ATI RN
ATI nur 211 Med Surg Final Assessment 2025 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: Tracheal deviation indicates tension pneumothorax, a life-threatening emergency requiring immediate notification.
Question 2 of 5
A nurse is caring for a client who has thrombophlebitis and is receiving a continuous heparin infusion. Which of the following medications should the nurse have available to reverse heparin's effects?
Correct Answer: A
Rationale: Protamine sulfate is the antidote for heparin, neutralizing its anticoagulant effects.
Question 3 of 5
A nurse is caring for a client who is receiving radiation therapy to treat lung cancer. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: Xerostomia is a common side effect of radiation to the chest, requiring monitoring to manage oral complications.
Question 4 of 5
A nurse is observing the closed chest drainage system of a client who is 24 hr post thoracotomy. The nurse notes slow, steady bubbling in the suction control chamber. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: Slow, steady bubbling in the suction control chamber is expected, indicating proper function of the drainage system. Clamping the tube or checking for leaks is unnecessary unless there are signs of malfunction.
Question 5 of 5
A nurse is analyzing a client's electrocardiogram (ECG) strip and identifies the following information: Heart rate: 92/min, Rhythm: Irregular, P wave: Unable to identify, PR interval: Unable to measure, QRS duration: 0.10 seconds. Based upon this information, the nurse should interpret the client's rhythm as indicating which of the following?
Correct Answer: B
Rationale: Irregular rhythm, absent P waves, and unmeasurable PR interval are characteristic of atrial fibrillation.