ATI RN
ATI Detailed Answer Key Medical Surgical Questions
Question 1 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 2 of 5
A client developed fat embolism syndrome (FES) following a fracture. Which of the following laboratory findings should the nurse expect?
Correct Answer: A
Rationale: The correct answer is A: Decreased serum calcium level. In fat embolism syndrome (FES), fat globules enter the bloodstream and can cause hypocalcemia due to the formation of calcium soaps. This can lead to symptoms such as confusion and tetany. The other choices are incorrect because in FES, there is no direct impact on serum lipids or ESR. Platelet count may be normal or decreased due to the consumption of platelets in the process.
Question 3 of 5
A client is unconscious with a breathing pattern characterized by alternating periods of hyperventilation and apnea. The nurse should document that the client has which of the following respiratory alterations?
Correct Answer: C
Rationale: The correct answer is C: Cheyne-Stokes respirations. This breathing pattern is characterized by alternating periods of deep, rapid breathing (hyperventilation) followed by periods of apnea. This pattern is often seen in clients with neurological or cardiac conditions. Kussmaul respirations (A) are deep and rapid breathing associated with metabolic acidosis. Apneustic respirations (B) are characterized by prolonged inhalation and short, insufficient exhalation. Stridor (D) is a high-pitched, noisy breathing sound caused by obstructed air flow in the upper airway, not associated with the described breathing pattern.
Question 4 of 5
A nurse is teaching a client who is obese and has obstructive sleep apnea how to decrease the number of nightly apneic episodes. Which of the following client statements indicates an understanding of the teaching?
Correct Answer: D
Rationale: The correct answer is D because losing weight can help reduce the severity and frequency of obstructive sleep apnea. Excess weight can lead to fat deposits around the upper airway, causing obstruction during sleep. By losing weight, the airway may become less obstructed, reducing apneic episodes. Choice A is incorrect because sleeping on the back can actually worsen sleep apnea by causing the tongue and soft tissues to block the airway. Choice B is incorrect because sleeping pills can relax the muscles in the airway, making it more likely for an individual with sleep apnea to experience episodes of apnea. Choice C is incorrect because while a humidifier can alleviate some symptoms like dryness, it does not directly address the underlying cause of obstructive sleep apnea related to obesity.
Question 5 of 5
A client with a chest tube connected to a closed drainage system needs to be transported to the x-ray department. Which of the following actions should the nurse take?
Correct Answer: C
Rationale: The correct answer is C: Keep the drainage system below the level of the client's chest at all times. This is important to prevent backflow of air or fluid into the client's chest, which can lead to complications such as a pneumothorax or hemothorax. Gravity ensures that the drainage system functions properly and prevents any potential harm to the client. A: Clamping the chest tube prior to transferring the client is incorrect as it can cause a dangerous buildup of pressure in the chest. B: Disconnecting the chest tube from the drainage system can also lead to complications and disrupt the drainage process. D: Emptying the collection chamber is important but not the priority during transport; keeping the drainage system below the chest level is crucial for the client's safety.