Advanced Med-Surg Proctored ATI
Review 2025/2026
Arterial Blood Gas - correct answer.correct detailed answer ✔<<<<<ABG's via arterial puncture or
arterial line: allows the most accurate method of assessing respiratory function.
Steps for collecting ABG's - correct answer.correct detailed answer ✔<<<<<a. Perform Allen test if no
arterial line b. sample is drawn into heparinized syringe
c. keep on ice and transport to laboratory immediately
d. document amount and method of oxygen delivered for accurate results
e. apply direct pressure to puncture site at least 5 min (longer for clients at risk for bleeding)
Bronchoscopy - correct answer.correct detailed answer ✔<<<<<visualizes the larynx, trachea,
bronchi; obtains tissue biopsy; and removes foreign bodies.
Steps for a bronchoscopy procedure - correct answer.correct detailed answer ✔<<<<<a. obtain
informed consent b. maintain NPO 8 to 12 hr.
c. Provide local anesthetic throat spray
d. position upright
,e. administer medications as prescribed, such as atropine (to reduce oral secretions), sedation, and/or
anti-anxiety.
f. label specimen
g. observe postprocedure
-gag reflex
-bleeding
-respiratory status, vital signs, and level of consciousness
Mantoux test - correct answer.correct detailed answer ✔<<<<<Positive test indicates exposure to
tuberculosis. Diagnosis must be confirmed with sputum culture for presence of acid-fast bacillus (AFB).
Mantoux test steps - correct answer.correct detailed answer ✔<<<<<a. administer 0.1 mL of purified
protein derivation intradermal to upper half inner surface of forearm (insert needle bevel up)
b. Assess for reaction in 48 to 72 hr following injection; induration (hardening) of 10 mm or greater is
considered a positive test; 5 mm may be considered significant if immunocompromised.
QuantiFERON-TB Gold test (QFT-GT) and T-SPOT.TB - correct answer.correct detailed answer
✔<<<<<Identify the presence of Mycobacterium tuberculosis infection by measuring the immune
response to the TB bacteria in whole blood.
Thoracentesis - correct answer.correct detailed answer ✔<<<<<Surgical perforation of the pleural
space to obtain specimen, to remove fluid or air, or to instill medication.
,Steps for Thoracentesis - correct answer.correct detailed answer ✔<<<<<a. informed consent
b. educate client: remain still, feeling of pressure, positioning
c. position upright
d. monitor respiratory status and vital signs
e. label specimens
f. Document client response, amount, color and viscosity of fluid (maximum amount of fluid to be
removed at a time is 1L).
g. Chest tube at bedside
h. Obtain CXR before and after procedure
Asthma - correct answer.correct detailed answer ✔<<<<<Chronic inflammatory disorder of the
airways resulting in intermittent and reversible airflow obstruction of the bronchioles.
Contributing factors of asthma - correct answer.correct detailed answer ✔<<<<<-Extrinsic: antigen-
antibody reaction triggered by food, medications, or inhaled substances
-Intrinsic: pathophysiological abnormalities within the respiratory tract
-Older clients: beta receptors are less responsive to agonist and trigger bronchospasms.
Manifestations of asthma - correct answer.correct detailed answer ✔<<<<<-Sudden, severe dyspnea
with use of accessory muscles
-sitting up, leaning forward
-diaphoresis and anxiety
, -wheezing, gasping
-coughing
-cyanosis (late sign)
-barrel chest
Diagnostic procedures for asthma - correct answer.correct detailed answer ✔<<<<<-ABGs
-sputum cultures
-pulmonary function tests
Nursing interventions for asthma - correct answer.correct detailed answer ✔<<<<<-remain with the
client during the attack
-position in high-fowler's
-assess lung sounds and pulse oximetry
-administer oxygen therapy
-maintain oxygen access
Medications for athma - correct answer.correct detailed answer ✔<<<<<Administer bronchodilators
before antiinflammatory
1. Bronchodilators
-short-acting inhaled: albuterol; for rapid relief
-Methylxanthines: theophylline; monitor therapeutic range for toxicity.
