ATI RN
ATI RN Adult Medical Surgical Online Practice 2023 A
1. A client who experienced a femur fracture 8 hr ago now reports sudden onset dyspnea and severe chest pain. Which of the following actions should the nurse take first?
- A. Provide high-flow oxygen.
- B. Check the client for a positive Chvostek's sign.
- C. Administer an IV vasopressor medication.
- D. Monitor the client for headache.
Correct answer: A
Rationale: In this situation, the priority action is to provide high-flow oxygen to the client. Sudden onset dyspnea and severe chest pain can be indicative of a pulmonary embolism, which is a life-threatening emergency. Oxygen therapy helps improve oxygenation and stabilizes the client's condition. Checking for Chvostek's sign, administering IV vasopressors, or monitoring for a headache are not the immediate priorities in this critical situation.
2. A client has developed atelectasis postoperatively. Which of the following findings should the nurse expect?
- A. Facial flushing
- B. Increasing dyspnea
- C. Decreasing respiratory rate
- D. Friction rub
Correct answer: B
Rationale: Atelectasis is a condition where the alveoli in the lungs collapse, leading to impaired gas exchange. As a result, the client may experience increasing dyspnea (difficulty breathing) due to the decreased lung capacity for oxygen exchange. Facial flushing, decreasing respiratory rate, and friction rub are not typically associated with atelectasis.
3. How can a nurse manager best improve hand-off communication among the staff? (SATA)
- A. Attending hand-off rounds to coach and mentor.
- B. Conducting audits of staff using a new template.
- C. Creating a template of topics to include in the report.
- D. Utilizing the SHARE model as a tool for standardizing hand-off reports and other critical communication.
Correct answer: D
Rationale: The SHARE model is a valuable tool for standardizing hand-off reports and other critical communication. By utilizing this model, the nurse manager can ensure consistency and clarity in hand-off communication among the staff. While attending hand-off rounds to coach and mentor, conducting audits using a new template, and creating a template of topics to include in the report can all be beneficial actions, the most effective approach to achieve the goal of improving hand-off communication is by implementing a standardized tool like the SHARE model.
4. A student asks the faculty to explain best practices when communicating with a person from the LGBTQ community. What answer by the faculty is most accurate?
- A. Avoid embarrassing the individual by asking questions.
- B. Don't make assumptions about their health needs.
- C. Most LGBTQ individuals do not want to share information.
- D. No differences exist in communicating with this group.
Correct answer: B
Rationale: It is essential not to make assumptions about the health needs of individuals from the LGBTQ community. Each person is unique, and assuming their needs based on their sexual orientation or gender identity can lead to incorrect care and communication. By being open-minded and avoiding assumptions, healthcare providers can create a safe and supportive environment for LGBTQ individuals to discuss their health needs openly and honestly.
5. 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.
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