ATI RN
ATI Medical Surgical Proctored Exam
1. A client has a pulmonary embolism & is started on oxygen. The student nurse asks why the client's oxygen saturation has not significantly improved. What response by the nurse is best?
- A. Breathing so rapidly interferes with oxygenation.
- B. Maybe the client has respiratory distress syndrome.
- C. The blood clot interferes with perfusion in the lungs.
- D. The client needs immediate intubation & mechanical ventilation.
Correct answer: C
Rationale: A large blood clot in the lungs will significantly impair gas exchange & oxygenation. Unless the clot is dissolved, this process will continue unabated.
2. A client with a chest tube connected to a closed drainage system needs to be transported to the x-ray department. Which of the following actions should the nurse take?
- A. Clamp the chest tube prior to transferring the client to a wheelchair.
- B. Disconnect the chest tube from the drainage system during transport.
- C. Keep the drainage system below the level of the client's chest at all times.
- D. Empty the collection chamber prior to transport.
Correct answer: C
Rationale: When transporting a client with a chest tube connected to a closed drainage system, it is crucial to keep the drainage system below the level of the client's chest at all times. This positioning prevents the backflow of drainage into the client's chest, reducing the risk of complications. Clamping the chest tube, disconnecting it from the drainage system, or emptying the collection chamber are incorrect actions and can potentially harm the client or lead to complications.
3. A student learns about modifiable risk factors for coronary artery disease. Which factors does this include? (Select one that does not apply)
- A. Age
- B. Hypertension
- C. Obesity
- D. Smoking
Correct answer: A
Rationale: Hypertension, obesity, smoking, and excessive stress are all modifiable risk factors for coronary artery disease, as they can be changed or controlled through interventions. Age, on the other hand, is a nonmodifiable risk factor, meaning it cannot be altered. Understanding the difference between modifiable and nonmodifiable risk factors is essential in preventive healthcare strategies.
4. A client's arterial blood gas results show a pH of 7.3 and a PaCO2 of 50 mm Hg. The client is experiencing which of the following acid-base imbalances?
- A. Metabolic acidosis
- B. Metabolic alkalosis
- C. Respiratory acidosis
- D. Respiratory alkalosis
Correct answer: C
Rationale: In respiratory acidosis, there is an excess of carbon dioxide (PaCO2 > 45 mm Hg) leading to a decrease in pH (<7.35). The given values of a pH of 7.3 and PaCO2 of 50 mm Hg indicate respiratory acidosis. Metabolic acidosis involves a primary decrease in bicarbonate levels with a compensatory decrease in PaCO2 to maintain balance. Metabolic alkalosis is characterized by elevated pH and bicarbonate levels. Respiratory alkalosis is marked by low PaCO2 and increased pH levels.
5. A client is in the immediate postoperative period following a partial laryngectomy. Which of the following parameters should the nurse assess first?
- A. Pain severity
- B. Wound drainage
- C. Tissue integrity
- D. Airway patency
Correct answer: D
Rationale: In a client following a partial laryngectomy, the priority assessment is always airway patency. This is crucial to ensure that the client can breathe adequately and prevent any complications related to airway obstruction. Monitoring airway patency takes precedence over other assessments such as pain severity, wound drainage, and tissue integrity. Any compromise in airway patency requires immediate intervention to maintain the client's respiratory function and safety.
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