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ATI PHARMACOLOGY PROCTORED EXAM
1. The nurse is caring for a patient in preadmission testing. The patient has been assigned a
physical status classification by the American Society of Anaesthesiologists of ASA III.
Which assessment will support this classification?
a. Normal, healthy patient
b. Denial of any major illnesses or conditions
c. Poorly controlled hypertension with implanted pacemaker
d. Moribund patient not expected to survive without the operation
Answer: c. Poorly controlled hypertension with implanted pacemaker
Rationale:
An ASA III rating is a patient with a severe systemic disease, such as poorly controlled
hypertension with an implanted pacemaker. ASA I is a normal healthy patient with no major
illnesses or conditions. ASA II is a patient with mild systemic disease. ASA V is a moribund
patient who is not expected to survive without the operation and includes patients with
ruptured abdominal/thoracic aneurysm or massive trauma.
2. The patient has presented to the ambulatory surgery center to have a colonoscopy. The
patient is scheduled to receive moderate sedation (conscious sedation) during the procedure.
How will the nurse interpret this information?
a. The procedure results in loss of sensation in an area of the body.
b. The procedure requires a depressed level of consciousness.
c. The procedure will be performed on an outpatient basis.
d. The procedure necessitates the patient to be immobile.
Answer: b. The procedure requires a depressed level of consciousness.
Rationale:
Moderate sedation (conscious sedation) is used routinely for procedures that do not require
complete anesthesia but rather a depressed level of consciousness. Not all patients who are
treated on an outpatient basis receive moderate sedation. Regional anesthesia such as local
anesthesia provides loss of sensation in an area of the body. General anesthesia is used for
patients who need to be immobile and to not remember the surgical procedure.

3. The nurse is caring for a patient in the postanesthesia care unit who has undergone a left
total knee arthroplasty. The anesthesia provider has indicated that the patient received a left
femoral peripheral nerve block. Which assessment will be an expected finding for this
patient?
a. Sensation decreased in the left leg
b. Patient report of pain in the left foot
c. Pulse decreased at the left posterior tibia
d. Left toes cool to touch and slightly cyanotic
Answer: a. Sensation decreased in the left leg
Rationale:
Induction of regional anesthesia results in loss of sensation in an area of the body —in this
case, the left leg. The peripheral nerve block influences the portions of sensory pathways that
are anesthetized in the targeted area of the body. Decreased pulse, toes cool to touch, and
cyanosis are indications of decreased blood flow and are not expected findings. Reports of
pain in the left foot may indicate that the block is not working or is subsiding and is not an
expected finding in the immediate postoperative period.
4. The nurse is preparing a patient for surgery. Which goal is a priority for assessing the
patient before surgery?
a. Plan for care after the procedure.
b. Establish a patient’s baseline of normal function.
c. Educate the patient and family about the procedure.
d. Gather appropriate equipment for the patient’s needs.
Answer: b. Establish a patient’s baseline of normal function.
Rationale:
The goal of the preoperative assessment is to identify a patient’s normal preoperative function
and the presence of any risks to recognize, prevent, and minimize possible postoperative
complications. Gathering appropriate equipment, planning care, and educating the patient and
family are all important interventions that must be provided for the surgical patient; they are
part of the nursing process but are not the priority reason/goal for completing an assessment
of the surgical patient.

5. The nurse is completing a medication history for the surgical patient in preadmission
testing. Which medication should the nurse instruct the patient to hold (discontinue) in
preparation for surgery according to protocol?
a. Warfarin
b. Vitamin C
c. Prednisone
d. Acetaminophen
Answer: a. Warfarin
Rationale:
Medications such as warfarin or aspirin alter normal clotting factors and thus increase the risk
of hemorrhaging. Discontinue at least 48 hours before surgery. Acetaminophen is a pain
reliever that has no special implications for surgery. Vitamin C actually assists in wound
healing and has no special implications for surgery. Prednisone is a corticosteroid, and
dosages are often temporarily increased rather than held.

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