a nurse is assessing a client who has chronic obstructive pulmonary disease copd which of the following findings should the nurse report to the provid

ATI RN

ATI RN Exit Exam

1. A nurse is assessing a client who has chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse report to the provider?

A. Oxygen saturation of 91%
B. Use of pursed-lip breathing
C. Productive cough with green sputum
D. Decreased breath sounds in the right lower lobe

Correct answer: D

Rationale: The correct finding the nurse should report to the provider is decreased breath sounds in the right lower lobe. This can indicate a respiratory infection or atelectasis in clients with COPD, requiring further evaluation and intervention. Choice A, an oxygen saturation of 91%, although slightly lower than normal, does not necessarily require immediate reporting unless the client's baseline is significantly higher. Choice B, the use of pursed-lip breathing, is actually a beneficial technique for clients with COPD to improve oxygenation and reduce shortness of breath, so it does not need reporting. Choice C, a productive cough with green sputum, can be common in clients with COPD and may indicate an infection, but it is not as concerning as decreased breath sounds in a specific lung lobe which may signify a more acute issue.

2. A client with a colostomy needs optimal skin integrity. What action should the nurse take to promote this?

A. Cleanse the peristomal skin with alcohol.
B. Change the colostomy pouch every 3 days.
C. Use a barrier cream to protect the skin from the pouch contents.
D. Cleanse the stoma with hydrogen peroxide.

Correct answer: C

Rationale: To promote optimal skin integrity in a client with a colostomy, using a barrier cream to protect the skin from the irritating effects of the colostomy pouch contents is essential. Cleansing the peristomal skin with alcohol (Choice A) can be too harsh and drying for the skin. Changing the colostomy pouch every 3 days (Choice B) is important for hygiene but using a barrier cream is more directly related to skin protection. Cleaning the stoma with hydrogen peroxide (Choice D) is not recommended as it can be too abrasive for the sensitive stoma area.

3. What is the initial step when a patient is experiencing chest pain?

A. Administer oxygen
B. Reposition the patient
C. Provide pain relief
D. Provide nitroglycerin

Correct answer: A

Rationale: Administering oxygen is the initial step in managing chest pain. Oxygen helps improve oxygenation levels in the blood, which is crucial in cases of chest pain. Repositioning the patient, providing pain relief, or administering nitroglycerin may be necessary steps depending on the underlying cause, but administering oxygen takes precedence as it addresses the primary concern of oxygen supply to the body during chest pain.

4. A healthcare professional is reviewing the medical record of a client scheduled for a CT scan with contrast media. The healthcare professional should identify which of the following findings as a contraindication to the procedure?

A. White blood cell count of 6,000/mmÂ³
B. Urine specific gravity of 1.025
C. History of asthma
D. History of allergy to shellfish

Correct answer: D

Rationale: The correct answer is D, a history of allergy to shellfish. A known allergy to shellfish is a contraindication for the use of contrast media in a CT scan due to the potential risk of an allergic reaction, which could be severe and life-threatening. Choices A, B, and C are not contraindications to the procedure. A normal white blood cell count, urine specific gravity within the normal range, and a history of asthma do not typically interfere with the administration of contrast media for a CT scan.

5. How should a healthcare professional prepare a patient for a colonoscopy?

A. Provide clear instructions on diet
B. Explain the procedure in detail
C. Ensure the patient has an empty stomach
D. Give a bowel prep solution

Correct answer: D

Rationale: Giving a bowel prep solution is essential to clean out the colon thoroughly before a colonoscopy. This process is crucial as it helps to achieve a clear view of the colon during the procedure. Providing clear instructions on diet (Choice A) and ensuring the patient has an empty stomach (Choice C) are important steps in the preparation process but may not be sufficient on their own to adequately cleanse the colon. Explaining the procedure in detail (Choice B) is helpful for patient education but does not directly contribute to the physical preparation required for a successful colonoscopy.