ATI Med Surg Exam 1
Practice Questions
A nurse is planning care for a client who is having a percutaneous transluminal
coronary angioplasty (PTCA) with stent placement. Which of the following actions
should the nurse anticipate in the post-procedure plan of care?
A. Instruct the client about a long-term cardiac conditioning program
B. Administer scheduled doses of acetaminophen
C. Check for peak laboratory markers of myocardial damage
D. Monitor for bleeding - ANSWER D. Monitor for bleeding
Correct Answer: D.
Monitor for bleeding
Bleeding is a post-procedure complication of PTCA because of the administration
of heparin during the procedure and the removal of the femoral (or brachial)
sheath. Manual pressure or a closure device is used to obtain hemostasis to the site.
The client should remain on bed rest until hemostasis is assured.
Incorrect Answers:A. The nurse should provide teaching about cardiac
rehabilitation prior to the client's discharge from the hospital.
B. The nurse should plan to administer scheduled doses of aspirin post-procedure.
This maintains the patency of the client's coronary arteries following the PTCA by
preventing platelet aggregation and thrombus formation around the newly placed
stent.
C. The nurse should monitor for peak laboratory markers of myocardial damage
following a myocardial infarction and reperfusion with thrombolytic therapy.
,A nurse in a provider's office is reviewing the medical records of a group of
clients. Which of the following clients is at risk for iron deficiency? (Select all that
apply.)
A. A client who is postmenopausal
B. A client who is a vegetarian
C. A middle adult male client
D. A client who is pregnant
E. A toddler who is overweight - ANSWER B. A client who is a
vegetarian
D. A client who is pregnant
E. A toddler who is overweight
A client who is a vegetarian might require additional iron because the availability
of iron in vegetable food sources is limited. During pregnancy, maternal blood
volume increases, and the fetus requires additional iron. Therefore, the RDA of
iron for clients who are pregnant is increased to 27 mg per day. Toddlers who are
overweight may get most of their calories from milk and foods that are not
considered healthy, which increases their risk for iron-deficiency anemia.
A nurse is reviewing the laboratory findings of a client who has protein-calorie
malnutrition. Which of the following findings should the nurse expect?
A. Decreased albumin
B. Elevated hemoglobin
C. Elevated lymphocytes
D. Decreased cortisol - ANSWER A. Decreased albumin
Correct Answer: A.
Decreased albumin
A decrease in the albumin level can be an indication of long-term protein
depletion. Other potential conditions that result in decreased albumin levels include
burns, wound drainage, and impaired hepatic function.
,A nurse is assessing a client who has increased intracranial pressure and has
received intravenous mannitol. Which of the following findings indicates a
therapeutic effect of this medication?
A. Decreased blood glucose
B. Decreased bronchospasms
C. Increased urine output
D. Increased temperature - ANSWER C. Increased urine output
Mannitol is an osmotic diuretic used to reduce intracranial pressure by mobilizing
intracranial fluid and inhibiting the reabsorption of water and electrolytes in the
kidneys. Increased urine output and decreased intracranial pressure are therapeutic
effects of this medication.
A nurse is preparing an in-service presentation about assessing clients who are
having an acute myocardial infarction (MI). What is the most common assessment
finding with acute MI?
A. Dyspnea
B. Pain in the shoulder and left arm
C. Substernal chest pain
D. Palpitations - ANSWER C. Substernal chest pain
Evidence-based practice indicates that the most common manifestation of acute MI
is substernal chest pain that does not subside with rest or nitroglycerin. Therefore,
nurses should make pain management with morphine a priority to reduce
myocardial oxygen demand and increase oxygenation.
, A nurse is providing discharge teaching for a client who had a bone marrow
transplant and has thrombocytopenia. Which of the following statements indicates
that the client understands the precautions he must take at home?
A. "I'll stick with soft foods for now."
B. "My family will be bringing me fresh flowers today."
C. "I'll use a new disposable razor each day."
D. "I'll blow my nose more often to avoid nosebleeds." - ANSWER A.
"I'll stick with soft foods for now."
Thrombocytopenia (a low platelet count) is common after a bone marrow
transplant. To prevent bleeding until the client's platelet count improves, the client
should avoid hard foods that could cause mouth trauma.
Incorrect Answers:
C. To reduce the risk of injury and bleeding, the client should use an electric
shaver rather than a razor.
A nurse is caring for a client who has a tracheostomy with an inflated cuff in place.
Which of the following findings indicates that the nurse should suction the client's
airway secretions?
A. The client is unable to speak.
B. The client's airway secretions were last suctioned 2 hr ago.
C. The client coughs and expectorates a large mucous plug.
D. The nurse auscultates coarse crackles in the lung fields. - ANSWER
D. The nurse auscultates coarse crackles in the lung fields.
Correct Answer: D.
The nurse auscultates coarse crackles in the lung fields.
The nurse should auscultate coarse crackles or rhonchi, identify a moist cough,
hear or see secretions in the tracheostomy tube, and then suction the client's airway
secretions.
Incorrect Answers:A. A client who has a tracheostomy with an inflated cuff in
place is unable to speak.
