)
d. Have the client lie down for 30 minutes after meals (Lying down after a meal slows
the movement of food within the intestines)
Rationale: ATI pg. 318 Dumping syndromes is a term that refers to a constellation of vasomotor
symptoms that occurs after eating, especially following a Billroth II procedure. Early
manifestations usually occur within 30 minutes of eating and include vertigo, tachycardia,
syncope, sweating, pallor, palpitations, and the desire to lie down. The nurse should instruct the
client to decrease the amount of fluid taken at meals and to avoid high-carbohydrate foods,
including fluids such as fruit nectars; to assume a low-Fowler's position during meals; to lie down
for 30 minutes after eating to delay gastric emptying; and to take antispasmodics as prescribed.

12. A nurse is teaching a group of young adult clients about risk factors for hearing loss.
Which of the following factors should the nurse include in the teaching?
a. Born with a high weight
b. Chronic infections of the middle ear
c. Use a loop diuretic diuretic such as furosemide and antibiotics like aminoglycoside
and gentamicin leads to ototoxic medication
d. Perforation of the ear drum
e. Frequent exposure to low volume noise
Rationale: Pedia ATI pg. 77
Exposure to loud environmental sounds. Hearing defects can be caused by a variety of conditions,
including anatomic malformation, maternal ingestion of toxic substances during pregnancy,
perinatal asphyxia, perinatal infection, chronic ear infection, and ototoxic medications.


13. A nurse is preparing to administer fresh frozen plasma to a client. Which of
the following actions should the nurse take?
a. Administer the plasma immediately after thawing
b. Transfuse the plasma over 4 hour (Can be in 2 to 4 hours)
c. Hold the transfusion if the client is actively bleeding (YOU HAVE TO GIVE IT.
That’s the whole point! The patient is losing blood so you have to replace it. We give
fresh frozen plasma because he or she may have clotting deficiencies)
d. Administer the transfusion through a 24 gauge saline lock (Has to be a 18 or 20
gauge) Rationale: Saunders pg. 164
Fresh-frozen plasma
1. Fresh-frozen plasma may be used to provide clotting factors or volume expansion;
it contains no platelets.
2. Fresh-frozen plasma is infused within 2 hours of thawing, while clotting factors
are still viable, and is infused over a period of 15 to 30 minutes.
3. Rh compatibility and ABO compatibility are required for the transfusion of plasma
products.
4. Evaluation of an effective response is assessed by monitoring coagulation studies,
particularly the prothrombin time and the partial thromboplastin time, and resolution
of hypovolemia.

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