ATI RN
ATI Med Surg Custom N235 Final Summer 2023 Questions
Extract:
Question 1 of 5
A nurse is observing the closed chest drainage system of a client who is 24 hr post thoracotomy. The nurse notes slow, steady bubbling in the suction control chamber. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: Slow, steady bubbling in the suction control chamber is normal; monitoring is appropriate.
Question 2 of 5
A nurse is caring for a client who has just developed a pulmonary embolism. Which of the following medications should the nurse anticipate administering?
Correct Answer: B
Rationale: Heparin is the anticoagulant of choice to prevent further clot formation in pulmonary embolism.
Question 3 of 5
A nurse in the emergency department is caring for a client following an automobile crash in which the client was unrestrained and thrown from the vehicle. When assessing the client, the nurse observes clear fluid draining from the client's nose. Which of the following interventions should the nurse take?
Correct Answer: A
Rationale: Clear nasal drainage may be CSF; allowing it to drip onto gauze avoids contamination.
Question 4 of 5
A nurse working for a home health agency is assessing an older adult male client. Which of the following findings is the priority for the nurse to address?
Correct Answer: B
Rationale: Dysphagia poses an immediate risk of aspiration and airway compromise, making it the priority.
Question 5 of 5
A nurse in a critical care unit is caring for a client 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: D
Rationale: Muffled heart sounds are a classic sign of cardiac tamponade due to pericardial fluid accumulation.