ATI RN
ATI SP 250 Exam 3 Med Surg Exam Questions
Extract:
Question 1 of 5
A nurse is caring for a client who has HIV. Which of the following laboratory values is the nurse's priority?
Correct Answer: D
Rationale: CD4-T-cell count 180 cells/mm3 is the nurse's priority.
Rationale: This is because a low CD4-T-cell count indicates a high risk of opportunistic infections and impaired immune function. The nurse should implement infection prevention measures and monitor the client for signs of infection. The other values are not as critical as the CD4-T-cell count.
Question 2 of 5
A nurse in a clinic sees a client who has an acute asthma exacerbation. Which of the following medications should reduce the symptoms?
Correct Answer: B
Rationale: This is because albuterol is a short-acting beta2 agonist that relaxes the smooth muscles of the airways and improves bronchodilation and airflow. Montelukast, budesonide, and cromolyn are long-term control medications that prevent inflammation and reduce the frequency of asthma attacks, but they do not provide immediate relief.
Extract:
Nurses' Notes
Vital Signs
Medication
Home health nurse admission note:
Client discharged from healthcare facility yesterday following a 4-day stay for exacerbation of COPD. Lives alone; alert and oriented to person, place, and time. Lung fields with scattered rhonchi throughout, cough productive for thick white sputum, dyspnea with minimal exertion.
Clubbing is noted on fingers, chest is barrel-shaped. Supplemental oxygen at 2L/min via nasal cannula.
Home Health Nurse Note 3 days following discharge from health care facility: Client sleeping in recliner with nasal canula on their lap; awakens easily and is oriented to person but disoriented to place and time.
Lung sounds with scattered rhonchi, cough productive for thick, yellow secretions. 2+pitting edema bilateral in ankles and feet.
Re-oriented client. Client states "I don't remember if I did that breathing machine thing you told me about."
Instructed client on oxygen use, safety, and nebulizer treatments. Elevated lower extremities.
Question 3 of 5
A nurse is caring for a client who has COPD. Select the 5 findings that require follow-up.
Correct Answer: A,C,D,E,F
Rationale: Disorientation may indicate hypoxia, infection, or medication side effects. Yellow sputum may indicate a bacterial infection that requires antibiotics. Nebulizer use may indicate that the client is not using it correctly or regularly as prescribed, which can affect their lung function and oxygenation. Ankle edema may indicate fluid overload or heart failure, which can worsen COPD symptoms and increase the risk of complications. Living alone may pose safety risks for the client, especially if they are disoriented or have difficulty managing their oxygen and nebulizer treatments.
Extract:
Question 4 of 5
A nurse is assessing a client who has systemic lupus erythematosus (SLE). Which of the following findings should the nurse expect?
Correct Answer: C
Rationale: This is because SLE is an autoimmune disorder that causes inflammation and damage to various tissues and organs, including the skin. A facial rash, also known as a malar rash or butterfly rash, is one of the characteristic signs of SLE and affects about half of people with the condition.
Question 5 of 5
A nurse on a medical-surgical unit is performing an admission assessment of a client who has COPD with emphysema. The client reports that he has a frequent productive cough and is short of breath. The nurse should anticipate which of the following assessment findings for this client?
Correct Answer: D
Rationale: This is because emphysema causes destruction of alveolar walls and loss of elastic recoil, which leads to air trapping and hyperinflation of the lungs. This results in a barrel-shaped chest and increased chest circumference.