ATI RN
ATI Med Surg Custom N235 Final Summer 2023 Questions
Extract:
Question 1 of 5
A nurse is caring for a client who has a disposable three-chamber chest tube in place. Which of the following findings should indicate to the nurse that the client is experiencing a complication?
Correct Answer: A
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak, a potential complication.
Question 2 of 5
A nurse is assessing a client's cranial nerves as part of a neurological examination. Which of the following actions should the nurse take to assess cranial nerve III?
Correct Answer: D
Rationale: Cranial nerve III (oculomotor) controls pupil constriction, so checking pupillary response to light assesses its function.
Question 3 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 to the unaffected side indicates tension pneumothorax, a medical emergency.
Question 4 of 5
A nurse in the emergency department is caring for a client who was injured in a motor-vehicle crash. The client reports dyspnea and severe pain. The nurse notes that the client's chest moves inward during inspiration and bulges out during expiration. The nurse should identify this finding as which of the following?
Correct Answer: C
Rationale: Paradoxical chest movement (inward on inspiration, outward on expiration) is characteristic of flail chest.
Question 5 of 5
A nurse is caring for a client who has increased intracranial pressure. Which of the following interventions should the nurse take?
Correct Answer: D
Rationale: Elevating the head (typically 30°, but 20° here) reduces ICP by aiding venous drainage.