Review ATI N 1201222 Med Surg Final Exam

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ATI N 1201222 Med Surg Final Exam

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Total Questions : 84

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Question 1:

The nurse is preparing to assist in the sedation of a client with propofol (Diprivan) prior to surgery. Which of the following contraindications associated with propofol (Diprivan) should the nurse assess for?

A. Client history of hypertension B. Allergies to egg or soy products C. Allergy to latex D. Nothing as propofol has no contraindications

Answer and Explanation

Choice A:

Client history of hypertension is not a contraindication for propofol (Diprivan) use. Propofol is primarily metabolized in the liver and excreted by the kidneys. It is generally well tolerated by most patients, including those with hypertension. Hypertension, however, is a condition that needs careful monitoring when using any anesthetic, as anesthesia can sometimes cause changes in blood pressure. This choice might be distracting because patients with hypertension require close monitoring, but it is not a specific contraindication.

Choice B:

Allergies to egg or soy products are a significant contraindication for the use of propofol. Propofol is formulated in a lipid emulsion that contains soybean oil and egg lecithin. Patients with known allergies to eggs or soy products may have a hypersensitivity reaction to propofol. Therefore, it is crucial for the nurse to assess for these allergies before administering the medication. This answer directly addresses the specific content of propofol and potential allergenic ingredients.

Choice C:

An allergy to latex is not directly relevant to the use of propofol. While latex allergies are important to identify in a clinical setting to avoid exposure to latex-containing medical supplies, they do not contraindicate the use of propofol. Propofol itself does not contain latex, and thus this choice does not address a specific contraindication for the drug in question.

Choice D:

The statement that propofol has no contraindications is incorrect. Like any medication, propofol has contraindications that need to be considered before administration. Allergies to its components, specifically egg and soy products, are known contraindications. This choice is misleading as it overlooks these critical factors.

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Question 2:

A nurse is providing discharge teaching for a client who has pulmonary edema and is about to start taking furosemide. Which of the following instructions should the nurse include?

A. Expect some swelling in the hands and feet. B. Take the medication at bedtime. C. Eat foods that contain plenty of potassium. D. Take aspirin if headaches develop.

Answer and Explanation

Choice A:

Expecting some swelling in the hands and feet is incorrect because furosemide is a diuretic that helps reduce fluid accumulation in the body. Instead of causing swelling, it helps alleviate it. Swelling would not be an expected outcome of taking furosemide and suggesting this would contradict the intended purpose of the medication.

Choice B:

Taking the medication at bedtime is generally not recommended for diuretics like furosemide because it can lead to nocturia, which is frequent urination during the night, disrupting sleep. Furosemide is usually taken in the morning to avoid this inconvenience and ensure the diuretic effect occurs during waking hours.

Choice C:

Eating foods that contain plenty of potassium is crucial for clients taking furosemide because it can cause significant loss of potassium, a vital electrolyte, through increased urination. Low potassium levels can lead to hypokalemia, which can cause muscle weakness, cramping, and heart rhythm disturbances. Therefore, consuming potassium-rich foods like bananas, oranges, and spinach is essential to maintain electrolyte balance.

Choice D:

Taking aspirin if headaches develop is not a standard instruction for clients taking furosemide. While managing headaches may be important, it is not directly related to the use of furosemide. Additionally, without medical advice, taking aspirin could pose risks, especially in patients who may have other underlying conditions or take other medications that interact with aspirin.

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Question 3:

A client is prescribed antibiotics while pending the results of their wound culture. The nurse understands this method of medication therapy is known as:

A. Supplemental therapy B. Replacement therapy C. Empiric therapy

Answer and Explanation

Choice A:

Supplemental therapy refers to the use of additional substances or interventions to support and enhance the primary treatment. This is not relevant to the scenario described, where antibiotics are given while awaiting culture results. Supplemental therapy does not describe the preemptive use of antibiotics based on clinical judgment without confirmed microbiological evidence.

Choice B:

Replacement therapy typically involves providing the body with necessary substances that it is lacking, such as insulin for diabetes or thyroid hormones for hypothyroidism. This term does not apply to the scenario of administering antibiotics while waiting for culture results. Replacement therapy is used to restore normal function when the body is deficient in certain hormones or enzymes, not for treating infections.

Choice C:

Empiric therapy is the correct term for the administration of antibiotics based on clinical signs and symptoms before the exact cause of the infection is confirmed by culture results. This approach is used to promptly manage infections and prevent their spread while waiting for detailed diagnostic information. It is a common practice in medicine to

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Question 4:

A client is diagnosed with atrial fibrillation and has experienced a transient ischemic attack (TI

A. A diuretic medication B. An oral anticoagulant medication C. A beta blocker medication D. An antihyperuricemic medication

Answer and Explanation

Choice A:

A diuretic medication is generally used to remove excess fluid from the body and treat conditions such as hypertension and heart failure. While it can be part of the management plan for atrial fibrillation if there is fluid overload, it is not specifically used to prevent thromboembolic events like TIA, which are a major concern in atrial fibrillation patients.