Review 2025/2026
Arterial Blood Gas - correct answer.correct detailed answer ✔<<<<<ABG's via arterial puncture or
arterial line: allows the most accurate method of assessing respiratory function.
Steps for collecting ABG's - correct answer.correct detailed answer ✔<<<<<a. Perform Allen test if no
arterial line b. sample is drawn into heparinized syringe
c. keep on ice and transport to laboratory immediately
d. document amount and method of oxygen delivered for accurate results
e. apply direct pressure to puncture site at least 5 min (longer for clients at risk for bleeding)
Bronchoscopy - correct answer.correct detailed answer ✔<<<<<visualizes the larynx, trachea,
bronchi; obtains tissue biopsy; and removes foreign bodies.
Steps for a bronchoscopy procedure - correct answer.correct detailed answer ✔<<<<<a. obtain
informed consent b. maintain NPO 8 to 12 hr.
c. Provide local anesthetic throat spray
d. position upright
,e. administer medications as prescribed, such as atropine (to reduce oral secretions), sedation, and/or
anti-anxiety.
f. label specimen
g. observe postprocedure
-gag reflex
-bleeding
-respiratory status, vital signs, and level of consciousness
Mantoux test - correct answer.correct detailed answer ✔<<<<<Positive test indicates exposure to
tuberculosis. Diagnosis must be confirmed with sputum culture for presence of acid-fast bacillus (AFB).
Mantoux test steps - correct answer.correct detailed answer ✔<<<<<a. administer 0.1 mL of purified
protein derivation intradermal to upper half inner surface of forearm (insert needle bevel up)
b. Assess for reaction in 48 to 72 hr following injection; induration (hardening) of 10 mm or greater is
considered a positive test; 5 mm may be considered significant if immunocompromised.
QuantiFERON-TB Gold test (QFT-GT) and T-SPOT.TB - correct answer.correct detailed answer
✔<<<<<Identify the presence of Mycobacterium tuberculosis infection by measuring the immune
response to the TB bacteria in whole blood.
Thoracentesis - correct answer.correct detailed answer ✔<<<<<Surgical perforation of the pleural
space to obtain specimen, to remove fluid or air, or to instill medication.
,Steps for Thoracentesis - correct answer.correct detailed answer ✔<<<<<a. informed consent
b. educate client: remain still, feeling of pressure, positioning
c. position upright
d. monitor respiratory status and vital signs
e. label specimens
f. Document client response, amount, color and viscosity of fluid (maximum amount of fluid to be
removed at a time is 1L).
g. Chest tube at bedside
h. Obtain CXR before and after procedure
Asthma - correct answer.correct detailed answer ✔<<<<<Chronic inflammatory disorder of the
airways resulting in intermittent and reversible airflow obstruction of the bronchioles.
Contributing factors of asthma - correct answer.correct detailed answer ✔<<<<<-Extrinsic: antigen-
antibody reaction triggered by food, medications, or inhaled substances
-Intrinsic: pathophysiological abnormalities within the respiratory tract
-Older clients: beta receptors are less responsive to agonist and trigger bronchospasms.
Manifestations of asthma - correct answer.correct detailed answer ✔<<<<<-Sudden, severe dyspnea
with use of accessory muscles
-sitting up, leaning forward
-diaphoresis and anxiety
, -wheezing, gasping
-coughing
-cyanosis (late sign)
-barrel chest
Diagnostic procedures for asthma - correct answer.correct detailed answer ✔<<<<<-ABGs
-sputum cultures
-pulmonary function tests
Nursing interventions for asthma - correct answer.correct detailed answer ✔<<<<<-remain with the
client during the attack
-position in high-fowler's
-assess lung sounds and pulse oximetry
-administer oxygen therapy
-maintain oxygen access
Medications for athma - correct answer.correct detailed answer ✔<<<<<Administer bronchodilators
before antiinflammatory
1. Bronchodilators
-short-acting inhaled: albuterol; for rapid relief
-Methylxanthines: theophylline; monitor therapeutic range for toxicity.
