Questions 60

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ATI Advanced Med Surg Exam 3 Questions

Extract:


Question 1 of 5

A patient admitted with urosepsis and alcohol abuse had three seconds of PVCS and returns to sinus tachycardia. The patient's baseline heart rate is 116/min with a temperature of 101.1F, respirations of 22/min and blood pressure is 114/64. What should the nurse anticipate to do first?

Correct Answer: D

Rationale: Assessing level of consciousness is the priority to detect neurological deterioration in urosepsis, guiding further interventions.

Question 2 of 5

A nurse is caring for a client with a ventricular pacemaker who is on ECG monitoring. The nurse understands that the pacemaker is functioning properly when which of the following appears on the monitor strip?

Correct Answer: A

Rationale: Pacemaker spikes before each QRS complex indicate proper ventricular pacing, stimulating ventricular depolarization.

Question 3 of 5

The nurse is caring for a patient receiving a continuous norepinephrine IV infusion. Which finding indicates that the infusion rate may need to be adjusted?

Correct Answer: C

Rationale: A MAP of 56 mm Hg indicates inadequate perfusion, suggesting the norepinephrine dose may need adjustment to maintain adequate blood pressure.

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: D

Rationale: Regular oral hygiene with a suction toothbrush reduces bacterial load, decreasing the risk of ventilator-associated pneumonia.

Question 5 of 5

Norepinephrine has been prescribed for a patient who was admitted with dehydration and hypotension. Which data indicate that the nurse should consult with the health care provider before starting the norepinephrine?

Correct Answer: A

Rationale: Low central venous pressure indicates hypovolemia, requiring fluid resuscitation before vasopressors like norepinephrine to prevent worsening hypotension.

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