Questions 49

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ATI SP 250 Exam 3 Med Surg Exam Questions

Extract:


Question 1 of 5

A nurse is providing dietary teaching for a client who has chronic obstructive pulmonary disease. Which of the following instructions should the nurse include?

Correct Answer: B

Rationale: Using a bronchodilator 1 hour before eating can improve breathing and oxygenation, making it easier for the client to eat. The nurse should also advise the client to drink fluids between meals, eat small frequent meals, and increase protein intake to maintain muscle mass and immune function.

Question 2 of 5

A nurse is assessing a client who has asthma. Which of the following areas should the nurse evaluate as the most reliable indicator of central cyanosis?

Correct Answer: C

Rationale: This is because central cyanosis reflects a decrease in arterial oxygen saturation and is best seen in areas where blood vessels are close to the surface, such as the oral mucosa, tongue, and lips. Peripheral cyanosis, which may be caused by vasoconstriction or poor circulation, can be seen in the soles of the feet, ear lobes, and nail beds, but it does not necessarily indicate hypoxemia.

Question 3 of 5

A nurse is admitting a client who has sustained severe burn injuries in a grease fire. The nurse shades in a diagram indicating the burned surface areas. Using the Rule of Nines, the nurse should estimate that the client has burned what percentage of body surface area? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer: 31.5

Rationale: The anterior chest wall and abdomen accounts for 18%, the left upper limb 9% (4.5% anteriorly and 4.5% posteriorly), and the right upper limb 4.5% (2.25% anteriorly and 2.25% posteriorly). (18+9+4.5) = 31.5%.

Question 4 of 5

A nurse is developing a plan of care for a client who is rehabilitating from major burns. Which of the following interventions should the nurse include to provide emotional support?

Correct Answer: C

Rationale: This is because talking with the client can help reduce anxiety, pain, and isolation, as well as build trust and rapport between the nurse and the client. Talking with the client can also provide an opportunity for education, feedback, and encouragement.

Question 5 of 5

A nurse is caring for a client who has HIV. Which of the following laboratory values is the nurse's priority?

Correct Answer: D

Rationale: CD4-T-cell count 180 cells/mm3 is the nurse's priority.
Rationale: This is because a low CD4-T-cell count indicates a high risk of opportunistic infections and impaired immune function. The nurse should implement infection prevention measures and monitor the client for signs of infection. The other values are not as critical as the CD4-T-cell count.

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