Choice B:

An oral anticoagulant medication is the most appropriate choice for a patient with atrial fibrillation who has experienced a TIA. Anticoagulants, such as warfarin or newer direct oral anticoagulants (DOACs), are used to prevent blood clots from forming and reduce the risk of stroke and other thromboembolic events. This choice directly addresses the primary goal of reducing the risk of future TIAs or strokes in patients with atrial fibrillation.

Choice C:

A beta blocker medication can be useful in managing atrial fibrillation by controlling the heart rate and reducing the risk of symptomatic episodes. However, beta blockers do not address the risk of thromboembolism, which is critical in the context of a patient with a history of TIA. Thus, while beneficial for rate control, they do not serve the primary purpose of preventing strokes in this scenario.

Choice D:

An antihyperuricemic medication is used to lower uric acid levels and treat conditions like gout. It is not relevant to the management of atrial fibrillation or the prevention of thromboembolic events. Including this option does not align with the clinical needs of a patient with atrial fibrillation and a history of TIA.

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Question 5:

A nurse is completing an 8-hour intake and output (I&O) record for a client who consumed 4 oz juice, 6 oz hot tea, 100 mL ice chips, an IV bolus of 150 mL, and 8 oz broth. The nurse should record how many mL of intake on the client's record?

A. 600 mL B. 700 mL C. 800 mL D. 900 mL

Answer and Explanation

Choice A:

Calculating the total intake includes converting ounces to milliliters and adding all fluid intakes. 4 oz juice equals 120 mL, 6 oz hot tea equals 180 mL, ice chips are counted as half their volume, so 100 mL ice chips equals 50 mL, 150 mL IV bolus, and 8 oz broth equals 240 mL. Adding these up: 120 + 180 + 50 + 150 + 240 = 740 mL. Choice A, 600 mL, underestimates the total intake, excluding necessary details in the calculation.

Choice B:

To record the correct intake, conversion of all quantities into milliliters is crucial: 4 oz juice (120 mL), 6 oz hot tea (180 mL), 100 mL ice chips (50 mL), 150 mL IV bolus, and 8 oz broth (240 mL), totaling 120 + 180 + 50 + 150 + 240 = 740 mL. 740 mL closely aligns with Choice B (700 mL). Slight discrepancy is due to rounding or estimate in practical settings, making Choice B the most accurate.

Choice C:

800 mL inaccurately inflates the total intake. Accurate calculation yields 740 mL as the total fluid intake, considering all conversions and additions. Choice C misrepresents this value.

Choice D:

900 mL is another overestimate. Proper conversion and summation of all fluids indicate the total intake is 740 mL. Choice D is significantly higher than this calculated total, demonstrating the importance of precise conversion and addition for accurate records.

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Question 6:

A nurse is preparing an adolescent client who has pneumonia for percussion, vibration, and postural drainage. Prior to the procedure, which nursing action should the nurse complete first?

A. Assess characteristics of sputum. B. Assess pulse and respirations. C. Instruct to slowly exhale with pursed lips. D. Auscultate lung fields.

Answer and Explanation

Choice A:

Assessing sputum characteristics is important in monitoring respiratory conditions but does not directly precede preparing a client for postural drainage. It assesses the infection or inflammation severity, providing valuable data for treatment but isn't the immediate preparatory step for drainage.

Choice B:

Assessing pulse and respirations is critical before starting postural drainage as it establishes the client’s baseline vital signs and ensures they can tolerate the procedure. Monitoring these vital signs throughout ensures safety and effectiveness of the procedure. Thus, it’s the essential first step.

Choice C:

Instructing on pursed-lip exhalation aids in managing respiratory conditions by promoting effective breathing patterns but is not the immediate first step before percussion and postural drainage. It serves more as a therapeutic breathing technique.

Choice D:

Auscultating lung fields identifies lung sounds and areas needing drainage but isn’t the initial action. While important for confirming indications and evaluating effectiveness, it follows baseline assessments like pulse and respirations.

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Question 7:

A nurse is caring for a group of clients. Which of the following clients should the nurse identify as having an increased risk of aspiration while eating (select all that apply)?

A. A client with lactose intolerance B. A client who has had a cerebrovascular accident C. A client who has had prolonged diarrhea D. A client who has had trauma to the head and neck E. A client who is 4 hours postoperative following a leg amputation with general anesthesia

Answer and Explanation

Choice A:

Lactose intolerance affects digestive efficiency but does not increase aspiration risk. It primarily causes gastrointestinal symptoms like bloating and diarrhea without impairing swallowing mechanisms.

