ATI RN
ATI Medical Surgical Proctored Exam 2023
1. A healthcare provider assesses a client with pneumonia. Which clinical manifestation should the provider expect to find?
- A. Fremitus
- B. Hyperresonance
- C. Dullness on percussion
- D. Decreased tactile fremitus
Correct answer: C
Rationale: Pneumonia often leads to the consolidation of lung tissue, resulting in dullness on percussion. This occurs due to the presence of fluid or inflammatory material in the alveoli. Fremitus and decreased tactile fremitus are more indicative of conditions like pleural effusion or pneumothorax, where there is an increase in the density of the pleural space or air in the pleural cavity. Hyperresonance, on the other hand, is typically associated with conditions causing air trapping, such as emphysema, where there is increased air in the alveoli.
2. While suctioning the endotracheal tube of a client on a ventilator, the nurse notices an increase in the client's heart rate from 86/min to 110/min, with irregularity. What should the nurse do next?
- A. Obtain a cardiology consult.
- B. Suction the client less frequently.
- C. Administer an antidysrhythmic medication.
- D. Perform pre-oxygenation prior to suctioning.
Correct answer: D
Rationale: When a client's heart rate increases and becomes irregular during suctioning of an endotracheal tube, it indicates potential hypoxemia. Performing pre-oxygenation before suctioning helps prevent hypoxemia and subsequent dysrhythmias. This intervention ensures that the client has adequate oxygen reserves before the procedure, reducing the risk of complications related to suctioning.
3. What information should be included as effective for preventing chronic bronchitis in a community presentation?
- A. Maintenance of ideal weight
- B. Annual influenza immunization
- C. Smoking cessation
- D. Regular moderate exercise
Correct answer: C
Rationale: Chronic bronchitis is often linked to smoking. Smoking cessation is the most effective preventive measure to reduce the risk of developing chronic bronchitis. Smoking damages the airways and leads to inflammation, making individuals more susceptible to chronic bronchitis. While maintaining an ideal weight, getting an annual influenza vaccine, and engaging in regular moderate exercise are beneficial for overall health, the most crucial intervention to prevent chronic bronchitis is quitting smoking.
4. A client is vomiting. Which of the following actions should the nurse take first?
- A. Provide the client with an emesis basin
- B. Notify housekeeping
- C. Prevent the client from aspirating
- D. Administer an antiemetic to the client
Correct answer: C
Rationale: When a client is vomiting, the priority action for the nurse is to prevent the client from aspirating. Aspiration can lead to serious respiratory complications. Providing the client with an emesis basin can be helpful but preventing aspiration takes precedence. Notifying housekeeping and administering an antiemetic are secondary actions that can be addressed once the client's safety is ensured.
5. A client had a bronchoscopy 2 hours ago and asks for a drink of water. Which action should the nurse take next?
- A. Call the healthcare provider to request a prescription for food and water.
- B. Provide the client with ice chips instead of a drink of water.
- C. Assess the client's gag reflex before giving any food or water.
- D. Let the client have a small sip to assess swallowing ability.
Correct answer: C
Rationale: After a bronchoscopy, a topical anesthetic affects the gag reflex. Therefore, the nurse should assess the client's gag reflex before providing any food or water to ensure its return. This assessment is crucial to prevent aspiration or choking risk in the client.
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