Ati adult health 2 exam (med) surg NJ university

Ati adult health 2 exam (med) surg NJ university

Total Questions : 60

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Question 1: View

A nurse is preparing a client for transfer to the ICU for placement of a pulmonary artery catheter. The nurse should explain to the client that this catheter is used to monitor which of the following conditions?

Explanation

A. Spinal cord perfusion is not monitored with a pulmonary artery catheter; it typically requires different neuromonitoring techniques.
B. Hemodynamic status is accurately monitored using a pulmonary artery catheter (also called a Swan-Ganz catheter), which provides information on cardiac output, pulmonary artery pressures, and other cardiovascular parameters.
C. Intracranial pressure is monitored using devices like an intraventricular catheter or subarachnoid bolt, not a pulmonary artery catheter.
D. Renal function is assessed through laboratory tests (e.g., BUN, creatinine) and urine output, not via a pulmonary artery catheter


Question 2: View

The nurse is monitoring a client in the post-anesthesia care unit (PACU) following a coronary artery bypass graft, observing a regular ventricular rate of 82 beats/min and "sawtooth" P waves with an atrial rate of approximately 300 beat/min. How does the nurse interpret this rhythm?

Explanation

A. Ventricular tachycardia presents with wide QRS complexes and a fast ventricular rate, but not sawtooth P waves.
B. Atrial flutter is characterized by a rapid atrial rate (typically around 250–350 beats/min) and "sawtooth" flutter waves on the ECG. The ventricular response is often regular, as seen in this client with a ventricular rate of 82 beats/min.
C. Atrial fibrillation presents with an irregularly irregular rhythm and absent P waves, replaced by fibrillatory waves — not the sawtooth pattern described here.
D. Ventricular fibrillation shows chaotic, irregular, and disorganized electrical activity with no identifiable P waves, QRS complexes, or T waves, and would not present as a stable rhythm with a ventricular rate of 82 bpm.


Question 3: View

A nurse is caring for a client who is experiencing hypovolemic shock. Which of the following blood products should the nurse anticipate administering to this client?

Explanation

A. Platelets are administered to treat or prevent bleeding due to thrombocytopenia or platelet dysfunction, not primarily for volume loss.
B. Albumin is a plasma volume expander and may be used in hypovolemia, but it does not replace oxygen-carrying capacity like RBCs do.
C. Cryoprecipitates are rich in clotting factors (e.g., fibrinogen, factor VIII) and are used for coagulopathies, not as a primary treatment for hypovolemic shock.
D. Packed RBCs are the appropriate choice in hypovolemic shock, especially when blood loss has occurred, as they restore oxygen-carrying capacity and circulating blood volume.


Question 4: View

The nurse is caring for a client who suddenly develops bradycardia. The client is breathing but with a decreased level of consciousness and decreased blood pressure. Which of the following treatments would be done by the nurse first?

Explanation

A. Transcutaneous pacing may be considered if the bradycardia does not respond to initial medical management, but it is not the first intervention.
B. Administering atropine IV is the first-line treatment for symptomatic bradycardia. Atropine works by increasing heart rate through its anticholinergic effects, helping to improve cardiac output and consciousness.
C. CPR is only indicated if the client is pulseless or not breathing. Since this client is still breathing, CPR is not appropriate at this stage.
D. Cardioversion is used for certain tachyarrhythmias (e.g., atrial fibrillation with rapid ventricular response), not for bradycardia.


Question 5: View

A nurse is assessing a client who has infective endocarditis. Which of the following findings should be the priority for the nurse to report to the provider?

Explanation

A. Splinter hemorrhages are a common sign of infective endocarditis but are not immediately life-threatening.
B. Fever is a typical manifestation of infection and expected in infective endocarditis, not a priority unless unresponsive to treatment.
C. Clusters of petechiae in the mouth indicate microemboli or vascular involvement, but they are not an acute threat.
D. Dyspnea is the priority finding because it may indicate heart failure or pulmonary embolism, both of which are serious complications of infective endocarditis and require immediate intervention.


