ATI Medical Surgical Proctored Exam

Correct Answer: C

Rationale: The most appropriate action for the nurse in this scenario is to teach the client about factor V Leiden testing. Factor V Leiden is an inherited thrombophilia that can lead to abnormal clotting events, including pulmonary embolism (PE). In a case where a client has no known risk factors for PE, testing for this genetic disorder is crucial to determine if it is a contributing factor. Encouraging the client to walk or referring them to smoking cessation classes, while beneficial for overall health, are not directly relevant to the development of a PE in this specific case. While it is true that sometimes no cause for a disease is found, prematurely assuming this without appropriate investigations may lead to missed opportunities for preventive measures or treatments.

Correct Answer: D

Rationale: The Institute of Medicine (IOM) report 'Health Professions Education: A Bridge to Quality' outlines five core competencies that healthcare providers should possess. These competencies include collaborating with an interdisciplinary team, implementing evidence-based care, providing family-focused care, using informatics in practice, and focusing on patient-centered care. Therefore, to ensure that nurses are practicing at their highest levels of competency as per the IOM report, the nurse manager should assess all of these areas.

Correct Answer: B

Rationale: The correct answer is B. A nurse should ask the client if they have any chronic breathing problems when the anteroposterior (AP) chest diameter is the same as the lateral chest diameter. This finding indicates a barrel chest, which can be associated with chronic respiratory conditions such as chronic obstructive pulmonary disease (COPD) or emphysema. Assessing for chronic breathing problems can help the nurse further evaluate the client's respiratory status and provide appropriate care.

Correct Answer: D

Rationale: The correct first intervention for a client experiencing hypoglycemia is administering 15-20 grams of fast-acting carbohydrate orally. If the client is conscious and able to swallow, providing quick-acting carbohydrates helps raise blood glucose levels rapidly and effectively. This approach is preferred over other options like administering insulin, dextrose solution intravenously, or glucagon, which are not the initial interventions for hypoglycemia.

Correct Answer: B

Rationale: The presence of expired food in the refrigerator is concerning as it raises safety issues for the client and indicates potential financial constraints preventing them from buying fresh food. The nurse should consider referring the client to services like Meals on Wheels or other home-based food programs to address this issue and ensure the client's nutritional needs are met.