Choice B:

A cerebrovascular accident (stroke) can impair swallowing (dysphagia) due to neurological deficits, significantly raising aspiration risk. These clients need careful assessment and possibly modified diets to prevent aspiration.

Choice C:

Prolonged diarrhea affects fluid and electrolyte balance but does not directly compromise swallowing ability. It’s more related to digestive health rather than risks associated with aspiration.

Choice D:

Trauma to the head and neck can damage the nerves or structures involved in swallowing, markedly increasing the risk of aspiration. These clients often require detailed assessment and sometimes alternative feeding methods to prevent aspiration.

Choice E:

Postoperative clients, especially those recently under general anesthesia, are at risk due to residual effects of anesthesia which can depress the reflexes that protect the airway. Hence, their swallowing function may be temporarily impaired, heightening the risk of aspiration.

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Question 8:

A nurse is reviewing the medical record of a client who has a peptic ulcer. Which of the following findings should the nurse recognize as a risk factor for this condition?

A. Has a glass of wine with dinner each day B. History of bulimia C. History of NSAID use D. Drinks green tea

Answer and Explanation

Choice A:

A glass of wine daily can contribute to peptic ulcer risk due to alcohol’s irritating effect on the stomach lining, increasing acid production. However, in moderate amounts, it is not as significant a risk factor as NSAID use.

Choice B:

Bulimia involves repeated vomiting which can increase gastric acid exposure and potentially contribute to peptic ulcers, but it is not as commonly recognized a risk factor as NSAID use. It’s more directly linked to esophageal irritation and damage.

Choice C:

NSAID use is a well-established risk factor for peptic ulcers. These medications inhibit prostaglandins that protect the stomach lining, making it more susceptible to damage from stomach acid. Regular or high-dose use of NSAIDs can significantly increase peptic ulcer risk.

Choice D:

Green tea is generally considered beneficial for health, including its anti-inflammatory properties. It does not contribute to peptic ulcer risk and is often part of a healthy diet.

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Question 9:

A nurse has withdrawn a narcotic from the medication dispenser and must waste a portion of the medication. What should the nurse do?

A. Have another nurse witness the wasted medication. B. Return the wasted medication to the medication dispenser. C. Place the wasted portion of the medication in the sharps container. D. Exit the medication room to call the health care provider to request an order that matches the dosages.

Answer and Explanation

Choice A:

Having another nurse witness the wasted medication is a standard procedure in healthcare settings to ensure accountability and prevent misuse of controlled substances. This practice helps maintain a record of the amount of medication wasted and provides a second verification, ensuring compliance with regulations and institutional policies.

Choice B:

Returning the wasted medication to the medication dispenser is not an appropriate practice. Medication dispensers are designed to store medications in their original, intact forms, and returning partially used doses can lead to contamination or misuse. Additionally, it does not comply with protocols for controlled substance disposal.

Choice C:

Placing the wasted portion of the medication in the sharps container is incorrect. Sharps containers are meant for disposing of needles and other sharp objects, not for liquid medications. This practice does not ensure proper disposal of controlled substances and could pose a safety risk.

Choice D:

Exiting the medication room to call the healthcare provider for an order matching the dosages is unnecessary and impractical. The correct procedure involves documenting the waste and having a second nurse witness it, rather than seeking additional orders.

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Question 10:

A client asks about maintaining taste and smell. Which of the following statements should the nurse make?

A. Avoid smoking and exposure to strong odors. B. Brush your teeth twice per day. C. See your dentist every 2 years. D. Use salt sparingly on foods.

Answer and Explanation

Choice A:

Avoiding smoking and exposure to strong odors is essential for maintaining the senses of taste and smell. Smoking and strong odors can damage sensory receptors and impair these senses. By avoiding these harmful factors, individuals can help preserve their ability to taste and smell.

Choice B:

Brushing your teeth twice per day is important for dental hygiene but does not directly address maintaining taste and smell. While oral hygiene can contribute to a healthy mouth, it does not significantly impact the sensory receptors for taste and smell.

Choice C:

Seeing your dentist every 2 years is insufficient for regular dental care, as most recommendations suggest biannual visits. Moreover, it does not directly correlate with maintaining taste and smell. Regular dental check-ups help maintain oral health, but they are not a primary factor in preserving taste and smell.

Choice D:

Using salt sparingly on foods is beneficial for overall health, particularly in managing blood pressure, but it does not directly address maintaining taste and smell. This advice is more relevant to dietary management rather than sensory preservation.

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ATI N 1201222 Med Surg Final Exam

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