ATI Med Surg Custom N235 Final Summer 2023 | Nurselytic

Questions 70

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ATI Med Surg Custom N235 Final Summer 2023 Questions

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Question 1 of 5

A nurse is caring for a female client in the emergency department who reports shortness of breath and pain in the lung area. She states that she started taking birth control pills 3 weeks ago and that she smokes. Her heart rate is 110/min, respiratory rate 40/min, and blood pressure 140/80 mm Hg. Her arterial blood gases are pH 7.50, PaCO2 29 mm Hg, PaO2 60 mm Hg, HCO3 20 mEq/L, and SaO2 86%. Which of the following is the priority nursing intervention?

Correct Answer: B

Rationale: Low PaO2 (60 mm Hg) and SaO2 (86%) indicate hypoxemia; oxygen administration is the priority.

Question 2 of 5

A nurse in an emergency department is caring for an adult client who has burns on the front and back of both his legs and arms. Using the rule of nines, the nurse should document burns to which percentage of the client's total body surface area (TBSA)?

Correct Answer: A

Rationale: Rule of nines: each arm (18%) + each leg (18%) = 9% × 4 (front and back) = 54% TBSA.

Question 3 of 5

A nurse in the ICU is caring for a client who has heart failure and is receiving a dobutamine drip. The nurse should identify that which of the following findings indicates that the medication is effective?

Correct Answer: A

Rationale: Dobutamine improves cardiac output, leading to increased urine output in heart failure.

Question 4 of 5

A nurse is reviewing the laboratory values of a client who has respiratory acidosis. Which of the following findings should the nurse expect?

Correct Answer: A

Rationale: Elevated PaCO2 (50 mm Hg) is expected in respiratory acidosis due to CO2 retention.

Question 5 of 5

A nurse in the emergency department is caring for a client who has sustained a head injury. The nurse notes the client's IV fluids are infusing at 125 mL/hr. Which of the following is an appropriate action by the nurse?

Correct Answer: C

Rationale: In head injury, rapid fluid infusion (125 mL/hr) can worsen ICP; slowing to 20 mL/hr is safer.

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