ATI MATERNAL NEWBORN PROCTORED EXAM
g g g g
1. Thegnursegisgpreparinggagpatientgforgsurgery.gWhichggoalgisga
prioritygforgassessinggthegpatientgbeforegsurgery?
a. Plangforgcaregaftergthegprocedure.
b. Establishgagpatient’sgbaselinegofgnormalgfunction.
c. Educategthegpatientgandgfamilygaboutgthegprocedure.
d. Gathergappropriategequipmentgforgthegpatient’sgneeds.
ANS:gB
Theggoalgofgthegpreoperativegassessmentgisgtogidentifygagpatient’sgnormalgpreop
erativegfunctiongandgthegpresencegofganygrisksgtogrecognize,gprevent,gandgmini
mizegpossiblegpostoperativegcomplications.gGatheringgappropriategequipment,g
planninggcare,gandgeducatinggthegpatientgandgfamilygaregallgimportantginterventi
onsgthatgmustgbegprovidedgforgthegsurgicalgpatient;gtheygaregpartgofgthegnursinggp
rocessgbutgaregnotgthegprioritygreason/goalgforgcompletinggangassessmentgofgtheg
surgicalgpatient.
2. Thegnursegisgcompletinggagmedicationghistorygforgthegsurgicalgpatient
gingpreadmissiongtesting.gWhichgmedicationgshouldgthegnurseginstructgthe
patientgtogholdg(discontinue)gingpreparationgforgsurgerygaccordinggtogprotoc
ol?
a. Warfarin
b. VitamingC
c. Prednisone
d. Acetaminophen
ANS:gA
Medicationsgsuchgasgwarfaringorgaspiringaltergnormalgclottinggfactorsgandgthusgin
creasegthegriskgofghemorrhaging.gDiscontinuegatgleastg48ghoursgbefore
,surgery.gAcetaminophengisgagpaingrelievergthatghasgnogspecialgimplicationsgforgsu
rgery.gVitamingCgactuallygassistsgingwoundghealinggandghasgnogspecialgimplicati
onsgforgsurgery.gPrednisonegisgagcorticosteroid,gandgdosagesgaregoftengtemporaril
ygincreasedgrathergthangheld.
3. Theg nurseg isg prescreeningg ag surgicalg patientg ing theg preadmission
gtestingg unit.g Theg medicationg historyg indicatesg thatg g theg g patientg i
s
currentlygtakingganganticoagulant.gWhichgactiongshouldgthegnursegtakeg wh
engconsultinggwithgtheghealthgcaregprovider?
a. Askgforgagradiologicalgexaminationgofgthegchest.
b. Askgforganginternationalgnormalizedgratiog(INR).
c. Askgforgagbloodgureagnitrogeng(BUN).
d. Askgforgagserumgsodiumg(Na).
ANS:gB
INR,gPTg(prothrombingtime),gAPTTg(activatedgpartialgthromboplastingtime),gandg
plateletgcountsgrevealgthegclottinggabilitygofgthegblood.gAnticoagulantsgcangbeguti
lizedgforgdifferentgconditions,gbutgitsgactiongisgtogincreasegthegtimegitgtakesgforgth
egbloodgtogclot.gThisgactiongcangputgthegsurgicalgpatientgatgriskgforgbleedinggtend
encies.
Typically,gifgatgallgpossible,gthisgmedicationgisgheldgseveralgdaysgbeforegagsurgic
algproceduregtogdecreasegthisgrisk.gChestgx-
ray,gBUN,gandgNagaregdiagnosticgscreeninggtoolsgforgsurgerygbutgaregnotgspecific
gtoganticoagulants.
