ATI RN
ATI Med Surg Custom N235 Final Summer 2023 Questions
Extract:
Question 1 of 5
A nurse is caring for a client who is receiving positive-pressure mechanical ventilation. Which of the following interventions should the nurse implement to prevent complications? (Select all that apply.)
Correct Answer: A,C,E
Rationale: Verifying settings prevents errors, pantoprazole prevents ulcers, and elevating the head reduces aspiration risk.
Question 2 of 5
A nurse in an emergency department is preparing to care for a client who is being brought in with multiple system trauma following a motor vehicle crash. Which of the following should the nurse identify as the priority focus of care?
Correct Answer: B
Rationale: In trauma situations, the priority is to ensure a patent airway (airway protection) as per the ABCs (Airway, Breathing, Circulation) of emergency care, since oxygenation is critical for survival.
Question 3 of 5
A nurse is assessing a client in the oliguric phase of acute kidney injury. Which of the following findings should the nurse expect?
Correct Answer: B
Rationale: Hyperkalemia is expected in the oliguric phase of AKI due to reduced potassium excretion.
Question 4 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 5 of 5
A nurse in an emergency department is caring for a client who had a seizure and became unresponsive after stating she had a sudden, severe headache and vomiting. The client's vital signs are as follows: blood pressure of 198/110 mm Hg, pulse of 82/min, respirations of 24/min, and a temperature of 38.2°C (100.8°F). Which of the following neurologic disorders should the nurse suspect?
Correct Answer: D
Rationale: Sudden headache, seizure, and hypertension suggest a hemorrhagic stroke, likely from a ruptured vessel.