Practice Questions
A nurse is planning care for a client who is having a percutaneous transluminal
coronary angioplasty (PTCA) with stent placement. Which of the following actions
should the nurse anticipate in the post-procedure plan of care?
A. Instruct the client about a long-term cardiac conditioning program
B. Administer scheduled doses of acetaminophen
C. Check for peak laboratory markers of myocardial damage
D. Monitor for bleeding - ANSWER D. Monitor for bleeding
Correct Answer: D.
Monitor for bleeding
Bleeding is a post-procedure complication of PTCA because of the administration
of heparin during the procedure and the removal of the femoral (or brachial)
sheath. Manual pressure or a closure device is used to obtain hemostasis to the site.
The client should remain on bed rest until hemostasis is assured.
Incorrect Answers:A. The nurse should provide teaching about cardiac
rehabilitation prior to the client's discharge from the hospital.
B. The nurse should plan to administer scheduled doses of aspirin post-procedure.
This maintains the patency of the client's coronary arteries following the PTCA by
preventing platelet aggregation and thrombus formation around the newly placed
stent.
C. The nurse should monitor for peak laboratory markers of myocardial damage
following a myocardial infarction and reperfusion with thrombolytic therapy.
,A nurse in a provider's office is reviewing the medical records of a group of
clients. Which of the following clients is at risk for iron deficiency? (Select all that
apply.)
A. A client who is postmenopausal
B. A client who is a vegetarian
C. A middle adult male client
D. A client who is pregnant
E. A toddler who is overweight - ANSWER B. A client who is a
vegetarian
D. A client who is pregnant
E. A toddler who is overweight
A client who is a vegetarian might require additional iron because the availability
of iron in vegetable food sources is limited. During pregnancy, maternal blood
volume increases, and the fetus requires additional iron. Therefore, the RDA of
iron for clients who are pregnant is increased to 27 mg per day. Toddlers who are
overweight may get most of their calories from milk and foods that are not
considered healthy, which increases their risk for iron-deficiency anemia.
A nurse is reviewing the laboratory findings of a client who has protein-calorie
malnutrition. Which of the following findings should the nurse expect?
A. Decreased albumin
B. Elevated hemoglobin
C. Elevated lymphocytes
D. Decreased cortisol - ANSWER A. Decreased albumin
Correct Answer: A.
Decreased albumin
A decrease in the albumin level can be an indication of long-term protein
depletion. Other potential conditions that result in decreased albumin levels include
burns, wound drainage, and impaired hepatic function.
,A nurse is assessing a client who has increased intracranial pressure and has
received intravenous mannitol. Which of the following findings indicates a
therapeutic effect of this medication?
A. Decreased blood glucose
B. Decreased bronchospasms
C. Increased urine output
D. Increased temperature - ANSWER C. Increased urine output
Mannitol is an osmotic diuretic used to reduce intracranial pressure by mobilizing
intracranial fluid and inhibiting the reabsorption of water and electrolytes in the
kidneys. Increased urine output and decreased intracranial pressure are therapeutic
effects of this medication.
A nurse is preparing an in-service presentation about assessing clients who are
having an acute myocardial infarction (MI). What is the most common assessment
finding with acute MI?
A. Dyspnea
B. Pain in the shoulder and left arm
C. Substernal chest pain
D. Palpitations - ANSWER C. Substernal chest pain
Evidence-based practice indicates that the most common manifestation of acute MI
is substernal chest pain that does not subside with rest or nitroglycerin. Therefore,
nurses should make pain management with morphine a priority to reduce
myocardial oxygen demand and increase oxygenation.
, A nurse is providing discharge teaching for a client who had a bone marrow
transplant and has thrombocytopenia. Which of the following statements indicates
that the client understands the precautions he must take at home?
A. "I'll stick with soft foods for now."
B. "My family will be bringing me fresh flowers today."
C. "I'll use a new disposable razor each day."
D. "I'll blow my nose more often to avoid nosebleeds." - ANSWER A.
"I'll stick with soft foods for now."
Thrombocytopenia (a low platelet count) is common after a bone marrow
transplant. To prevent bleeding until the client's platelet count improves, the client
should avoid hard foods that could cause mouth trauma.
Incorrect Answers:
C. To reduce the risk of injury and bleeding, the client should use an electric
shaver rather than a razor.
A nurse is caring for a client who has a tracheostomy with an inflated cuff in place.
Which of the following findings indicates that the nurse should suction the client's
airway secretions?
A. The client is unable to speak.
B. The client's airway secretions were last suctioned 2 hr ago.
C. The client coughs and expectorates a large mucous plug.
D. The nurse auscultates coarse crackles in the lung fields. - ANSWER
D. The nurse auscultates coarse crackles in the lung fields.
Correct Answer: D.
The nurse auscultates coarse crackles in the lung fields.
The nurse should auscultate coarse crackles or rhonchi, identify a moist cough,
hear or see secretions in the tracheostomy tube, and then suction the client's airway
secretions.
Incorrect Answers:A. A client who has a tracheostomy with an inflated cuff in
place is unable to speak.