4. Thegnursegisgencouraginggthegpostoperativegpatientgtogutilizegdiaphragmatic
breathing.gWhichgpriorityggoalgisgthegnursegtryinggtogachieve?
a. Managegpain
b. Preventgatelectasis
c. Reduceghealinggtime
d. Decreasegthrombusgformation
ANS:gB
Aftergsurgery,gpatientsgmayghavegreducedglunggvolumegandgmaygrequireggreat
ergeffortgtogcoughgandgdeepgbreathe;ginadequateglunggexpansiongcanglead
, togatelectasisgandgpneumonia.gPurposelygutilizinggdiaphragmaticgbreathinggca
ngdecreasegthisgrisk.gDuringggeneralganesthesia,gtheglungsgaregnotgfullyginflate
dgduringgsurgerygandgthegcoughgreflexgisgsuppressed,gsogmucusgcollectsgwithi
ngairwaygpassages.gDiaphragmaticgbreathinggdoesgnotgmanagegpain;gingsomeg
cases,gifgsplintinggandgpaingmedicationsgaregnotggiven,gitgcangcausegpain.gDiap
hragmaticgbreathinggdoesgnotgreduceghealinggtimegorgdecreasegthrombusgform
ation.gBetter,gmoregeffectiveginterventionsgaregavailablegforgthesegsituations.
5. Thegnursegisgcaringgforgagpostoperativegpatientgongthegmedical-surgical
floor.gWhichgactivitygwillgthegnursegencouragegtogpreventgvenousgstasisgand
gthegformationgofgthrombus?
a. Diaphragmaticgbreathing
b. Incentivegspirometry
c. Leggexercises
d. Coughing
ANS:gC
Afterggeneralganesthesia,gcirculationgslows,gandgwhengthegrategofgbloodgslow
s,gaggreatergtendencygforgclotgformationgisgnoted.gImmobilizationgresultsgingde
creasedgmusculargcontractionsgingtheglowergextremities;gthese
promotegvenousgstasis.gCoughing,gdiaphragmaticgbreathing,gandgincentivegspiro
metrygaregutilizedgtogdecreasegatelectasisgandgpneumonia.
6. Thegnursegisgcaringgforgagpreoperativegpatient.gThegnursegteachesgthe
gprinciplesgandgdemonstratesgleggexercisesgforgthegpatient.gThegpatientgi
s
unablegtogperformgleggexercisesgcorrectly.gWhatgisgthegnurse’sgbestgnext
step?
a. Encouragegthegpatientgtogpracticegatgaglatergdate.
b. Assessgforgthegpresencegofganxiety,gpain,gorgfatigue.
c. Askgthegpatientgwhygexercisesgaregnotgbeinggdone.
d. Evaluategthegeducationalgmethodsgusedgtogeducategthegpatient.
g g g g
1. Thegnursegisgpreparinggagpatientgforgsurgery.gWhichggoalgisga
prioritygforgassessinggthegpatientgbeforegsurgery?
a. Plangforgcaregaftergthegprocedure.
b. Establishgagpatient’sgbaselinegofgnormalgfunction.
c. Educategthegpatientgandgfamilygaboutgthegprocedure.
d. Gathergappropriategequipmentgforgthegpatient’sgneeds.
ANS:gB
Theggoalgofgthegpreoperativegassessmentgisgtogidentifygagpatient’sgnormalgpreop
erativegfunctiongandgthegpresencegofganygrisksgtogrecognize,gprevent,gandgmini
mizegpossiblegpostoperativegcomplications.gGatheringgappropriategequipment,g
planninggcare,gandgeducatinggthegpatientgandgfamilygaregallgimportantginterventi
onsgthatgmustgbegprovidedgforgthegsurgicalgpatient;gtheygaregpartgofgthegnursinggp
rocessgbutgaregnotgthegprioritygreason/goalgforgcompletinggangassessmentgofgtheg
surgicalgpatient.
2. Thegnursegisgcompletinggagmedicationghistorygforgthegsurgicalgpatient
gingpreadmissiongtesting.gWhichgmedicationgshouldgthegnurseginstructgthe
patientgtogholdg(discontinue)gingpreparationgforgsurgerygaccordinggtogprotoc
ol?
a. Warfarin
b. VitamingC
c. Prednisone
d. Acetaminophen
ANS:gA
Medicationsgsuchgasgwarfaringorgaspiringaltergnormalgclottinggfactorsgandgthusgin
creasegthegriskgofghemorrhaging.gDiscontinuegatgleastg48ghoursgbefore
,surgery.gAcetaminophengisgagpaingrelievergthatghasgnogspecialgimplicationsgforgsu
rgery.gVitamingCgactuallygassistsgingwoundghealinggandghasgnogspecialgimplicati
onsgforgsurgery.gPrednisonegisgagcorticosteroid,gandgdosagesgaregoftengtemporaril
ygincreasedgrathergthangheld.
