ATI RN
Medical Surgical Nursing Practice Questions Questions
Question 1 of 5
A healthcare professional is monitoring a client following a thoracentesis. The healthcare professional should identify which of the following manifestations as a complication and contact the provider immediately?
Correct Answer: C
Rationale: The correct answer is C, increased heart rate, as it indicates a potential complication such as hemorrhage or pneumothorax post-thoracentesis. An increased heart rate can signify hypovolemia or respiratory distress, requiring immediate provider notification. Serosanguineous drainage (A) is expected initially, discomfort (B) is common, and decreased temperature (D) is not typically a complication post-thoracentesis.
Question 2 of 5
A client has a chest tube in place connected to a closed chest drainage system. Which of the following findings should indicate to the nurse that the client's lung has re-expanded?
Correct Answer: B
Rationale: The correct answer is B: No fluctuations in the water seal chamber. This finding indicates that the lung has re-expanded because it means there is no air leaking from the lung into the pleural space, causing fluctuations in the water seal chamber. Option A, oxygen saturation of 95%, is not directly related to lung re-expansion. Option C, no reports of pleuritic chest pain, is a subjective symptom and does not provide a direct indication of lung re-expansion. Option D, occasional bubbling in the water-seal chamber, indicates air is escaping from the lung into the pleural space, suggesting incomplete lung re-expansion.
Question 3 of 5
A client has a chest tube in place connected to wall suction due to a right-sided pneumothorax. The client complains of chest burning. Which of the following actions should be taken?
Correct Answer: D
Rationale: The correct answer is D: Reposition the client. This action should be taken because chest burning could indicate that the chest tube is irritating the pleura. Repositioning the client may help alleviate the pressure on the pleura, reducing discomfort. Increasing wall suction (A) could worsen the irritation. Stripping the chest tube (B) is outdated and can cause damage. Clamping the chest tube (C) can lead to tension pneumothorax.
Question 4 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 5 of 5
Prior to performing percussion, vibration, and postural drainage on an adolescent client with pneumonia, which of the following nursing actions should the nurse complete first?
Correct Answer: A
Rationale: The correct answer is A: Auscultate lung fields. Before performing percussion, vibration, and postural drainage on a client with pneumonia, it is essential to assess the current condition of the lungs through auscultation. This step provides valuable information about the areas of congestion, lung sounds, and overall respiratory status. By auscultating first, the nurse can determine the appropriate areas to target and assess the effectiveness of the interventions. Assessing pulse and respirations (B) is important but does not directly guide the specific interventions needed for pneumonia. Assessing the characteristics of the sputum (C) is relevant but not as crucial as directly assessing the lung fields. Instructing the client to exhale with pursed lips (D) is not a priority before assessing the lung fields.