ATI RN
ATI Nur 175 Med Surg Exam Questions
Extract:
Question 1 of 5
The nurse is assessing a client with a diagnosis of acute emphysema. The client is receiving oxygen at a flow rate of 5 L/min by nasal cannula. Which assessment findings should be reported to the provider immediately?
Correct Answer: B
Rationale: This posture, known as the tripod position, is common among clients with emphysema as it helps them breathe more easily by using accessory muscles. While it indicates respiratory distress, it is not immediately life-threatening. A respiratory rate of 8 breaths/min is significantly below the normal range (12-20 breaths/min) and indicates hypoventilation, which can lead to life-threatening conditions such as hypercapnia (elevated carbon dioxide levels in the blood). This finding needs immediate attention from the provider. A barrel chest is a common physical finding in clients with chronic emphysema. It develops over time due to hyperinflation of the lungs but is not an urgent finding that needs immediate reporting. Fine bibasilar crackles can indicate fluid accumulation in the lungs or other lung pathology, but this finding alone does not necessarily require immediate intervention unless accompanied by other critical symptoms.
Question 2 of 5
Which symptoms would the nurse expect to assess in a client experiencing serotonin syndrome?
Correct Answer: D
Rationale: Serotonin syndrome involves mental status changes, autonomic instability, and neuromuscular abnormalities.
Question 3 of 5
The emergency department nurse administers a prescribed narcotic for a client with renal colic and then discharges the client without ensuring the client has a designated driver. The client is subsequently involved in a motor vehicle collision on their way home, causing injury to self and others. Which ethical principle did the nurse violate?
Correct Answer: D
Rationale: Veracity is the principle of truthfulness and honesty. It involves providing accurate information to clients and being truthful in communication. While important in healthcare, veracity does not specifically address the nurse's failure to ensure the client's safety after administering a narcotic. Autonomy refers to respecting the client's right to make their own decisions about their care. While autonomy is a fundamental ethical principle, the scenario involves the nurse's responsibility to ensure safety, which falls under a different principle. Beneficence is the principle of acting in the best interest of the client by promoting good and preventing harm. Although related to the scenario, beneficence focuses more on the proactive aspect of providing care rather than preventing harm resulting from inaction. Nonmaleficence is the ethical principle of 'do no harm.' The nurse violated this principle by discharging the client without ensuring they had a designated driver, leading to a motor vehicle collision and injuries. The nurse's action indirectly caused harm, violating the principle of nonmaleficence.
Question 4 of 5
A nurse is caring for a client who is exhibiting a depressed mood one week before the start of their menstrual cycle. The nurse should identify that the client is exhibiting manifestations consistent with which of the following disorders?
Correct Answer: C
Rationale: PMDD causes severe mood disturbances before menstruation.
Question 5 of 5
The nurse is working in the emergency department and is receiving multiple clients from a mass casualty incident. The client arrives by ambulance and is awake, alert, and oriented, complaining of severe abdominal pain with nausea and vomiting. The client's respiratory rate is 20 and has a good radial pulse with normal capillary refill. How would you triage this client using the START triage?
Correct Answer: B
Rationale: The red category in the START triage system is assigned to clients who require immediate life-saving intervention. Although this client is in pain and has severe symptoms, their respiratory rate, pulse, and capillary refill are normal, indicating that they do not need immediate life-saving intervention. The yellow category is designated for clients whose condition is stable but requires observation. This client is awake, alert, and oriented, with a normal respiratory rate, good radial pulse, and normal capillary refill. While they have severe abdominal pain and nausea, their condition does not appear to be life-threatening, making yellow the appropriate triage level. The black category is used for clients who are deceased or have injuries so severe that they are not expected to survive even with immediate medical intervention. This client is stable and responsive, so they do not fall into this category. The green category is for clients with minor injuries who can walk and do not require urgent medical attention. Since this client has severe symptoms and needs medical attention, the green category is not appropriate.