3. Theg nurseg isg prescreeningg ag surgicalg patientg ing theg preadmission
gtestingg unit.g Theg medicationg historyg indicatesg thatg g theg g patientg i
s
currentlygtakingganganticoagulant.gWhichgactiongshouldgthegnursegtakeg wh
engconsultinggwithgtheghealthgcaregprovider?
a. Askgforgagradiologicalgexaminationgofgthegchest.
b. Askgforganginternationalgnormalizedgratiog(INR).
c. Askgforgagbloodgureagnitrogeng(BUN).
d. Askgforgagserumgsodiumg(Na).
ANS:gB
INR,gPTg(prothrombingtime),gAPTTg(activatedgpartialgthromboplastingtime),gandg
plateletgcountsgrevealgthegclottinggabilitygofgthegblood.gAnticoagulantsgcangbeguti
lizedgforgdifferentgconditions,gbutgitsgactiongisgtogincreasegthegtimegitgtakesgforgth
egbloodgtogclot.gThisgactiongcangputgthegsurgicalgpatientgatgriskgforgbleedinggtend
encies.
Typically,gifgatgallgpossible,gthisgmedicationgisgheldgseveralgdaysgbeforegagsurgic
algproceduregtogdecreasegthisgrisk.gChestgx-
ray,gBUN,gandgNagaregdiagnosticgscreeninggtoolsgforgsurgerygbutgaregnotgspecific
gtoganticoagulants.
4. Thegnursegisgencouraginggthegpostoperativegpatientgtogutilizegdiaphragmatic
breathing.gWhichgpriorityggoalgisgthegnursegtryinggtogachieve?
a. Managegpain
b. Preventgatelectasis
c. Reduceghealinggtime
d. Decreasegthrombusgformation
ANS:gB
Aftergsurgery,gpatientsgmayghavegreducedglunggvolumegandgmaygrequireggreat
ergeffortgtogcoughgandgdeepgbreathe;ginadequateglunggexpansiongcanglead
, togatelectasisgandgpneumonia.gPurposelygutilizinggdiaphragmaticgbreathinggca
ngdecreasegthisgrisk.gDuringggeneralganesthesia,gtheglungsgaregnotgfullyginflate
dgduringgsurgerygandgthegcoughgreflexgisgsuppressed,gsogmucusgcollectsgwithi
ngairwaygpassages.gDiaphragmaticgbreathinggdoesgnotgmanagegpain;gingsomeg
cases,gifgsplintinggandgpaingmedicationsgaregnotggiven,gitgcangcausegpain.gDiap
hragmaticgbreathinggdoesgnotgreduceghealinggtimegorgdecreasegthrombusgform
ation.gBetter,gmoregeffectiveginterventionsgaregavailablegforgthesegsituations.
5. Thegnursegisgcaringgforgagpostoperativegpatientgongthegmedical-surgical
floor.gWhichgactivitygwillgthegnursegencouragegtogpreventgvenousgstasisgand
gthegformationgofgthrombus?
a. Diaphragmaticgbreathing
b. Incentivegspirometry
c. Leggexercises
d. Coughing
ANS:gC
Afterggeneralganesthesia,gcirculationgslows,gandgwhengthegrategofgbloodgslow
s,gaggreatergtendencygforgclotgformationgisgnoted.gImmobilizationgresultsgingde
creasedgmusculargcontractionsgingtheglowergextremities;gthese
promotegvenousgstasis.gCoughing,gdiaphragmaticgbreathing,gandgincentivegspiro
metrygaregutilizedgtogdecreasegatelectasisgandgpneumonia.
6. Thegnursegisgcaringgforgagpreoperativegpatient.gThegnursegteachesgthe
gprinciplesgandgdemonstratesgleggexercisesgforgthegpatient.gThegpatientgi
s
unablegtogperformgleggexercisesgcorrectly.gWhatgisgthegnurse’sgbestgnext
step?
a. Encouragegthegpatientgtogpracticegatgaglatergdate.
b. Assessgforgthegpresencegofganxiety,gpain,gorgfatigue.
c. Askgthegpatientgwhygexercisesgaregnotgbeinggdone.
d. Evaluategthegeducationalgmethodsgusedgtogeducategthegpatient.
