ATI PN Med-Surg 2023 PDF

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Sample questions from ATI PN Med-Surg 2023 PDF

This material has 60 questions with answers and rationales. Here are the first 5.

1. 1.In a long-term care facility, an older adult with heart failure who takes digoxin reports nausea and blurred vision. The apical pulse is 54/min, and the client took the prescribed dose this morning. Which action should the practical nurse take?

   • A.Withhold the next dose and report the findings promptly to the registered nurse
   • B.Give the next dose with food to reduce the nausea
   • C.Encourage the client to increase dietary potassium before the next dose
   • D.Recheck the apical pulse in 4 hours and give the dose if it is above 50/min

   Rationale: Nausea, visual changes, and bradycardia are concerning for digoxin toxicity, so the practical nurse should withhold a subsequent dose and promptly report the findings. Giving the medication with food does not address possible toxicity, and dietary potassium changes should not be initiated without direction. Waiting several hours risks delaying care; digoxin is generally withheld and reported when the apical pulse is below the prescribed parameter, commonly 60/min in adults.

2. 2.A client states, "I have chest pressure, but it is probably just indigestion." The client is pale and diaphoretic, and the discomfort began while walking to the bathroom. Which action should the practical nurse take first?

   • A.Offer an antacid and reassess the discomfort in 30 minutes
   • B.Assist the client to rest and promptly report the new symptoms to the registered nurse
   • C.Ask the client to describe all usual dietary triggers before notifying anyone
   • D.Encourage the client to walk slowly to determine whether the discomfort resolves

   Rationale: New exertional chest pressure with pallor and diaphoresis may indicate myocardial ischemia and requires prompt escalation; reducing exertion while reporting the change is appropriate. An antacid may delay recognition of a cardiac problem, and walking further could worsen ischemia. A detailed history can be useful, but it should not delay reporting these acute cues.

3. 3.At a community clinic, a client with hypertension is learning to monitor blood pressure at home. Which instructions should the practical nurse reinforce? Select all that apply.

   • A.Sit quietly for 5 minutes with the back supported and feet flat on the floor
   • B.Support the bare arm at heart level during the measurement
   • C.Avoid caffeine, smoking, and exercise for at least 30 minutes before measuring
   • D.Stop prescribed antihypertensive medication on days when the reading is normal
   • E.Place the cuff over a sleeve to avoid irritating the skin
   • F.Take two readings about 1 minute apart and record both

   Rationale: Avoiding recent caffeine, smoking, and exercise, resting in a supported seated position, supporting the bare arm at heart level, and recording two readings help produce useful measurements. A cuff should be placed on a bare arm because clothing can alter the reading. Medication should not be stopped based on a single normal reading; the client should follow the prescribed regimen and report concerns.

4. 4.A client's potassium is 6.1 mEq/L (reference range 3.5 to 5.0 mEq/L), and the electrocardiogram shows tall, peaked T waves. The client takes lisinopril and spironolactone. Which action is the practical nurse's priority?

   • A.Administer the scheduled medications and recheck potassium tomorrow
   • B.Encourage a potassium-rich snack to prevent a further decline in potassium
   • C.Ask the client to walk in the hallway to improve circulation
   • D.Promptly notify the registered nurse of the result and electrocardiogram change

   Answer and rationale are in the full material.

5. 5.During a home visit, a client with a mechanical mitral valve reports new fatigue and shortness of breath when walking from the bedroom to the kitchen. Refer to the client's chart. Which finding should the practical nurse report to the RN immediately?

   • A.The client has a heart rate of 96/min after walking and denies palpitations.
   • B.The client has trace ankle edema that is unchanged from the prior visit.
   • C.The INR is below the prescribed therapeutic range, and the client reports new exertional dyspnea.
   • D.The client reports taking warfarin with the evening meal.

   Answer and rationale are in the full material.