Questions 70

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ATI Med Surg Nursing 300 Final Exam Questions

Extract:


Question 1 of 5

The nurse is caring for a client who has a chest tube in place following a pneumothorax. Which assessment finding indicates that the chest tube is functioning properly?

Correct Answer: B

Rationale: Fluctuation (tidaling) in the water seal chamber with respirations indicates the chest tube is patent and functioning, reflecting pleural pressure changes.

Question 2 of 5

A client who is postoperative following a coronary artery bypass graft (CABG) has a blood pressure of 90/50 mmHg, heart rate of 112 beats/min, respiratory rate of 28 breaths/min, and an oxygen saturation of 90% on 2L of oxygen via nasal cannula. Which action should the nurse take first?

Correct Answer: A

Rationale: Low oxygen saturation (90%) indicates hypoxemia, a priority. Increasing oxygen to 4L addresses this immediately, before fluids, notification, or positioning.

Question 3 of 5

The nurse is assessing a client with a suspected pulmonary embolism. Which assessment finding is most indicative of this condition?

Correct Answer: B

Rationale: Pleuritic chest pain, worsened by breathing, is a hallmark of pulmonary embolism due to pleural irritation from emboli.

Question 4 of 5

The nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which assessment finding indicates a complication of TPN therapy?

Correct Answer: A

Rationale: Blood glucose of 180 mg/dL indicates hyperglycemia, a common TPN complication due to high dextrose content, requiring insulin or rate adjustment.

Question 5 of 5

A client who has been on a mechanical ventilator for three days develops a fever of 101 degrees Fahrenheit green sputum, and right lower lobe crackles. The nurse contacts the physician regarding possible development of which complication?

Correct Answer: A

Rationale: Fever, green sputum, and crackles suggest ventilator-associated pneumonia, a common complication after 48 hours on a ventilator.

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