ATI Vn Med-Surg

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Sample questions from ATI Vn Med-Surg

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.In the emergency department, a 58-year-old client reports sudden chest pressure radiating to the jaw and nausea. The ECG shows ST-segment elevation in leads II, III, and aVF. Which action should the nurse take first?

   • A.Offer an oral antacid and reassess the discomfort in 30 minutes
   • B.Obtain a detailed family history of cardiovascular disease
   • C.Encourage the client to walk to assess activity tolerance
   • D.Administer prescribed sublingual nitroglycerin after checking blood pressure and contraindications

   Rationale: The findings indicate an acute inferior myocardial infarction, so immediate interventions to reduce myocardial oxygen demand and relieve ischemic pain are appropriate; check blood pressure and screen for recent phosphodiesterase-5 inhibitor use before giving nitroglycerin. A family history is useful but does not take priority over acute treatment. Walking increases cardiac workload, and an antacid delays care for suspected myocardial infarction. Activate the facility's acute coronary syndrome response and anticipate time-sensitive reperfusion treatment.

2. 2.A client states, "I take warfarin for atrial fibrillation, and I started an antibiotic yesterday." Which response is most important?

   • A."Avoid all foods that contain vitamin K until the antibiotic is finished."
   • B."Stop taking warfarin until you finish the antibiotic."
   • C."Contact your anticoagulation provider promptly because the antibiotic may change your INR."
   • D."Take an extra dose of warfarin while you are taking the antibiotic."

   Rationale: Some antibiotics interact with warfarin and can increase bleeding risk by raising the INR, so the client should promptly contact the anticoagulation provider for guidance and monitoring. Stopping or increasing warfarin without an order can cause harm. Avoiding all vitamin K is not appropriate; consistent dietary vitamin K intake is the teaching point. Clients taking warfarin should report new medications and signs of bleeding.

3. 3.Refer to the client's chart. Which findings require the nurse to intervene promptly for worsening heart failure? Select all that apply.

   • A.Weight increase of 1.2 kg (2.6 lb) since the previous morning
   • B.Blood pressure of 138/82 mm Hg at 1000
   • C.SpO2 of 92% on room air at 1000, decreased from 96% at 0800
   • D.Urine output of 45 mL/hr over the last 2 hours
   • E.New crackles at the lung bases at 1000

   Rationale: New crackles, a 1.2 kg weight increase, and a decreasing oxygen saturation are chart findings consistent with worsening fluid overload and impaired gas exchange, so they require prompt assessment and intervention. The urine output of 45 mL/hr is not low for this adult and does not indicate acute renal hypoperfusion on its own. The blood pressure is not markedly abnormal. In heart failure, trends in weight, lung sounds, and oxygenation help identify decompensation early.

4. 4.At a community clinic, a 16-year-old asks how to reduce the risk of hypertension later in life. Which recommendation is best?

   • A.Choose foods lower in sodium and include regular physical activity
   • B.Use an over-the-counter decongestant before exercise
   • C.Avoid all dietary fats, including unsaturated fats
   • D.Limit fluid intake to prevent an increase in blood pressure

   Answer and rationale are in the full material.

5. 5.A provider prescribes digoxin for a 74-year-old client with heart failure. Before administering the medication, which finding should the nurse report?

   • A.Potassium level of 4.0 mEq/L
   • B.Apical pulse of 54/min
   • C.Blood pressure of 128/74 mm Hg
   • D.Respiratory rate of 16/min

   Answer and rationale are in the full material.