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ATI n300 Med Surg Exam Questions

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Question 1 of 5

A client with hypovolemic shock who did not respond to fluid resuscitation is started on norepinephrine. What is the desired outcome?

Correct Answer: C

Rationale: A MAP of at least 65 mmHg ensures adequate perfusion of vital organs, the primary goal of norepinephrine therapy.

Question 2 of 5

The nurse is caring for an adult with a burn injury. The following parts of the patient's body were burned: anterior and posterior right arm, posterior trunk. and posterior right leg. Using the Rule of Nines, calculate the Total Body Surface Area (TBSA) percentage that is involved.

Correct Answer: C

Rationale: Using the Rule of Nines: Entire right arm (9%) + Posterior trunk (18%) + Posterior right leg (9%) = 36% TBSA.

Question 3 of 5

The nurse is caring for an elderly client with type II diabetes who has had nausea, vomiting and diarrhea for several days and who now is disoriented and listless. Initial vital signs: B/P 72/62, pulse 146 irregular and thready, respirations 38 breaths per minute and shallow, and temperature of 97.0 F rectally. The skin is cool and clammy. The nurse recognizes that this client's symptoms are most indicative of which stage and type of shock? The:

Correct Answer: C

Rationale: The client shows signs of hypovolemic shock from fluid loss, with progressive stage indicated by hypotension, tachycardia, and altered mental status.

Question 4 of 5

The nurse is caring for a patient with major burns Total Body Surface Area (TBSA) of 63%. The nurse understands that this patient is at the highest risk for the combination of which types of shock? (Select All that Apply.)

Correct Answer: A,D

Rationale: Severe burns cause hypovolemic shock from fluid loss and distributive shock from systemic inflammatory response syndrome (SIRS).

Question 5 of 5

The nurse is caring for a client, with no other pertinent medical history, who was burned over 70% Total Body Surface Area (TBSA) and weighs 70kg. Using the Parkland Formula, calculate the amount of intravenous fluid required in the first 8 hours after the burn.

Correct Answer: B

Rationale: Using the Parkland Formula:
Total fluid requirement = 4 × 70 kg × 70% TBSA = 19,600 mL (total for 24 hours). Fluids in first 8 hours = 19,600 mL ÷ 2 = 9,800 mL.

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