ATI-AMS ATI Adult medical surgical Exam - Set 2 - Part 3

Correct Answer: I will let my legs hang down

In peripheral arterial disease, a dependent position lets gravity improve arterial blood flow to the legs, relieving pain. Letting the legs hang down increases perfusion to the ischemic tissue below the obstruction. Option a is incorrect because elevating the legs above heart level reduces arterial inflow and worsens ischemic pain in peripheral arterial disease. Elevation suits venous problems, but here gravity-assisted dependent positioning is what improves perfusion to the oxygen-starved legs. Option b is incorrect because a heating pad is dangerous in peripheral arterial disease because reduced sensation and poor circulation make burns likely. Warmth should come from insulated socks and a warm room, never from direct heat applied to the feet. Option d is incorrect because tight compression stockings further restrict already-compromised arterial flow in peripheral arterial disease. Compression benefits venous disorders, whereas in this arterial condition constriction reduces perfusio

Correct Answer: Peripheral arterial disease

Pallor with elevation and rubor when dependent are classic signs of peripheral arterial disease. Poor arterial inflow leaves the elevated limb pale, while dependency lets sluggish blood pool and redden the tissue. Option b is incorrect because venous insufficiency shows brown stasis dermatitis, edema, and ulcers around the medial malleolus, not the elevation pallor and dependent rubor of arterial disease. Its problem is impaired outflow, producing a very different skin picture. Option c is incorrect because deep vein thrombosis presents with calf pain, sudden swelling, warmth, and induration from a clot blocking venous return. These acute findings differ entirely from the chronic elevation-pallor and dependent-rubor pattern of arterial insufficiency. Option d is incorrect because varicose veins appear as distended, twisted superficial veins with aching and cramping. They do not cause the positional color changes described, which instead reflect the arterial inflow problem of peripheral

Correct Answer: I will follow the DASH diet

The DASH diet, rich in fruits, vegetables, and low-fat dairy with limited sodium, helps lower blood pressure. Combined with keeping sodium below the recommended limit, it is a cornerstone of nonpharmacologic hypertension management. Option a is incorrect because stopping medication once the pressure normalizes lets hypertension return, since the drug is controlling rather than curing it. Clients must continue therapy as prescribed even when readings look good to keep the pressure managed long term. Option c is incorrect because hypertension often causes few or no symptoms, so waiting to feel something before taking medication leaves the pressure dangerously uncontrolled. The client should adhere to the regimen consistently regardless of how they feel. Option d is incorrect because canned soups are high in sodium, which raises blood pressure and works against control. Increasing them contradicts the low-sodium goal, so this choice reflects a misunderstanding of the dietary teaching for

Correct Answer: Report the cough to the provider

A persistent dry cough is a known adverse effect of ACE inhibitors like lisinopril. The nurse should report it, because the provider may switch the client to an ARB, which does not cause this troublesome cough. Option a is incorrect because simply reassuring the client overlooks that the dry cough is a recognized ACE inhibitor effect the provider should know about. The drug often must be changed to an ARB, so the cough warrants reporting rather than passive waiting. Option b is incorrect because doubling the dose would intensify the medication's effects, including the cough, and risks hypotension and hyperkalemia. Altering the dose is never the client's decision, making this an unsafe response to the reported symptom. Option d is incorrect because restricting fluids does nothing for an ACE inhibitor cough, which stems from the drug's effect on the airways, not from fluid status. The appropriate step is notifying the provider about this characteristic adverse effect.

Correct Answer: Obtain IV access for an antihypertensive

A severely elevated pressure with headache and visual changes is a hypertensive crisis, a life-threatening emergency. The nurse should obtain IV access and prepare an IV antihypertensive first, since lowering the pressure safely takes priority. Option a is incorrect because acetaminophen may ease the headache but does nothing about the dangerously high pressure threatening the brain and other organs. Treating the symptom rather than the crisis would dangerously delay the lifesaving blood pressure reduction needed first. Option c is incorrect because adherence teaching is valuable later but is useless during an acute crisis demanding immediate pressure control. Education addresses prevention, not the emergency at hand, so it cannot be the first action when organs are at risk. Option d is incorrect because a social services consult may help with medication access afterward but offers nothing for the immediate threat. The priority is establishing IV access to lower the pressure, not arran

