ATI RN
Medical Surgical Nursing Practice Questions Questions
Question 1 of 5
During an asthma attack, a healthcare provider is assessing a client for hypoxemia. Which of the following manifestations should the provider expect?
Correct Answer: C
Rationale: The correct answer is C: Agitation. During an asthma attack, hypoxemia can lead to increased respiratory effort and decreased oxygen delivery to tissues, causing agitation. Nausea (A) is not a typical manifestation of hypoxemia in asthma. Dysphagia (B) refers to difficulty swallowing and is not directly related to hypoxemia. Hypotension (D) is unlikely in asthma as it is more commonly associated with shock or severe systemic conditions.
Question 2 of 5
A client had an evacuation of a subdural hematoma. Which of the following actions should the nurse take first?
Correct Answer: C
Rationale: Step 1: Checking the oximeter is essential to assess the client's oxygen saturation levels immediately post-procedure. Step 2: Hypoxia can lead to serious complications, impacting the client's neurological status. Step 3: The nurse must prioritize oxygenation status to prevent further brain injury or hypoxemia. Step 4: Observing for CSF leaks, assessing temperature, and monitoring ICP are important but not as immediate as ensuring adequate oxygen supply. Summary: Option C is correct as it addresses the most critical and immediate concern post-procedure, ensuring optimal oxygenation for the client's neurological recovery. Options A, B, and D are important but secondary to maintaining oxygen levels.
Question 3 of 5
A client has a disposable three-chamber chest tube in place. Which of the following findings should indicate to the nurse that the client is experiencing a complication?
Correct Answer: A
Rationale: Correct Answer: A Rationale: 1. Continuous bubbling in the water-seal chamber indicates air leaks, which can lead to pneumothorax. 2. Occasional bubbling in the water-seal chamber is normal as air exits the pleural space. 3. Constant bubbling in the suction-control chamber indicates high suction pressure, not a complication. 4. Fluctuations in the fluid level in the water-seal chamber are expected during normal respiration.
Question 4 of 5
A nurse is assessing a client for a suspected anaphylactic reaction following a CT scan with contrast media. For which of the following client findings should the nurse intervene first?
Correct Answer: B
Rationale: The correct answer is B: Stridor. Stridor is a high-pitched, inspiratory sound that indicates upper airway obstruction and impending respiratory distress, which is a life-threatening complication of anaphylaxis. The nurse should intervene first by ensuring a patent airway to prevent respiratory compromise. Urticaria (A) is a common symptom of an allergic reaction but does not pose an immediate threat to airway patency. Vomiting (C) can be a sign of gastrointestinal distress but does not require immediate intervention for airway protection. Hypotension (D) is a serious manifestation of anaphylaxis but addressing airway obstruction takes precedence to prevent respiratory failure.
Question 5 of 5
A nurse is caring for a client who is postoperative following surgical repair of a mandibular fracture with fixed occlusion of the jaws in a closed position. Which of the following statements is the priority for the nurse to make?
Correct Answer: B
Rationale: The correct answer is B: "Keep wire cutters with you at all times." This is the priority statement because in the event of an emergency, such as airway obstruction or trauma, quick access to wire cutters is crucial to ensure timely removal of the jaw fixation wires. Without immediate access to wire cutters, the client may suffer serious complications. Incorrect choices: A: "We can teach you some relaxation techniques to minimize your pain." - While pain management is important, it is not the priority in this situation where the immediate risk is airway compromise. C: "Use a water pick device to keep your teeth clean." - Oral hygiene is important but not as critical as ensuring access to wire cutters for emergency situations. D: "Consume a high-protein, liquid diet." - Nutrition is important for healing but is not as time-sensitive as having wire cutters readily available in case of an emergency.