ATI n232 Med Surg Exam | Nurselytic

Questions 49

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ATI n232 Med Surg Exam Questions

Extract:

Physical Examination
Nurses Notes
Vital Signs
Diagnostic Results
0800:
Lung sounds diminished in the bases bilateral, no adventitious sounds noted
Bowel sounds active x 4 quadrants, abdomen soft
Capillary refill less than 2 seconds
Skin dry and intact, 1+ edema noted to legs bilaterally


Question 1 of 5

Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.

Check the drainage system and tubing
Assess for subcutaneous emphysema
Obtain blood cultures
Administer prescribed blood products
Observe surgical dressing
Choices A. Bleeding B. Pulmonary edema C. Pneumonia D. Airleak
Parameter to Monitor:A. Client's ability to perform lung expansion exercises B. Chest tube drainage C. Respiratory status D. Sputum E. Blood pressure

Correct Answer: A,B,C

Rationale: Condition: Air leak (continuous bubbling, tidaling). Actions: A. Ensure drainage system integrity. B. Detect subcutaneous emphysema. Parameters: B. Monitor drainage output. C. Assess respiratory status. Other options are irrelevant for air leak.

Extract:


Question 2 of 5

Correct Answer:

Rationale:

Question 3 of 5

Correct Answer:

Rationale:

Question 4 of 5

Correct Answer:

Rationale:

Question 5 of 5

Correct Answer:

Rationale:

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