ATI Nurs285 Med Surg Exam | Nurselytic

Questions 49

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ATI Nurs285 Med Surg Exam Questions

Question 1 of 5

During assessment of a client on the respiratory unit, the pulse oximetry monitor indicates a drop of SpO2 from 98% to 87% over four hours in a client who previously had normal range oxygen saturation level. Which of the following actions should the nurse perform first?

Correct Answer: B

Rationale: Checking the pulse oximeter probe position ensures the reading's accuracy, as faulty placement can cause false lows. This step precedes oxygen administration or further assessment.

Question 2 of 5

A client is admitted to the emergency room with an asthma attack. To decrease the client's dyspnea and anxiety, which of the following interventions will the nurse perform?

Correct Answer: D

Rationale: Staying with the client and encouraging pursed-lip breathing reduces anxiety and improves ventilation, alleviating dyspnea during an asthma attack.

Question 3 of 5

A patient who is experiencing an acute asthma attack is admitted to the emergency department. Which assessment should the nurse complete first?

Correct Answer: C

Rationale: Assessing lung sounds first provides critical information about airway obstruction severity, guiding immediate interventions for an acute asthma attack.

Question 4 of 5

Postural drainage with percussion and vibration is ordered twice daily for a patient with chronic obstructive pulmonary disease (COPD). Which intervention should the nurse include in the plan of care?

Correct Answer: A

Rationale: Administering a bronchodilator before postural drainage opens airways, enhancing secretion clearance. Fluid restriction is inappropriate, deep breathing is secondary, and supine positioning is not ideal.

Question 5 of 5

A patient on prolonged bedrest following a pelvic fracture becomes dyspneic and confused. Pulse = 135 beats/minute, blood pressure = 90/50 mmHg, respirations = 36/minute, Oxygen saturation starts dropping rapidly. Which of the following conditions should the nurse prepare to treat for this patient?

Correct Answer: C

Rationale: The patient's symptoms (dyspnea, confusion, tachycardia, hypotension, and desaturation) after prolonged bedrest suggest pulmonary embolism, a life-threatening condition requiring urgent treatment.

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