ATI RN
ATI RN Adult Medical Surgical Online Practice 2023 A
1. A client has a disposable three-chamber chest tube in place. Which of the following findings should indicate to the nurse that the client is experiencing a complication?
- A. Continuous bubbling in the water-seal chamber
- B. Occasional bubbling in the water-seal chamber
- C. Constant bubbling in the suction-control chamber
- D. Fluctuations in the fluid level in the water-seal chamber
Correct answer: A
Rationale: Continuous bubbling in the water-seal chamber indicates air is leaking into the pleural space, which is a complication. The water-seal chamber should have intermittent bubbling during normal functioning. Occasional bubbling in the water-seal chamber is normal and shows the system is working as intended. Constant bubbling in the suction-control chamber suggests an issue with the suction control. Fluctuations in the fluid level in the water-seal chamber are an expected finding.
2. When prioritizing client care after receiving change-of-shift report, which of the following clients should the nurse plan to see first?
- A. A client who is scheduled for an abdominal x-ray and is awaiting transport
- B. A client who has a prescription for discharge
- C. A client who received oral pain medication 30 minutes ago
- D. A client who told an assistive personnel he is short of breath
Correct answer: D
Rationale: When a client expresses being short of breath, it may indicate a serious condition requiring immediate attention to ensure adequate oxygenation. This client should be seen first to assess the severity of the situation and initiate appropriate interventions. The other options, such as awaiting transport for an x-ray, having a prescription for discharge, or receiving oral pain medication 30 minutes ago, do not present immediate life-threatening concerns compared to a client experiencing shortness of breath.
3. 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.
4. A client who will undergo a bronchoscopy procedure with a rigid scope and general anesthesia will have their neck in which of the following positions?
- A. A flexed position
- B. An extended position
- C. A neutral position
- D. A hyperextended position
Correct answer: D
Rationale: During a bronchoscopy with a rigid scope and general anesthesia, the provider will typically place the client's neck in a hyperextended position to allow better visualization and access to the airways. This position helps to align the trachea for easier insertion of the scope.
5. A client with chronic obstructive pulmonary disease is being taught by a nurse about ways to facilitate eating. Which of the following statements indicates a need for further teaching?
- A. I will rest for at least 30 minutes before eating.
- B. I will take my bronchodilators after meals.
- C. I will eat five or six small meals each day.
- D. I will choose foods that are not gas-forming.
Correct answer: B
Rationale: Option B, 'I will take my bronchodilators after meals,' indicates a need for further teaching. Bronchodilators should be taken before meals to help open the airways and make breathing easier before eating. This statement suggests a misunderstanding of the timing for optimal bronchodilator effectiveness. Options A, C, and D are all appropriate strategies for facilitating eating for a client with chronic obstructive pulmonary disease.
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