ATI Medical Surgical Proctored Exam

ATI Medical Surgical Proctored Exam Related

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A healthcare professional is assessing a client who is recovering from a lung biopsy. Which assessment finding requires immediate action?

  • A. Increased temperature
  • B. Absent breath sounds
  • C. Productive cough
  • D. Incisional discomfort
Correct Answer: B

Rationale: The correct answer is B: Absent breath sounds. This finding requires immediate action because it could indicate a pneumothorax, which is a potentially life-threatening complication following a lung biopsy. Absent breath sounds suggest air trapped in the pleural space, leading to lung collapse. Immediate intervention is necessary to prevent respiratory distress.

A: Increased temperature is concerning but may indicate infection, which would require monitoring and possibly treatment, but it is not as urgent as addressing a potential pneumothorax.

C: Productive cough is common post-lung biopsy and may be managed symptomatically. It does not typically require immediate action.

D: Incisional discomfort is expected after a biopsy and can be managed with pain medication. It does not indicate a critical issue requiring immediate intervention.

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A client tests positive for alpha1-antitrypsin (AAT) deficiency and asks the nurse, What does this mean? How should the nurse respond?

  • A. Your children may be at high risk for developing chronic obstructive pulmonary disease.
  • B. I will arrange for a genetic counselor to discuss your condition.
  • C. Your risk for chronic obstructive pulmonary disease is higher, particularly if you smoke.
  • D. This is a recessive gene that should not affect your health.
Correct Answer: C

Rationale: Rationale:
C is correct because AAT deficiency increases the risk of COPD, especially with smoking. This response provides accurate information regarding the client's health risk. A is incorrect as it specifically mentions children rather than the client's own risk. B is incorrect as it focuses on genetic counseling rather than addressing the client's question. D is incorrect as it inaccurately states that the gene does not affect health.

A client had a hemicolectomy performed two days ago. Today, the nurse assessed the incision and discovered a small part of the abdominal viscera protruding through the incision. This complication of wound healing is known as:

  • A. excoriation.
  • B. dehiscence.
  • C. decortication.
  • D. evisceration.
Correct Answer: D

Rationale: Excoriation is an abrasion of the epidermis, or of any organ coating of the body, caused by trauma, chemicals, burns, or other causes. Dehiscence is a partial to complete separation of the wound edges with no abdominal tissue protrusion. Decortication is removal of the surface layer of an organ or structure, such as removing the fibrinous peel from the visceral pleura in thoracic surgery. Evisceration occurs when the incision separates and the contents of the cavity spill out.

A client has a pleural chest tube. Which action should the nurse take to ensure safe use of this equipment?

  • A. Never strip the tubing to maintain patency.
  • B. Secure tubing junctions with tape to prevent accidental disconnections.
  • C. Set wall suction at the level recommended by the device manufacturer.
  • D. Keep padded clamps at the bedside for use if the drainage system is interrupted.
Correct Answer: D

Rationale: The correct answer is D: Keep padded clamps at the bedside for use if the drainage system is interrupted. This is essential because if the drainage system is interrupted, the nurse needs to immediately clamp the tube to prevent air from entering the pleural space. Clamping the tube can prevent a potentially life-threatening situation.

A: Never strip the tubing to maintain patency - Stripping the tubing can lead to increased negative pressure, which can be harmful.
B: Secure tubing junctions with tape to prevent accidental disconnections - While securing tubing is important, clamping the tube in case of interruption is more critical.
C: Set wall suction at the level recommended by the device manufacturer - This is important for proper functioning but not as crucial as having clamps ready for emergencies.

When caring for a client with pneumonia, what intervention is most effective in preventing the spread of infection?

  • A. Administer prescribed antibiotics on time.
  • B. Encourage the client to use a tissue when coughing.
  • C. Place the client in a private room.
  • D. Perform hand hygiene before and after client contact.
Correct Answer: D

Rationale: The correct answer is D because performing hand hygiene before and after client contact is crucial in preventing the spread of infection in pneumonia. This intervention helps in reducing the transmission of infectious agents from one client to another and from surfaces to clients. It is a fundamental infection control measure that minimizes the risk of spreading pathogens. Option A is important for treating the infection but does not directly prevent its spread. Option B is a good practice to contain respiratory secretions but may not be as effective as hand hygiene. Option C isolates the client but does not address the primary mode of transmission through contaminated hands.

Priority Decision: Upon admission of a patient to the PACU, the nurse's priority assessment is

  • A. vital signs.
  • B. surgical site.
  • C. respiratory adequacy.
  • D. level of consciousness.
Correct Answer: C

Rationale: Respiratory adequacy is critical immediately postoperatively to ensure oxygenation and ventilation.

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