ATI Med Surg Respiratory exam Detailed
Answer Key 2024
A nurse is caring for four clients. Which of the following clients is at greatest risk for
pulmonary embolism?
A. A client who is 48 hr postoperative following a total hip arthroplasty
B. A client who is 8 hr postoperative following an open surgical appendectomy
C. A client who is 2 hr postoperative following an open reduction external fixation of the
right radius
D. A client who is 4 hr postoperative following a laparoscopic cholecystectomy - A. A
client who is 48 hr postoperative following a total hip arthroplasty
A nurse is caring for a client who is 1 hr postoperative following a thoracentesis. Which
of following is the priority assessment finding?
A. Pallor
B. Insertion site pain
C. Persistent Cough
D. Temperature 37.3 (99.1) - C. Persistent Cough
When using the airway, breathing, circulation approach to client care, the nurse should
determine that the priority finding is a persistent cough because this can indicate a
tension pneumothorax, which is a medical emergency.
A nurse working in the emergency department is caring for a client following a chest
trauma. Which of the following findings indicates a tension pneumothorax?
A. Collapsed neck veins on the affected side
B. Collapsed neck veins on the unaffected side
C. Tracheal deviation to the affected side
D. Tracheal deviation to the unaffected side - D. Tracheal deviation to the unaffected
side
A nurse is assessing a client who has lung cancer. Which of the following
manifestations should the nurse expect?
A. Blood-tinged Sputum
B. Decreased Tactile Fremitis
C. Resonance with percussion
d. Peripheral edema - A. Blood-tinged Sputum
A nurse in an emergency department is caring for a client who is experiencing acute
respiratory failure. Which of the following laboratory findings should the nurse expect?
A. Arterial pH 7.5
, PaCo2 25 mm Hg
SaO2 92%
PaO2 58 mm Hg - PaO2 58 mm Hg
A nurse is preparing a client for discharge following a bronchoscopy with the use of
moderate (conscious) sedation. Which of the following assessments by the nurse is the
priority?
A. Gag reflex
B. Pain level
C. Dehydration
D. Redness at the IV insertion site - A. Gag reflex
A nurse is caring for a client who is in respiratory distress and requires endotracheal
suctioning. Which of the following actions should the nurse take?
A. Use clean technique to suction the client's endotracheal tube.
B. Use a rotating motion to remove the suction catheter.
C. Suction the oropharyngeal cavity prior to suctioning the endotracheal tube.
D. Suction the client's endotracheal tube every 2 hr. - B. Use a rotating motion to
remove the suction catheter.
A nurse is caring for who has a chest tube following a lobectomy. Which of the following
items should the nurse keep easily accessible for the client?
A. Extra drainage system
B. Suture removal set
C. container of sterile water
D. Nonadherent pads - C. container of sterile water.
The nurse should have a container of sterile water in a location that is easily accessible
for this client. The nurse should plan to place the open end of the tubing into the sterile
water if the tubing becomes disconnected to prevent a pneumothorax.
A nurse is assisting with a thoracentesis. Which of the following actions is appropriate
for the nurse to take when assisting with this procedure? (Select all that apply.)
A. Wear goggles and mask during the procedure.
B. