ATI RN
ATI Nurs285 Med Surg Exam Questions
Extract:
Question 1 of 5
A nurse is assessing a client who has a pneumothorax with a chest tube in place. For which of the following findings should the nurse notify the provider?
Correct Answer: D
Rationale: Movement of the trachea toward the unaffected side indicates tension pneumothorax, a life-threatening condition requiring immediate provider notification and intervention.
Question 2 of 5
A client had a right-sided chest tube inserted two hours ago for pneumothorax. Which action should the nurse implement if there is no fluctuation in the water seal compartment?
Correct Answer: A
Rationale: Lack of fluctuation in the water seal compartment may indicate kinks, obstructions, or lung re-expansion. The nurse should first check the chest tube system for issues before escalating or adjusting suction.
Question 3 of 5
The nurse is caring for a client diagnosed with end-stage chronic obstructive pulmonary disease (COPD). Which of the following data warrants immediate intervention by the nurse?
Correct Answer: C
Rationale: A respiratory rate of 28 breaths per minute indicates tachypnea and potential respiratory distress, requiring immediate assessment. Other findings are common or acceptable in end-stage COPD.
Question 4 of 5
A nurse is caring for a client who has just developed a pulmonary embolism. Which of the following medications should the nurse anticipate administering?
Correct Answer: B
Rationale: Heparin, an anticoagulant, is administered to prevent further clot formation in pulmonary embolism, stabilizing the patient.
Question 5 of 5
A patient on prolonged bedrest following a pelvic fracture becomes dyspneic and confused. Pulse = 135 beats/minute, blood pressure = 90/50 mmHg, respirations = 36/minute, Oxygen saturation starts dropping rapidly. Which of the following conditions should the nurse prepare to treat for this patient?
Correct Answer: C
Rationale: The patient's symptoms (dyspnea, confusion, tachycardia, hypotension, and desaturation) after prolonged bedrest suggest pulmonary embolism, a life-threatening condition requiring urgent treatment.