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ATI Medical Surgical Proctored Exam 2019 Quizlet
1. When a client expresses, 'I don't know how I will go on' while discussing feelings related to a recent loss, the nurse remains silent. What is the most likely reason for the nurse's behavior?
- A. The nurse is indicating disapproval of the statement.
- B. The nurse is showing respect for the client's loss.
- C. Silence is mirroring the client's sadness.
- D. Silence enables the client to contemplate what was expressed.
Correct answer: D
Rationale: In therapeutic communication, silence can offer the client an opportunity to process their emotions and thoughts. By remaining silent, the nurse provides a space for the client to reflect on their own words, facilitating deeper exploration and understanding of their feelings.
2. A male client is admitted to the neurological unit. He has just sustained a C-5 spinal cord injury. Which assessment finding of this client warrants immediate intervention by the nurse?
- A. Is unable to feel sensation in the arms and hands.
- B. Has flaccid upper and lower extremities.
- C. Blood pressure is 110/70 and the apical pulse is 68.
- D. Respirations are shallow, labored, and 14 breaths/minute.
Correct answer: D
Rationale: Respirations that are shallow, labored, and at 14 breaths/minute indicate potential respiratory compromise, which is a critical situation requiring immediate intervention to maintain adequate oxygenation and prevent respiratory failure.
3. A male infant born at 30-weeks gestation at an outlying hospital is being prepared for transport to a Level IV neonatal facility. His respirations are 90/min, and his heart rate is 150 beats per minute. Which drug is the transport team most likely to administer to this infant?
- A. Ampicillin (Omnipen) 25 mg/kg slow IV push.
- B. Gentamicin sulfate (Garamycin) 2.5 mg/kg IV.
- C. Digoxin (Lanoxin) 20 micrograms/kg IV.
- D. Beractant (Survanta) 100 mg/kg per endotracheal tube.
Correct answer: D
Rationale: In this scenario, the infant is a preterm neonate with respiratory distress and is being transported to a Level IV neonatal facility. The drug most likely to be administered by the transport team is Beractant (Survanta) via endotracheal tube. Beractant is a surfactant used to treat respiratory distress syndrome in preterm infants by improving lung compliance and reducing the need for mechanical ventilation.
4. A client with newly diagnosed diabetes mellitus is being discharged home. Which statement indicates the client understands the instructions about managing blood glucose levels?
- A. I will test my blood glucose level once a week.
- B. I should eat a snack if my blood glucose is 70 mg/dl.
- C. If I feel shaky, I should take another dose of insulin.
- D. It's okay to skip a meal if I'm not hungry.
Correct answer: B
Rationale: Choice B is the correct answer. Eating a snack when blood glucose is low (70 mg/dl) can help prevent hypoglycemia. It is important for clients with diabetes to manage their blood glucose levels to prevent complications, and consuming a snack when glucose levels drop can help maintain the balance.
5. Following a CVA, the nurse assesses that a client developed dysphagia, hypoactive bowel sounds, and a firm, distended abdomen. Which prescription for the client should the nurse question?
- A. Continuous tube feeding at 65 ml/hr via gastrostomy.
- B. Total parenteral nutrition to be infused at 125 ml/hour.
- C. Nasogastric tube connected to low intermittent suction.
- D. Metoclopramide (Reglan) intermittent piggyback.
Correct answer: A
Rationale: In a client with dysphagia, hypoactive bowel sounds, and a firm, distended abdomen post-CVA, continuous tube feeding at 65 ml/hr via gastrostomy may exacerbate abdominal distension and hypoactive bowel sounds. This situation requires immediate assessment and reevaluation before continuing with the prescription.
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