ATI MS I Final Exam Study Guide Flashcards
A nurse is reinforcing teaching to a newly licensed nurse regarding the epidemiology of sudden cardiac arrest. Which of the following should the nurse include?
a. Sudden cardiac arrest is considered a public health burden worldwide.
b. Sudden cardiac arrest has a mortality rate similar to the mortality rate of cancer.
c. Sudden cardiac arrest accounts for few cardiovascular deaths in the United States and western Europe.
d. Sudden cardiac arrests have better outcomes when they occur outside of the hospital.
a. Sudden cardiac arrest is considered a public health burden worldwide.
The nurse should include the information that sudden cardiac arrest accounts for 15% to 20% of all natural deaths in adults in the U.S. and western Europe and is a public health burden throughout the world.
A nurse is caring for a client who has hypokalemia. Which of the following findings should the nurse associate with hypokalemia?
a. U waves on electrocardiogram
b. Hyperventilation
c. Bradypnea
d. Syncope
a. U waves on electrocardiogram
The nurse should anticipate U waves on the electrocardiogram in clients who have hypokalemia.
Which of the following can the nurse expect to find when assessing a client with manifestations of pulmonary edema? (Select all that apply.)
a. Jugular venous distention
b. Dizziness and excessive sweating
c. Absent pedal edema
d. Excessive shortness of breath that is worse with exertion or when lying down
e. Cold extremities
a. Jugular venous distention
b. Dizziness and excessive sweating
d. Excessive shortness of breath that is worse with exertion or when lying down
e. Cold extremities
Rationale A
Clients with pulmonary edema might present with shortness of breath, tachypnea, hypoxia and exhibit signs of distress.
Rationale B
Clients with pulmonary edema might present with agitation accompanied by excessive sweating.
Rationale C
Clients with pulmonary edema might present with hypertension, along with jugular venous distension.
Rationale D
A client with pulmonary edema might present with a general appearance of confusion, agitation accompanied by excessive sweating, cyanosis of the lips, and cold extremities.
Rationale E
Pedal edema is usually present in a client with pulmonary edema who has chronic heart failure.
A nurse is reinforcing teaching about use of a metered-dose inhaler (MD) with a client who has a new diagnosis of asthma. Identify the sequence the client should follow. (Move the steps into the box on the right, placing them in the selected order of performance. Use all steps.)
a. Exhale slowly through pursed lips.
b. Place her lips firmly around the mouthpiece.
c. Inhale slowly over 3 to 5 seconds while pushing down on the canister.
d. Hold her breath for 10 seconds.
e. Shake the canister 3 to 5 seconds vigorously.
e. Shake the canister 3 to 5 seconds vigorously.
b. Place her lips firmly around the mouthpiece.
c. Inhale slowly over 3 to 5 seconds while pushing down on the canister.
d. Hold her breath for 10 seconds.
a. Exhale slowly through pursed lips.
The first step the nurse should instruct the client to take is to shake the canister prior to using it in order to mix the medication evenly. Next, the client should place her lips firmly around the mouthpiece with the opening pointing toward the back of the throat, then inhale slowly over 3 to 5 seconds while pushing down on the canister. This slow, deep inhalation directs the medication down into the lower respiratory tract. Once the medication reaches the lower airways, it is more fully absorbed by the client holding her breath for 10 seconds after pushing down on the canister. Finally, the nurse should instruct the client to exhale slowly through pursed lips as a way to keep the smaller airways open during exhalation.
A nurse is reinforcing teaching with a client who uses a nitroglycerine patch to treat angina. The client now has a new prescription for nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?
a. Swallow the tablet whole with an 8 oz glass of water.
b. Store the medication in a pill box at the bedside.
c. Take the medication at the first indication of chest pain.
d. Remove the nitroglycerine patch before taking the sublingual tablet.
c. Take the medication at the first indication of chest pain.
The client should take nitroglycerin as soon as he feels pain, pressure, or tightness in his chest and not wait until his chest pain is severe.
A nurse is providing a client who has COPD with education regarding adapting their behavior. Which of the following describes an anticipated outcome following education of the client?
a. Repeating the same question over and over
b. Anxiety and restlessness
c. Motivation and engagement of the client
d. Awareness of COPD manifestations
c. Motivation and engagement of the client
Self-management and coaching by the nurse are important for motivating, engaging, and guiding clients to adapt their behavior in developing skills to manage COPD.
A nurse is assisting with the care of a client who is returning to the medical unit from the PACU following an abdominal hysterectomy. Which of the following data should the nurse collect first?
a. Airway patency
b. Skin color and temperature
c. Fluid balance
d. Pain level
a. Airway patency
When using the airway, breathing, circulation approach to client care, the nurse should first check the patency of the client’s airway.
A nurse is reinforcing teaching about diaphragmatic breathing with a client as part of preparing them for postoperative care. Which of the following instructions should the nurse include?
a. “Repeat these steps ten times quickly.”
b. “Lie on your side.”
c. “After placing your hands on your abdomen, blow out quickly two times.”
d. “Lie on your back or sit in a supportive chair.”
d. “Lie on your back or sit in a supportive chair.”
The client needs to be in the proper position to be able to expand their chest and tighten their diaphragm to help make this muscle stronger.
A nurse is collecting data from the medical record of an older adult client and sees that the client is taking Amiodarone. The client has reported feeling frequently tired and unable to tolerate the heat. Which of the following conditions should the nurse expect?
a. Low thyroid hormone levels
b. Elevated blood glucose levels
c. Elevated thyroid hormone levels
d. Low blood glucose levels
c. Elevated thyroid hormone levels
Thyrotoxicosis or thyroid storm is caused by the effects of hyperthyroidism and can be caused by Amiodarone. If untreated it can lead to thyroid storm, which can be a serious condition for an older adult.
