ATI RN
ATI Advanced Med Surg Exam 3 Questions
Extract:
Question 1 of 5
A nurse is caring for a client who has an acute respiratory failure (ARF). The nurse should monitor the client for which of the following manifestations of this condition? (Select all that apply.)
Correct Answer: A,C,D,E
Rationale: Hypotension, decreased consciousness, severe dyspnea, and headache are manifestations of ARF due to hypoxemia, hypercapnia, or acidosis.
Question 2 of 5
A patient admitted with urosepsis and alcohol abuse had three seconds of PVCS and returns to sinus tachycardia. The patient's baseline heart rate is 116/min with a temperature of 101.1F, respirations of 22/min and blood pressure is 114/64. What should the nurse anticipate to do first?
Correct Answer: D
Rationale: Assessing level of consciousness is the priority to detect neurological deterioration in urosepsis, guiding further interventions.
Extract:
Nurse's Notes
Client came to the ER for increase SOB worsening dyspnea and restlessness. Respiratory rate is currently 32/min with shallow breath BP 198/78 mm Hg. Oxygen has been increased from 2 L nasal cannula to 50% face mask with little improvement of oxygen saturation. Current oxygen saturation is 91% on 50% facemask. Arterial blood gases drawn and sent to lab.
Diagnostic Results
ABGS:
pH 7.25 (7.35 to 7.45)
pCO2 62 mm Hg (35 to 45 mm Hg)
HCO3-22 mEq/L (22 to 26 mEq/L)
Question 3 of 5
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.
Correct Answer:
Rationale:
Extract:
Question 4 of 5
A nurse is caring for a client who reports heart palpitations. An ECG confirms the client is experiencing ventricular tachycardia (VT). The nurse should anticipate the need for taking which of the following actions?
Correct Answer: A
Rationale: Elective cardioversion is appropriate for stable ventricular tachycardia with a pulse, as it synchronizes electrical shock to restore normal rhythm.
Question 5 of 5
A nurse is caring for a client in a critical care unit who suffered a knife wound to the chest. The nurse suspects the client is developing cardiac tamponade. Which of the following assessment findings should the nurse identify as supporting this suspicion?
Correct Answer: B
Rationale: Muffled heart sounds, part of Beck's triad, indicate fluid accumulation in the pericardial sac, supporting cardiac tamponade.