ATI Medical Surgical Comprehensive Exam

ATI MED SURG COMPREHENSIVE EXAM 1. A parent whose 12-year-old child has been inhaling paint fumes asks the nurse, "Can he become addicted to paint fumes?" What is the best response for the nurse to provide? A. Only hard drugs like cocaine and heroin can cause problems with addiction. B. Abuse of any of the inhalants can eventually lead to addiction C. Any time you use an illegal substance, you are abusing drugs. D. Tell me what you think may have caused him to start inhaling paint fumes. (C) Rationale: provides accurate information and answers the parent's question. (A) is a common misconception. (B) is not usually an effective treatment strategy, and information should be sought after determining if any other drugs have been taken. (D) does not address the parent's question. 2. A young adult female is brought to the emergency room by family members who report that she ingested a large quantity of acetaminophen (Tylenol). The nurse should prepare for which treatment to be implemented? A. IV administration of Narcan. B. Gastric lavage with normal saline. C. Acetylcysteine (Mucomyst) 140 mg/kg D. Syrup of ipecac per nasogastric tube. Mucomyst (C) is the antidote for acute acetaminophen (Tylenol) poisoning and is the treatment of choice for an overdose. (A) is used for an overdose of narcotics. (B) is used for ingestion of non-corrosive products such as iron tablets. (D) might also be implemented, depending on the amount of drugs ingested and the time elapsed since ingestion. Awarded 1.0 points out of 1.0 possible points. 3. An 8-year-old male client with nephrotic syndrome is in remission following treatment with prednisone (Deltasone). The nurse should teach the child to check his urine for which finding? A. Glucose. B. White blood cells. C. Protein D. Ketones. Children should be taught to check for protein (albumin) (0) in the urine daily, because a positive reading for protein in the urine is often the only indicator of a relapse of nephrotic syndrome. (A) is an indication of infection. (8 and C) should be assessed while the child is receiving corticosteroid therapy, since corticosteroids increase blood glucose. Awarded 1.0 points out of 1.0 possible points. 4. When making a home visit to a family with a teething 4-month-old, what information is most important for the nurse to provide the parents? A. A slight fever is often associated with teething, but a fever lasting more than three days requires medical attention. B. No action is required for the common symptoms associated with teething, which include drooling, irritability, and poor sleeping. C. Providing cooled teething toys can help decrease the discomfort associated with tooth eruption. D. Though child development is characterized by individual differences, first teeth usually erupt during the seventh month. A slight fever that persists longer than three days is likely to be associated with a pathological process, not teething, and the parents should seek the attention of their healthcare provider if it occurs (D). (A, B, and C) provide useful information about teething, but do not have the priority of (D). Awarded 1.0 points out of 1.0 possible points. 5. To treat cystitis, a 14-day course of treatment with cephalexin (Ceclor) is prescribed for a client residing in a long-term care facility. Which action is most important for the nurse to take prior to administering the first dose of this medication? A. Review the client's fasting blood glucose levels for a hyperglycemic trend. B. Restrict the use of dairy products in the client's diet for the next 3 weeks. C. Take the client's vital signs prior to the first dose and once daily for 14 days. D. determine if the client has ever had a hypersensitivity reaction to penicillins Most individuals who have an allergy to penicillins (B) are at risk of hypersensitivity to cephalosporins. To prevent a potential hypersensitivity reaction that could cause a lifethreatening episode of anaphylactic shock, the nurse must determine if the client has a known penicillin allergy before giving the client a cephalexin (Ceclor) dose . (A, C, and D) are not required interventions for the administration of cephalexin (Ceclor). Awarded 1.0 points out of 1.0 possible points. 6. A staff member tells the charge nurse that a float nurse assigned to work on the unit has made several medication errors in the past, but is currently working with the education department to improve this skill. What action is best for the charge nurse to take? A. Assign the float nurse to function as a UAP for the day. B. arrange for someone to be available to assess and assist the float nurse C. Dismiss the staff nurse's report about the float nurse because it may be just gossip. D. Call the nursing supervisor and request a different employee be sent to the unit. The float nurse is receiving education, but careful assessment of her or his skills and assistance, as needed, is still warranted, so (D) is the best choice. Though the staff member's report may indeed be gossip, failure to pay attention to the information could constitute negligence on the part of the charge nurse (A). (B) is not the best way to manage the unit. (C) is not the best use of a licensed person and would also eliminate the float nurse's opportunity to improve medication administration skills. Awarded 1.0 points out of 1.0 possible points. 7. The blood pressure readings obtained by a unlicensed assistive personnel (UAP) are consistently different from those obtained by other staff members. What action should the charge nurse take first? A. Make staff members aware of the possible errors in blood pressure readings. B. observe the UAP performing blood pressure measurements C. Counsel the UAP about the inaccurate blood pressure readings. D. Ask the education department to provide additional training for the UAP. The charge nurse should first observe the UAP1s performance (B), then take appropriate action, which might include (A, C and D). Awarded 1.0 points out of 1.0 possible points. 8. A client at 13-weeks' gestation is scheduled for an amniocentesis in one week. The nurse knows that the primary reason for conducting this procedure is to obtain what information? A. Determination of gestational age. B. Level of fetal lung maturity. C. Quantification of alpha-fetoprotein levels. D. presence of genetic disorders Amniocentesis is done at 14 to 16 weeks' gestation to determine chromosomal, genetic, and metabolic disorders (B). Amniocentesis in the third trimester assesses fetal lung maturity (A) by evaluating the lecithin/sphingomyelin (US) ratio and the presence of phosphatidylglycerol (PG). Amniocentesis is performed to quantify alpha-fetoprotein levels(C) after abnormal maternal serum alpha-fetoprotein levels (done at 15 to 18 weeks) are found. While specific levels of creatinine, bilirubin, and lipid cells are present in amniotic fluid only after 35 to 36 weeks' gestation, gestational age (D) is commonly evaluated by ultrasound. Awarded 1.0 points out of 1.0 possible points. 9. A hospitalized 5-year-old boy recovering from surgery refuses to drink fluids. Which intervention is best for the nurse to implement? A. offer the child a popsicle and allow him to pick the flavor he prefers B. Make a game of seeing who can finish a glass of water first--the nurse or the child. C. Tell the child he can go outside after he drinks a full glass of water. D. Ask the parents to participate in encouraging the child's fluid intake. Fluids in popsicle form (C) are an excellent choice for a child, and small children react best when they are provided with possible choices, such as choosing a flavor. (A) is a good intervention, but (C) is better. (B) is manipulative and the nurse must be careful not to make promises that may not be possible. Although (D) may be useful, it may also be manipulative and is not as likely as (C) to obtain the ultimate goal of increasing fluids. Awarded 1.0 points out of 1.0 possible points. 10. An overweight adolescent girl has been to the school nurse three times in the last two months complaining of vaginal and urinary tract infections. What action should the nurse take first? A. Encourage the girl to see the school counselor. B. Counsel the girl regarding hygiene. C. ask if she is going to the bathroom frequently D. Teach the girl the importance of practicing safe sex. All