Advanced Med-Surg Proctored ATI
Review 2025/2026
Arterial Blood Gas - correct answer.100%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.100%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.100%answer✔<<<<<visualizes the larynx, trachea, bronchi; obtains
tissue biopsy; and removes foreign bodies.
Steps for a bronchoscopy procedure - correct answer.100%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.100%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.100%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.100%answer✔<<<<<Identify the
presence of Mycobacterium tuberculosis infection by measuring the immune response to the TB
bacteria in whole blood.
Thoracentesis - correct answer.100%answer✔<<<<<Surgical perforation of the pleural space to obtain
specimen, to remove fluid or air, or to instill medication.
,Steps for Thoracentesis - correct answer.100%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.100%answer✔<<<<<Chronic inflammatory disorder of the airways resulting
in intermittent and reversible airflow obstruction of the bronchioles.
Contributing factors of asthma - correct answer.100%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.100%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.100%answer✔<<<<<-ABGs
-sputum cultures
-pulmonary function tests
Nursing interventions for asthma - correct answer.100%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.100%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.100%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.100%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.100%answer✔<<<<<visualizes the larynx, trachea, bronchi; obtains
tissue biopsy; and removes foreign bodies.
Steps for a bronchoscopy procedure - correct answer.100%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.100%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.100%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.100%answer✔<<<<<Identify the
presence of Mycobacterium tuberculosis infection by measuring the immune response to the TB
bacteria in whole blood.
Thoracentesis - correct answer.100%answer✔<<<<<Surgical perforation of the pleural space to obtain
specimen, to remove fluid or air, or to instill medication.
,Steps for Thoracentesis - correct answer.100%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.100%answer✔<<<<<Chronic inflammatory disorder of the airways resulting
in intermittent and reversible airflow obstruction of the bronchioles.
Contributing factors of asthma - correct answer.100%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.100%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.100%answer✔<<<<<-ABGs
-sputum cultures
-pulmonary function tests
Nursing interventions for asthma - correct answer.100%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.100%answer✔<<<<<Administer bronchodilators before
antiinflammatory
1. Bronchodilators
-short-acting inhaled: albuterol; for rapid relief
-Methylxanthines: theophylline; monitor therapeutic range for toxicity.
