ATI RN
ATI Detailed Answer Key Medical Surgical Questions
Question 1 of 5
During an assessment, a client with a long history of smoking and suspected laryngeal cancer will most likely report which early manifestation?
Correct Answer: B
Rationale: The correct answer is B: Hoarseness. Hoarseness is a common early manifestation of laryngeal cancer due to vocal cord involvement. Smoking is a major risk factor for laryngeal cancer. Dysphagia (choice A) is more commonly associated with esophageal cancer. Dyspnea (choice C) is usually a late manifestation of laryngeal cancer when it causes airway obstruction. Weight loss (choice D) may occur later in the disease progression but is not typically an early sign. Thus, hoarseness is the most likely early manifestation due to its direct connection to the vocal cords and smoking history.
Question 2 of 5
A client with chronic obstructive pulmonary disease (COPD tells the nurse, 'I can feel the congestion in my lungs, and I certainly cough a lot, but I can't seem to bring anything up.' Which of the following actions should the nurse take to help this client with tenacious bronchial secretions?
Correct Answer: D
Rationale: The correct answer is D: Encouraging the client to drink 2 to 3 L of water daily. Increased fluid intake helps to thin out bronchial secretions, making them easier to cough up. Step-by-step rationale: 1. Increased water intake promotes hydration, which thins mucus in the airways. 2. Thinner mucus is easier to expectorate, aiding in clearing airway congestion. 3. Adequate hydration also helps to prevent dehydration, which can further thicken secretions. Summary: A: Maintaining a semi-Fowler's position may help with breathing comfort but does not directly address the issue of thick secretions. B: Administering oxygen is important for COPD patients but does not specifically target bronchial secretions. C: Selecting a low-salt diet is beneficial for managing fluid retention but does not directly address the issue of tenacious bronchial secretions.
Question 3 of 5
A nurse is observing the closed chest drainage system of a client who is 24 hr post thoracotomy. The nurse notes slow, steady bubbling in the suction control chamber. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct answer is A: Check the tubing connections for leaks. 1. Slow, steady bubbling in the suction control chamber indicates an air leak in the system. 2. Checking the tubing connections for leaks is the appropriate action to identify and fix the issue. 3. This helps maintain the integrity of the closed chest drainage system and prevent complications. Other choices are incorrect: B: Checking the suction control outlet on the wall is not necessary as the issue is likely within the tubing system. C: Clamping the chest tube could lead to tension pneumothorax and is not recommended unless ordered by a physician. D: Continuing to monitor the client's respiratory status does not address the underlying problem of the air leak.
Question 4 of 5
A client is in the immediate postoperative period following a partial laryngectomy. Which of the following parameters should the nurse assess first?
Correct Answer: D
Rationale: The correct answer is D: Airway patency. Assessing airway patency is the priority in the immediate postoperative period following a laryngectomy to ensure the client's ability to breathe. If the airway is compromised, it can lead to life-threatening complications. Pain severity (A), wound drainage (B), and tissue integrity (C) are important assessments but are secondary to ensuring the client's airway is clear and functioning properly. Prioritizing airway patency allows for prompt intervention if any issues arise, ensuring the client's safety and optimal recovery.
Question 5 of 5
A client with a tracheostomy is being cared for by a nurse. The client's partner has been taught to perform suctioning. Which of the following actions by the partner should indicate to the nurse a readiness for the client's discharge?
Correct Answer: C
Rationale: The correct answer is C: Performing the procedure independently. This indicates readiness for discharge as it demonstrates the partner's ability to safely and effectively perform suctioning without direct supervision. Attending a class (A) and asking relevant questions (D) are important but do not necessarily indicate competence in performing the procedure. Verbally explaining the steps (B) shows understanding but does not confirm practical skill.