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ATI Medical Surgical Proctored Exam 2019 Quizlet
1. The client has acute kidney injury (AKI). Which assessment finding requires immediate intervention?
- A. Urine output of 50 ml in the last hour.
- B. Serum potassium of 6.2 mEq/L.
- C. Blood pressure of 150/90 mm Hg.
- D. Serum creatinine of 2.5 mg/dL.
Correct answer: B
Rationale: An elevated serum potassium level of 6.2 mEq/L in a client with AKI can lead to life-threatening cardiac arrhythmias, necessitating immediate intervention. Hyperkalemia is a serious complication in AKI as impaired kidney function can result in the accumulation of potassium in the blood, posing a risk of cardiac arrest. Prompt treatment to lower potassium levels is crucial to prevent cardiac complications in this situation.
2. The nurse is caring for four clients: Client A, who has emphysema and an oxygen saturation of 94%; Client B, with a postoperative hemoglobin of 8.7 g/dL; Client C, newly admitted with a potassium level of 3.8 mEq/L; and Client D, scheduled for an appendectomy with a white blood cell count of 15,000/mm3. What intervention should the nurse implement?
- A. Increase Client A's oxygen to 4 liters per minute via nasal cannula.
- B. Determine if Client B has two units of packed cells available in the blood bank.
- C. Ask the dietitian to add a banana to Client C's breakfast tray.
- D. Inform Client D that surgery is likely to be delayed until the infection is treated.
Correct answer: D
Rationale: A high white blood cell count, as seen in Client D, indicates infection, which may require postponing surgery to treat the infection adequately. It is crucial to address the underlying infection before proceeding with the appendectomy to prevent complications and ensure a successful surgical outcome.
3. What dietary advice should the nurse provide to help reduce the occurrence of hot flashes in a post-menopausal client?
- A. Increase intake of spicy foods.
- B. Limit caffeine and alcohol consumption.
- C. Consume a high-protein diet.
- D. Eat more dairy products.
Correct answer: B
Rationale: Limiting caffeine and alcohol consumption is recommended to help reduce the frequency of hot flashes in post-menopausal individuals. Caffeine and alcohol can trigger hot flashes and worsen their occurrence. Encouraging the client to reduce these stimulants in their diet may help alleviate hot flashes and improve their quality of life.
4. The healthcare provider is caring for a client with a chest tube. Which assessment finding requires immediate intervention?
- A. Intermittent bubbling in the water seal chamber.
- B. Drainage of 75 ml in the first hour post-insertion.
- C. Crepitus around the insertion site.
- D. Fluctuation of the water level in the water seal chamber with respiration.
Correct answer: C
Rationale: Crepitus (subcutaneous emphysema) around the insertion site can indicate air leakage, requiring immediate intervention to prevent complications such as pneumothorax. This assessment finding suggests that there may be a break in the chest tube system, leading to air entering the pleural space. Prompt intervention is crucial to prevent respiratory compromise and further complications.
5. Which client's laboratory value requires immediate intervention by a nurse?
- A. A client with GI bleeding who is receiving a blood transfusion and has a hemoglobin of 7 grams.
- B. A client with pancreatitis who has a fasting glucose of 190 mg/dl today and had 160 mg/dl yesterday.
- C. A client with hepatitis who is jaundiced and has a bilirubin level that is 4 times the normal value.
- D. A client with cancer who has an absolute neutrophil count < 500 today and had 2,000 yesterday.
Correct answer: D
Rationale: The correct answer is D. A sudden drop in neutrophil count to below 500 indicates severe neutropenia, putting the client at high risk for infections. Neutrophils are essential for fighting off infections, and a significant decrease in their count can compromise the client's immune response. Immediate intervention is necessary to prevent the development of serious infections in the client with neutropenia.
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