A nurse is caring for a client admitted for pyelonephritis. The client’s history includes frequent urinary tract infections (UTI). Which of the following statements by the client indicates that they are suffering from a psychosocial effect from frequent UTIs?
a. “Sometimes I get so nauseated and start throwing up and can’t even keep water down.”
b. “When I have one of these infections, I can’t go to my grandkids’ school activities like I normally do.”
c. “I have to be close to a bathroom no matter where I am when I have this infection.”
d. “I get such back pain with these urine infections. It hurts so bad.”
b. “When I have one of these infections, I can’t go to my grandkids’ school activities like I normally do.”
Disruption of life activities, such as not being able to attend family activities, is a psychosocial effect of a UTI.
A nurse is assisting in explaining the pathophysiology of systemic inflammatory response syndrome (SIRS) to a group of newly licensed nurses. Which of the following statements by the nurse is accurate?
a. “The major organ prone to injury during SIRS is the heart.”
b. “A deregulated cytokine storm causes an inflammatory response.”
c. “Spleen dysfunction causes blood clotting issues.”
d. “Activation of the inflammatory cascade causes increased perfusion.”
b. “A deregulated cytokine storm causes an inflammatory response.”
SIRS occurs when the balance between inflammatory and anti-inflammatory responses leans more toward the inflammatory response, followed by a deregulated cytokine storm that causes an immense increase in the inflammatory response.
A nurse is collecting data for a client who has valvular heart disease.
Admission Assessment
0800:
Admitted for management of valvular heart disease manifestations. Reports heart palpitations for over a month with an increase in fatigue and weakness. Heart sounds with murmur auscultated. Lungs sounds clear. Respirations even and unlabored. Abdomen distended, bowel sounds normoactive in all 4 quadrants. Reports abdominal pain in upper right quadrant. 2+ edema noted to lower legs. Oxygen intact at 2 L per nasal cannula.
Nurses’ Notes
1035:
Client reports weakness and fatigue. Heart sounds with murmur noted. Lung sounds clear. Dyspnea noted. Lower extremities with 3+ pitting edema. Bowel sounds hypoactive in all 4 quadrants. Abdomen distended and tender. Oxygen at 2 L per nasal cannula. Reports chest pain as 7 on a scale of 0 to 10.
Diagnostic Results
0830:
Echocardiogram: Aortic valve significantly more narrowed from last echocardiogram 2 years ago.
Vital Signs
0800:
Temperature 37° C (98.6° F)
Heart rate 90/min
Respiratory rate 20/min
Oxygen saturation 95%
1035:
Temperature 37° C (98.6° F)
Heart rate 102/min
Respiratory rate 24/min
Oxygen saturation 92%
For each potential provider’s prescription, click to specify if the potential prescription is anticipated, nonessential, or contraindicated for the client.
When generating solutions, the nurse should identify that the client is experiencing manifestations of worsening valvular heart disease, such as heart palpitations, fatigue, weakness, tachycardia, dyspnea, enlarged abdomen with abdominal pain, and edema. The nurse should anticipate the need to administer medications, including beta blockers, such as metoprolol, digoxin, and calcium channel blockers, such as enalapril, to control heart rate and help prevent arrhythmias. Diuretics, such as furosemide, are used to control blood pressure and vasodilators are used to decrease the workload of the heart.
Clients with valvular heart disease may present with abdominal pain due to an enlarged liver so acetaminophen is contraindicated due to liver involvement.
A nurse is assisting with weaning a client from the ventilator. Which of the following parts of the ABCDEF assessment tool does the weaning process represent?
a. Assess, Prevent, and Manage Pain
b. Delirium: Assess, Prevent, and Manage
c. Choice of Analgesia and Sedation
d. Breathing, Spontaneous Awakening Trials (SAT) and Spontaneous Breathing Trials (SBT)
d. Breathing, Spontaneous Awakening Trials (SAT) and Spontaneous Breathing Trials (SBT)
Spontaneous breathing trials (SBT) refers to the stopping of mechanical ventilation to allow the client to breathe spontaneously, which is accomplished by decreasing the ventilator respiratory rate. This intervention is “B” in the ABCDEF assessment.
A nurse is reinforcing teaching for a client who has a new prescription for warfarin. Which of the following information should the nurse include?
a. Mild nosebleeds are common during initial treatment.
b. The client should use an electric razor while on this medication.
c. If he misses a dose, he should double the dose at the next scheduled time.
d. Warfarin increases the risk for deep vein thrombosis.
b. The client should use an electric razor while on this medication.
Warfarin, an anticoagulant, increases the client’s risk for bleeding. The nurse should teach the client safety measure, such as using an electric razor, to decrease the risk for injury and bleeding.
A nurse is providing care for a client who has diabetes mellitus. Which of the following laboratory findings indicates the client most likely to be diagnosed with diabetic ketoacidosis (DKA)?
a. Arterial blood pH 7.46
b. Blood urea nitrogen (BUN) 18 mg/dL
c. Serum bicarbonate less than 15
d. Serum sodium 140 mg/dL
c. Serum bicarbonate less than 15
The nurse should identify that a serum bicarbonate level of less than15, blood glucose of 600 to 1220 mg/dL, arterial pH 6.8 to 7.3, and serum sodium 125 to 135 mg/dL are associated with diabetic ketoacidosis (DKA).
