ATI RN
ATI Nur285 Med Surg Fall Exam Questions
Extract:
Question 1 of 5
A nurse is preparing an adolescent client who has pneumonia for percussion, vibration, and postural drainage. Prior to the procedure, which of the following nursing actions should the nurse complete first?
Correct Answer: B
Rationale: Assessing pulse and respirations is the first step in ensuring the patient's baseline respiratory status is stable before performing respiratory therapies. This allows the nurse to detect any signs of distress or abnormal respiratory patterns, which could indicate the need for further intervention before the procedure.
Question 2 of 5
A nurse is assessing a client who has peptic ulcer disease. Which of the following findings should the nurse identify as the priority?
Correct Answer: B
Rationale: Hematemesis indicates active bleeding, which is life-threatening and requires immediate intervention to prevent hypovolemic shock or other complications.
Question 3 of 5
A nurse is caring for a client in the primary care office who has a recent diagnosis of a hiatal hernia. Which of the following new information will be beneficial for the nurse to relay to the client?
Correct Answer: A
Rationale: A hiatal hernia can increase the risk of GERD by causing the lower esophageal sphincter to malfunction, leading to acid reflux into the esophagus.
Question 4 of 5
A nurse is caring for a client who has an endotracheal tube and is receiving mechanical ventilation. Which of the following actions should the nurse take to reduce the risk of ventilator-associated pneumonia?
Correct Answer: A
Rationale: Brushing the client's teeth with a suction toothbrush every 12 hours is a key intervention to reduce the risk of ventilator-associated pneumonia (VAP). Oral hygiene helps to decrease the accumulation of bacteria in the mouth, which could potentially be aspirated into the lungs and cause infection.
Question 5 of 5
A nurse is teaching a client who has a hiatal hernia about dietary recommendations. Which of the following client statements indicates an understanding of the teaching? (Select all that apply.)
Correct Answer: A,B,D
Rationale: Maintaining a healthy weight, elevating the head of the bed, and avoiding caffeine and spicy foods reduce pressure and irritation, helping manage hiatal hernia symptoms.