MED SURG ATI ADVANCED FINAL EXAM /ATI MED SURG ADVANCED
FINAL PROCTORED EXAM 2024-2025 350 QUESTIONS AND ANSWERS
100 % PASS SOLUTION A+ GRADE
The nurse completes an admission assessment on a patient with asthma. Which information
given by patient is indicates a need for a change in therapy?
a. The patient uses albuterol (Ventolin HFA) before aerobic exercise.
b. The patient says that the asthma symptoms are worse every spring.
c. The patient's heart rate increases after using the albuterol (Ventolin HFA) inhaler.
d. The patient's only medications are albuterol (Ventolin HFAl) and salmeterol -
ANSWER--d.
The patient's only medications are albuterol (Ventolin HFAl) and salmeterol Long-acting b2-
agonists should be used only in patients who also are using an inhaled corticosteroid for
long-term control
When reviewing the results of an 83 y/o pt.'s diagnostic studies, which finding would be of
the MOST concern to the nurse?
a. Platelets 150,000/uL
b. Serum iron 50 mcg/dL
c. Partial thromboplastin time 60 seconds
d. ESR 35 mm in 1 hour - ANSWER--ANS: C.
Partial thromboplastin time 60 seconds
As a person ages the partial thromboplastin time (PTT) is normally decreased, so an
abnormally high PTT of 60 seconds is an indication that bleeding could readily occur.
Platelets are unaffected by aging and 150,000/ul is a normal count. Serum iron levels are
decreased and the erythrocyte sedimentation rate (ESR) is significantly increased with
aging, as are reflected in these values.
A nurse reviews the laboratory data for an older patient. The nurse would be most concerned
about which finding?
,a. Hematocrit of 35%
b. Hemoglobin of 11.8 g/dL
c. Platelet count of 400,000/µL
d. White blood cell (WBC) count of 2800/µL - ANSWER--ANS: D
Because the total WBC count is not usually affected by aging, the low WBC count in this
patient would indicate that the patient's immune function may
be compromised and the underlying cause of the problem needs to be investigated. The
platelet count is normal. The slight decrease in hemoglobin and hematocrit are not unusual
for an older patient
An appropriate nursing intervention for a hospitalized patient with severe hemolytic anemia
is to
a. provide a diet high in vitamin K.
b. alternate periods of rest and activity.
c. teach the patient how to avoid injury.
d. place the patient on protective isolation. - ANSWER--ANS: B
Nursing care for patients with anemia should alternate periods of rest and activity to
encourage activity without causing undue fatigue. There is no indication that the patient has
a bleeding disorder, so a diet high in vitamin K or teaching about how to avoid injury is not
needed. Protective isolation might be used for a patient with aplastic anemia, but it is not
indicated for hemolytic anemia.DIF: Cognitive Level: Apply (application) REF: 608TOP: Nursing
Process: Implementation MSC: NCLEX: Physiological Integrity
Which collaborative problem will the nurse include in a care plan for a patient admitted to
the hospital with idiopathic aplastic anemia?
a. Potential complication: seizures
b. Potential complication: infection
c. Potential complication: neurogenic shock
d. Potential complication: pulmonary edema - ANSWER--ANS: B
,Because the patient with aplastic anemia has pancytopenia, the patient is at risk for infection
and bleeding. There is no increased risk for seizures, neurogenic shock, or pulmonary edema.
DIF: Cognitive Level: Apply
The nurse notes scleral jaundice in a patient being admitted with hemolytic anemia. The
nurse will plan to check the laboratory results for the
a. Schilling test.
b. bilirubin level.
c. gastric analysis.
d. stool occult blood. - ANSWER--ANS: B
Jaundice is caused by the elevation of bilirubin level associated with red blood cell
hemolysis. The other tests would not be helpful in monitoring or treating a hemolytic
anemia. DIF: Cognitive Level: Apply (application) REF: 615TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity
A patient who has been receiving IV heparin infusion and oral warfarin (Coumadin) for a deep
vein thrombosis (DVT) is diagnosed with heparin- induced thrombocytopenia (HIT)when the
platelet level drops to 110,000/μL. Which action will the nurse include in the plan of care?
a. Prepare for platelet transfusion.
b. Discontinue the heparin infusion.
c. Administer prescribed warfarin (Coumadin).
d. Use low-molecular-weight heparin (LMWH). - ANSWER--ANS: B
All heparin is discontinued when HIT is diagnosed. The patient should be instructed to
never receive heparin or LMWH. Warfarin is usually not given until the platelet count has
returned to 150,000/μL. The platelet count does not drop low enough in HIT for a platelet
transfusion ,and platelet
transfusions increase the risk for thrombosis. DIF: Cognitive Level: Apply (application) REF:
622TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
, Which laboratory result will the nurse expect to show a decreased value if a patient develops
heparin-induced thrombocytopenia (HIT)?
a. Prothrombin time
b. Erythrocyte count
c. Fibrinogen degradation products
d. Activated partial thromboplastin time - ANSWER--ANS: D Platelet aggregation in
HIT causes neutralization of heparin, so the
activated partial thromboplastin time will be shorter, and more heparin will
be needed to maintain therapeutic levels. The other data will not be affected by HIT.DIF:
Cognitive Level: Understand (comprehension) REF: 622TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity
Which assessment finding should the nurse caring for a patient with thrombocytopenia
communicate immediately to the health care provider?
a. The platelet count is 52,000/μL.
b. The patient is difficult to arouse.
c. There are purpura on the oral mucosa.
d. There are large bruises on the patient's back. - ANSWER--ANS: B
Difficulty in arousing the patient may indicate a cerebral hemorrhage, which is life
threatening and requires immediate action. The other information should be documented
and reported but would not be unusual in a patient with thrombocytopenia. DIF: Cognitive
Level: Analyze (analysis) REF:
Which patient should the nurse assign as the roommate for a patient who has aplastic
anemia?
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