ATI RN
Medical Surgical Nursing Practice Questions Questions
Question 1 of 9
The trauma unit nurse has received a report on a client who has multiple injuries following a motor vehicle crash. Which of the following actions should the nurse plan to take first?
Correct Answer: A
Rationale: The correct answer is A: Evaluate chest expansion. This is the priority action because it assesses the client's airway and breathing, which are critical for survival. Checking chest expansion helps to identify any potential respiratory compromise or underlying lung injuries. Assessing pupillary response (B) and capillary refill (C) are important, but they are secondary to ensuring adequate oxygenation. Checking the client's orientation to place and time (D) is important for neurological assessment but is not as critical as assessing airway and breathing in this scenario.
Question 2 of 9
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 3 of 9
List in order the nociceptive processes that occur to communicate tissue damage to the CNS. No. 1 is the first process and No. 4 is the last process.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 4 of 9
Joan has osteoporosis. She has an increased risk for
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 5 of 9
A client has a newly inserted chest drainage system with a water seal. Which of the following actions should be taken?
Correct Answer: B
Rationale: The correct answer is B: Keep the collection device below the level of the client's chest. This is important to ensure proper drainage and prevent backflow or air from entering the pleural space. Placing the collection device below the chest allows gravity to assist in drainage. Clamping the tube while ambulating (choice A) can lead to increased pressure in the chest, risking complications. Coiling the tubes (choice C) may cause kinks, obstructing drainage. Positioning the client flat (choice D) can lead to leaks in the tubing due to elevated pressure.
Question 6 of 9
Rewrite each of the following questions asked by the nurse so that it is an open-ended question designed to gather information about the patient’s functional health patterns.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 7 of 9
Identify one example of how each of the following cultural factors may affect the nursing care of a patient of a different culture and one example of the functioning of a health care team made up of individuals from different cultures.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 8 of 9
A 72-year-old female client is lifted to the surgery table in preparation for a total knee replacement. The client is in stage III of inhalation anesthesia. An appropriate nursing action for this client is:
Correct Answer: B
Rationale: Preventing injury by restraining the client, if necessary, is a nursing action of stage II, which extends from loss of consciousness to relaxation. Stage III extends from the loss of lid reflex to cessation of voluntary respirations. Operative procedures are performed during stage III of inhalation anesthesia. Promoting restoration of ventilation and vasomotor tone is a nursing action for stage IV in which an overdose has occurred. Respiratory arrest and vasomotor collapse result from medullary paralysis. Reduction of external stimuli is a nursing action for stage I, which extends from induction to loss of consciousness.
Question 9 of 9
What should be included in Mr. Dean’s teaching plan for respiratory isolation?
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.