Correct Answer: Administer intravenous fluids to replace volume

Hypovolemic shock results from lost intravascular volume, so fluid replacement with crystalloids or blood comes first. Restoring volume must precede vasopressors, which would constrict vessels without correcting the underlying deficit driving the shock. Option a is incorrect because norepinephrine constricts vessels to raise pressure but does nothing to refill an empty vascular space. In hypovolemic shock, squeezing depleted vessels before replacing volume can worsen perfusion, so fluids must come first instead. Option b is incorrect because dobutamine strengthens cardiac contraction, which addresses pump failure rather than lost volume. The core problem in hypovolemic shock is missing fluid, so volume replacement, not an inotrope, is the priority intervention here. Option d is incorrect because an afterload-reducing agent is used in cardiogenic shock to help a struggling heart eject blood. Lowering afterload in a volume-depleted client would drop pressure further, making it the wrong

Correct Answer: Epinephrine

Wheezing and tongue swelling indicate anaphylaxis, a life-threatening airway emergency. Epinephrine is given first because it rapidly reverses bronchospasm and supports the airway, addressing the most immediate threat to breathing. Option a is incorrect because diphenhydramine is a secondary agent for the urticaria and angioedema of anaphylaxis and works too slowly to rescue a compromised airway. Epinephrine acts first because its rapid bronchodilation addresses the immediate breathing threat. Option b is incorrect because methylprednisolone reduces the later inflammatory phase of anaphylaxis but has a delayed onset. It cannot reverse the acute bronchospasm and swelling fast enough, so epinephrine is administered first to protect the airway. Option c is incorrect because dobutamine is an inotrope for cardiac pump failure, not for an allergic airway emergency. It does nothing for bronchospasm or tongue swelling, making epinephrine the correct first medication for this anaphylactic react

Correct Answer: Administer the prescribed antibiotic therapy

In septic shock, IV antibiotics are the priority and should be given within an hour of diagnosis. The greatest threat comes from endotoxins and inflammatory mediators, so prompt antimicrobial treatment targets the underlying cause. Option b is incorrect because warm blankets address comfort but do nothing about the overwhelming infection driving septic shock. While supportive care matters, the priority is timely antibiotics to combat the endotoxins causing the client's life-threatening deterioration. Option c is incorrect because fluid restriction is wrong in septic shock, where vasodilation and capillary leak demand fluid resuscitation, not limitation. The pressing intervention is administering antibiotics quickly, and restricting fluids would worsen the perfusion problem instead. Option d is incorrect because ambulation is inappropriate for an unstable client in shock who needs aggressive resuscitation and monitoring. Encouraging activity ignores the priority of prompt antibioti

Correct Answer: Avoid palpating the abdominal mass

The nurse should avoid palpating a pulsating abdominal mass because pressure can provoke rupture of the weakened aortic wall. A ruptured aneurysm causes massive hemorrhage, so the mass is monitored without manual manipulation. Option a is incorrect because palpating the mass to gauge its size endangers the client because manipulation of the fragile, dilated aorta can trigger a fatal rupture. Sizing is done with imaging studies, never by pressing on the aneurysm itself. Option b is incorrect because applying firm pressure over the aneurysm directly risks rupturing the weakened wall and causing catastrophic bleeding. The correct approach is to avoid touching the mass, allowing imaging rather than pressure to evaluate it safely. Option c is incorrect because pressing on the mass to auscultate still applies the very force that can rupture the aneurysm. Any manipulation is hazardous, so the nurse should refrain from palpation altogether rather than combine it with listening.

Correct Answer: Administer intravenous fluids

A dissecting aneurysm threatens circulatory volume through leakage and fluid shifts, so the nurse administers IV fluids first. Supporting perfusion under circulation priorities takes precedence over pain relief, warming, or obtaining an ECG. Option b is incorrect because pain medication is needed but does not address the threatened circulatory volume from a dissecting aneurysm. Maintaining perfusion with IV fluids comes first, since hemodynamic support outranks comfort when the client risks inadequate volume. Option c is incorrect because warm blankets provide comfort but do nothing for the perfusion threat of a leaking dissection. The priority is supporting circulating volume with IV fluids, so warming the client cannot be the first action in this emergency. Option d is incorrect because an ECG yields useful data but delays the immediate intervention of restoring circulatory volume. With a dissecting aneurysm risking inadequate perfusion, administering IV fluids takes priority over ob