ATI RN
ATI Nur285 Med Surg Fall Exam Questions
Extract:
Nurse's Notes: Day 1, 1530: Client appears restless. SaO2 92% on 40% humidified oxygen via tracheostomy collar. Lung fields with scattered rhonchi throughout. Tracheostomy suctioned for thin clear secretions. Day 1, 1545: Client appears less anxious. SaO2 98% on 40% humidified oxygen via tracheostomy collar. Breath sounds clear throughout. Day 3, 1530: Client appears restless. Buccal mucosa dusky. SaO2 88% on 40% humidified oxygen via tracheostomy collar. Lung fields with coarse crackles, diminished at right lower lobe. Tracheostomy suctioned for thick yellow secretions. Day 3, 1545: Client continues to appear restless. SaO2 94% on 40% humidified oxygen via tracheostomy collar. Breath sounds with intermittent crackles, diminished at right lower lobe. Vital Signs: Day 1, 1530: Temperature 36.9° C (98.5° F), Heart rate 100/min, Respiratory rate 22/min, Blood pressure 124/74 mm Hg, SaO2 92 % on 40% humidified oxygen. Day 3, 1530: Temperature 39.4° C (103° F), Heart rate 106/min, Respiratory rate 24/min, Blood pressure 128/76 mm Hg, SaO2 88% on 40% humidified oxygen. Diagnostic Results: Chest x-ray: right lower lobe opacity.
Question 1 of 5
A nurse is caring for a client who has a tracheostomy. Drag words from the choices below to fill in each blank in the following sentence. The client has manifestations of..... and....
Correct Answer: B,D
Rationale: Fever, decreased oxygen saturation, crackles, and chest x-ray opacity indicate pneumonia; low SaO2 and respiratory distress suggest hypoxia.
Extract:
Question 2 of 5
A patient has a nasogastric (NG) tube following esophagectomy. Following standards of practice, which of the following postoperative instructions should the nurse question the surgeon about?
Correct Answer: C
Rationale: A temperature under 100.5°F is not typically concerning post-surgery, so notifying the physician for this is unnecessary.
Question 3 of 5
A nurse is implementing a plan of care for a client who has AIDS with recurring pneumonia. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: Obtaining a sputum culture is a priority to identify the specific pathogen causing the pneumonia and guide antibiotic treatment, especially in an immunocompromised client with AIDS.
Question 4 of 5
A 36-year-old patient with suspected gastrointestinal (GI) bleeding undergoes a diagnostic endoscopy which determines the site of bleeding is a duodenal ulcer. The nurse explains to the patient that bleeding ulcers are commonly related to which of the following:
Correct Answer: D
Rationale: NSAIDs inhibit prostaglandin production, which protects the mucosal lining, leading to ulcer formation and bleeding risk.
Question 5 of 5
A client is admitted to the nursing unit with a diagnosis of gastric ulcer. Which assessment finding by the nurse supports the client's diagnosis of gastric ulcer?
Correct Answer: D
Rationale: Epigastric pain that worsens with eating is a hallmark symptom of a gastric ulcer, aggravated by increased acid during digestion.