ATI RN
ATI Med Surg Final Exam Nsg 232 Questions
Extract:
Question 1 of 5
A nurse is caring for a client with a chest tube in place for treatment of a hemothorax. The nurse should prioritize which nursing intervention when caring for this client?
Correct Answer: D
Rationale: Coughing and deep breathing exercises promote lung expansion and prevent atelectasis, critical for recovery from hemothorax.
Extract:
Nurses' Notes
Client admitted to medical-surgical floor from the emergency department (ED). Client has a history of HIV, first diagnosed 15 years ago, that has recently progressed to AIDS. Client presents with headache, diarrhea, night sweats, and weight loss for approximately 1 week.
Vital signs
Day 1:
Temperature: 37.3° C (99.1° F) Heart rate: 98/min
Respiratory rate: 16/min BP: 104/74 mm Hg
Oxygen saturation: 96% on room air Day 2:
Temperature 38.4 C (101.1 F) Heart rate 100/min Respiratory rate 18/min
BP 98/54 mm Hg
Oxygen saturation 95% on room air
A nurse is caring for a client who has AIDS.
Diagnostic Results
Day 1:
WBC count 3.500/mm3 (5,000-10,000 mm3)
Hemoglobin 16 g/dL (12 to 18 g/dL)
Hematocrit 48% (37% to 52%)
Potassium 3.7 mEq/L (3.5 to 5 mEq/L)
Sodium 141 mEq/L (136 to 145 mEq/L)
CD4 t-cell count 200 mm3 (800 to 1,000 mm3)
Day 2
WBC count 3,100/mm3 (5,000 to 10,000 mm3)
Hemoglobin 17 g/dL (12 to 18 g/dL)
Hematocrit 51% (37% to 52%)
Potassium 3.9 mEq/L (3.5 to 5 mEq/L)
Question 2 of 5
A nurse is caring for a client who has AIDS. The client is at highest risk for developing due to their
Correct Answer: B, D
Rationale: A CD4 T-cell count below 200/mm3 increases the risk of opportunistic infections like Pneumocystis pneumonia.
Extract:
Question 3 of 5
A nurse suspects impending respiratory failure in a client diagnosed with chronic obstructive pulmonary disease (COPD). The nurse should recognize that which assessment finding supports the presence of hypoxemia?
Correct Answer: C
Rationale: A pulse oximetry reading of 90% indicates hypoxemia, particularly significant in COPD patients with compromised respiratory function.
Question 4 of 5
The nurse is providing care to a client who sustained burns to 70% of the body 6 hours ago. Which of the following new assessment data requires the nurse to notify the healthcare provider?
Correct Answer: B
Rationale: Hypotension (96/50 mm Hg) indicates potential shock or inadequate perfusion, requiring immediate provider notification.
Question 5 of 5
A nurse is caring for a client diagnosed with advanced COPD. The nurse should anticipate which assessment findings when caring for clients with advanced COPD? (Select all that apply.)
Correct Answer: B,C,E
Rationale: Pursed-lip breathing, clubbing of fingers, and dyspnea at rest are characteristic of advanced COPD. Elevated temperature and concave chest are not typical.