ADVANCED MED-SURG PROCTORED ATI REVIEW ACTUAL
QUESTIONS AND ANSWERS 2027 UPDATE 100% CORRECT
Question 1.
Arterial Blood Gas
Correct Answer: ABG's via arterial puncture or arterial line: allows the most
accurate method of assessing respiratory function.
Question 2.
Steps for collecting ABG's
Correct 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)
Question 3.
Bronchoscopy
Correct Answer: visualizes the larynx, trachea, bronchi; obtains tissue biopsy;
and removes foreign bodies.
Question 4.
Steps for a bronchoscopy procedure
Correct 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
Question 5.
Mantoux test
Correct Answer: Positive test indicates exposure to tuberculosis. Diagnosis must
be confirmed with sputum culture for presence of acid-fast bacillus (AFB).
,Question 6.
Mantoux test steps
Correct 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.
Question 7.
QuantiFERON-TB Gold test (QFT-GT) and T-SPOT.TB
Correct Answer: Identify the presence of Mycobacterium tuberculosis infection
by measuring the immune response to the TB bacteria in whole blood.
Question 8.
Thoracentesis
Correct Answer: Surgical perforation of the pleural space to obtain specimen, to
remove fluid or air, or to instill medication.
Question 9.
Steps for Thoracentesis
Correct 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
Question 10.
Asthma
Correct Answer: Chronic inflammatory disorder of the airways resulting in
intermittent and reversible airflow obstruction of the bronchioles.
, Question 11.
Contributing factors of asthma
Correct 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.
Question 12.
Manifestations of asthma
Correct Answer: -Sudden, severe dyspnea with use of accessory muscles -sitting
up, leaning forward -diaphoresis and anxiety -wheezing, gasping -coughing
-cyanosis (late sign) -barrel chest
Question 13.
Diagnostic procedures for asthma
Correct Answer: -ABGs -sputum cultures -pulmonary function tests
Question 14.
Nursing interventions for asthma
Correct 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
Question 15.
Medications for athma
Correct Answer: Administer bronchodilators before anti-inflammatory
1. Bronchodilators -short-acting inhaled: albuterol; for rapid relief
-Methylxanthines: theophylline; monitor therapeutic range for toxicity.
2. Anti-inflammatory -corticosteriods: fluticasone and prednisone -Leukotriene
antagonist: montelukast
3. Combination agents -Ipratropium and albuterol (Combivent) -Fluticasone and
salmeterol (Advair)
Question 16.
Therapeutic measures for asthma
Correct Answer: -respiratory treatments -oxygen administration
QUESTIONS AND ANSWERS 2027 UPDATE 100% CORRECT
Question 1.
Arterial Blood Gas
Correct Answer: ABG's via arterial puncture or arterial line: allows the most
accurate method of assessing respiratory function.
Question 2.
Steps for collecting ABG's
Correct 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)
Question 3.
Bronchoscopy
Correct Answer: visualizes the larynx, trachea, bronchi; obtains tissue biopsy;
and removes foreign bodies.
Question 4.
Steps for a bronchoscopy procedure
Correct 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
Question 5.
Mantoux test
Correct Answer: Positive test indicates exposure to tuberculosis. Diagnosis must
be confirmed with sputum culture for presence of acid-fast bacillus (AFB).
,Question 6.
Mantoux test steps
Correct 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.
Question 7.
QuantiFERON-TB Gold test (QFT-GT) and T-SPOT.TB
Correct Answer: Identify the presence of Mycobacterium tuberculosis infection
by measuring the immune response to the TB bacteria in whole blood.
Question 8.
Thoracentesis
Correct Answer: Surgical perforation of the pleural space to obtain specimen, to
remove fluid or air, or to instill medication.
Question 9.
Steps for Thoracentesis
Correct 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
Question 10.
Asthma
Correct Answer: Chronic inflammatory disorder of the airways resulting in
intermittent and reversible airflow obstruction of the bronchioles.
, Question 11.
Contributing factors of asthma
Correct 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.
Question 12.
Manifestations of asthma
Correct Answer: -Sudden, severe dyspnea with use of accessory muscles -sitting
up, leaning forward -diaphoresis and anxiety -wheezing, gasping -coughing
-cyanosis (late sign) -barrel chest
Question 13.
Diagnostic procedures for asthma
Correct Answer: -ABGs -sputum cultures -pulmonary function tests
Question 14.
Nursing interventions for asthma
Correct 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
Question 15.
Medications for athma
Correct Answer: Administer bronchodilators before anti-inflammatory
1. Bronchodilators -short-acting inhaled: albuterol; for rapid relief
-Methylxanthines: theophylline; monitor therapeutic range for toxicity.
2. Anti-inflammatory -corticosteriods: fluticasone and prednisone -Leukotriene
antagonist: montelukast
3. Combination agents -Ipratropium and albuterol (Combivent) -Fluticasone and
salmeterol (Advair)
Question 16.
Therapeutic measures for asthma
Correct Answer: -respiratory treatments -oxygen administration
