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ATI Learning System PN Medical Surgical Final Quizlet
1. A patient with chronic obstructive pulmonary disease (COPD) is experiencing severe dyspnea. What position should the nurse encourage the patient to assume?
- A. Supine
- B. Prone
- C. High Fowler's
- D. Trendelenburg
Correct answer: C
Rationale: The High Fowler's position is the most appropriate position for a patient with COPD experiencing severe dyspnea. This position helps improve lung expansion and reduce dyspnea by allowing the diaphragm to move more freely and increasing the efficiency of breathing. It also helps reduce the work of breathing and enhances oxygenation in patients with COPD. Supine position (Choice A) may worsen dyspnea by limiting lung expansion. Prone position (Choice B) is not ideal for COPD patients experiencing severe dyspnea as it may restrict breathing. Trendelenburg position (Choice D) is not recommended for COPD patients with dyspnea as it can further compromise breathing.
2. An adolescent patient seeks care in the emergency department after sharing needles for heroin injection with a friend who has hepatitis B. To provide immediate protection from infection, what medication will the nurse administer?
- A. Corticosteroids
- B. Gamma globulin
- C. Hepatitis B vaccine
- D. Fresh frozen plasma
Correct answer: B
Rationale: In this scenario, the immediate need is to provide passive immunity to the adolescent patient. Gamma globulin contains antibodies against hepatitis B, which can offer immediate protection. The hepatitis B vaccine provides active immunity over time but is not immediate. Fresh frozen plasma and corticosteroids are not indicated for immediate protection against hepatitis B infection. Therefore, the correct choice is Gamma globulin as it can provide immediate passive immunity against hepatitis B.
3. The client is receiving intravenous (IV) morphine for pain control. Which assessment finding requires the most immediate intervention?
- A. Drowsiness.
- B. Itching.
- C. Nausea.
- D. Respiratory rate of 8 breaths per minute.
Correct answer: D
Rationale: A respiratory rate of 8 breaths per minute indicates severe respiratory depression, a life-threatening side effect of opioid therapy. Immediate intervention is crucial to prevent respiratory failure. Monitoring and managing respiratory status are critical in clients receiving opioids to prevent adverse events. Drowsiness, itching, and nausea are common side effects of morphine but are not as immediately life-threatening as severe respiratory depression.
4. What is the primary goal of care for a client experiencing esophageal varices secondary to liver cirrhosis?
- A. Preventing infection
- B. Controlling bleeding
- C. Reducing portal hypertension
- D. Maintaining nutritional status
Correct answer: B
Rationale: The primary goal of care for a client with esophageal varices secondary to liver cirrhosis is to control bleeding. Esophageal varices are fragile, enlarged veins in the esophagus that can rupture and lead to life-threatening bleeding. Controlling bleeding is crucial to prevent severe complications and ensure the client's safety and well-being. Preventing infection (Choice A) is important but not the primary goal in this case. Reducing portal hypertension (Choice C) is a long-term goal that may help prevent variceal bleeding but is not the immediate priority. Maintaining nutritional status (Choice D) is essential for overall health but is secondary to controlling bleeding in this critical situation.
5. A patient with cirrhosis of the liver and ascites is scheduled for a paracentesis. What should the nurse do to prepare the patient for the procedure?
- A. Have the patient void immediately before the procedure.
- B. Position the patient upright or semi-Fowler's in bed.
- C. Administer a full liquid diet.
- D. Encourage the patient to ambulate for 30 minutes.
Correct answer: A
Rationale: The correct preparation for a paracentesis in a patient with cirrhosis and ascites includes having the patient void immediately before the procedure. This is important to reduce the risk of bladder puncture during the paracentesis. Positioning for a paracentesis is typically upright or semi-Fowler's, not flat in bed. Administering a full liquid diet or encouraging ambulation for 30 minutes are not directly related to preparing a patient for a paracentesis procedure.
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