ATI RN
ATI RN Custom Cardiovascular Med Surg Questions
Extract:
Nurses' Notes.
Day 1: Vital Signs.
Bilateral breath sounds clear and present throughout.
Weight 80 kg (176 lb). Urine output 480 mL/8 hr. Day 4: Breath sounds scattered, crackles heard bilaterally.
Apical heart rate rapid and irregular.
Audible S3 gallop.
Weight 82.1 kg (181 lb). Urine output 320 mL/8 hr. Vital Signs.
Day 1: Temperature 37.6° C (99.7° F). Blood pressure 108/50 mm Hg. Pulse 98/min.
Respiratory rate 20/min.
Pulse oximetry 95% on room air.
Day 4: Temperature 36.8° C (98.2° F). Blood pressure 138/80 mm Hg. Pulse 112/min.
Respiratory rate 28/min.
Pulse oximetry 88% on room air.
Question 1 of 5
A nurse is reviewing the assessment findings for the client on day 4. Which of the following findings requires further action?
Correct Answer: Decreased oxygen saturation, increased blood pressure, weight gain, and bilateral crackles indicate worsening heart failure requiring further action. Temperature is normal, and urine output is adequate.
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Question 2 of 5
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Question 3 of 5
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Question 4 of 5
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Question 5 of 5
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