ATI RN
ATI Advanced Med Surg Final Exam 0924 Questions
Extract:
Question 1 of 5
A nurse is performing pulmonary hygiene for a client who has pneumonia and positions the client on his left side in Trendelenburg position. From which of the following lung segments should the nurse expect secretions to be mobilized with this position?
Correct Answer: A
Rationale: Placing the client on the left side in Trendelenburg position promotes drainage from the right lower lobe's lateral segment by using gravity to mobilize secretions.
Question 2 of 5
A nurse is assessing a client who has ataxia. Which of the following actions should the nurse take to evaluate the client's ability to safely ambulate?
Correct Answer: B
Rationale: Performing a Romberg's test evaluates balance and proprioception, which is important for assessing the ability to ambulate safely in a person with ataxia.
Extract:
Medical History
Day 1:
Patient came from ER complaining of chest pain. CPR initiated in ER and return to ROSC after 3 minutes. Intubated in ER (ACVC FIO2 100% Mode; RR13; PEEP 3: Tidal Volume 300ml and transferred to ICU for further care.
Nurses' Notes
Day 1:
S/p intubation, patient was given rocuronium, fentanyl and versed per radiology. Patient currently sedated. Lung crackles and bronchi. Heart regular and moderate. Pulses +1 on all extremities with +2 pitting edema. Hypoactive bowel sounds.
Diagnostic Results
Day 1:
Chest x-ray shows bilateral basilar infiltration
CBC
WBC 7.8
HGB13
K+3.9
Creatinine 2.0
BUN 60
GFR 38
BNP 1800
Troponin 1.7
ABG (Before intubation): pH7.2 CO2 76 HCO3 18
Vital Signs
Day 1
IN ER before cardiac arrest: Temperature 37.6° C (99.7° F)
Blood pressure 174/86 mm Hg
Heart rate 98/min
Respiratory rate 27/min
Pulse oximetry 93% on room air
After Intubation:
Temp 100.0F
Blood Pressure 87/40
HR 125/min. Sinus Tachycardia
RR: 13
Pulse Ox 100%
Question 3 of 5
For each potential nursing action, click to specify if the action is essential, nonessential, or contraindicated for the client.
| Options | Essential | Nonessential | Contraindicated |
|---|---|---|---|
| Administer furosemide | |||
| Administer ordered Epinephrine drip | |||
| Administer ordered low dose dopamine | |||
| Insert an indwelling urinary catheter | |||
| Administer ordered nitroglycerin | |||
| Administed 0.9% NS 500ML bolus |
Correct Answer: A,B,C,D,F
Rationale: Furosemide, epinephrine, dopamine, urinary catheter, and NS bolus are essential for managing pulmonary edema, hypotension, and monitoring fluid balance. Nitroglycerin is nonessential unless indicated for ongoing angina.
Extract:
Question 4 of 5
A nurse is preparing a client who is scheduled to undergo a paracentesis. Into which of the following positions should the nurse assist the client for this procedure?
Correct Answer: C
Rationale: High-Fowler's position helps pool the ascitic fluid in the lower abdomen, making it easier to access and drain during the procedure.
Question 5 of 5
A nurse is caring for a client who has an unrepaired femur fracture of the midshaft. Which of the following techniques should the nurse use when performing an assessment of the client's neurovascular status?
Correct Answer: C
Rationale: Instructing the client to wiggle his toes assesses motor function and circulation to the distal extremities, which are crucial for neurovascular status.