Question 6: View

The nurse caring for a client who is scheduled for a balloon valvuloplasty recalls that balloon valvuloplasty is most commonly used for which valvular heart disease?

Explanation

A. Mitral valve prolapse often requires no treatment or is managed with medications; balloon valvuloplasty is not typically used.
B. Aortic regurgitation usually requires surgical valve replacement rather than valvuloplasty.
C. Mitral regurgitation involves backward blood flow and is generally treated with valve repair or replacement, not balloon valvuloplasty.
D. Mitral stenosis is most commonly treated with balloon valvuloplasty, especially in clients with rheumatic heart disease. This procedure helps open a narrowed mitral valve by inflating a balloon within the valve to improve blood flow.


Question 7: View

What are the pathophysiologic changes that place a client who has suffered a myocardial infarction at risk for cardiogenic shock?

Explanation

A. Decreased cardiac output with increased mean arterial pressure (MAP) does not typically occur in cardiogenic shock. In shock states, MAP tends to decrease.
B. Decreased cardiac output and decreased MAP are the hallmark pathophysiologic changes in cardiogenic shock following a myocardial infarction. The damaged myocardium cannot pump effectively, leading to poor perfusion and hypotension.
C. Increased cardiac output and increased afterload are not features of cardiogenic shock; in fact, cardiac output is decreased.
D. Increased cardiac output and increased MAP suggest improved perfusion, not the compromised state seen in cardiogenic shock.


Question 8: View

A client comes to the emergency department with complaints of chest pain after using cocaine. The nurse assesses the client and obtains vital signs with results as follows: blood pressure 140/92, heart rate 128, respiratory rate 26, and an oxygen saturation of 98%. What rhythm on the monitor does the nurse anticipate viewing?

Explanation

A. Sinus bradycardia is characterized by a heart rate below 60 beats/min, which is inconsistent with this client’s elevated heart rate of 128.
B. Ventricular tachycardia is a potentially life-threatening rhythm with wide QRS complexes, usually not the immediate expected rhythm without other signs such as hypotension or loss of consciousness.
C. Normal sinus rhythm has a heart rate between 60–100 beats/min; this client’s rate of 128 exceeds that range.
D. Sinus tachycardia is the most likely rhythm, especially in a client who has used cocaine, a stimulant known to increase sympathetic nervous system activity, leading to increased heart rate and elevated blood pressure.


Question 9: View

A 57-year-old-client is being admitted to the intensive care unit (ICU) with a diagnosis of possible septic shock He has a normal blood pressure, increased heart rate, decreased bowel sounds, and their skin is cold and clammy. The ICU nurse suspects the client:

Explanation

A. A client showing signs of shock (e.g., cold, clammy skin, decreased bowel sounds, tachycardia) is not likely to stabilize and be released by the next day without intensive treatment.
B. The irreversible stage of shock is marked by profound hypotension, multi-organ failure, and unresponsiveness—more severe than this client’s current status.
C. The progressive stage of shock is characterized by impaired tissue perfusion, cold and clammy skin, tachycardia, hypoactive bowel sounds, and early signs of organ dysfunction. Even though the blood pressure is currently normal, perfusion is inadequate.
D. The compensatory stage is earlier and includes signs like tachycardia and restlessness, but perfusion to vital organs is still maintained, and skin may remain warm. This client’s cold skin and decreased bowel sounds suggest progression beyond this stage.


Question 10: View

A client is receiving an initial dose of penicillin IV. During the infusion, the client becomes short of breath. What is the first thing the nurse should do?

Explanation

A. Increasing the head of the bed may help ease breathing but does not address the potential cause of the problem.
B. The recovery position is used for unconscious patients to maintain an open airway—not appropriate here.
C. Stopping the infusion of the medication is the first and most critical action. The client is likely experiencing an allergic reaction or anaphylaxis to penicillin, and continuing the drug could worsen symptoms.
D. Slowing the infusion does not prevent further reaction and delays stopping the exposure to the allergen.


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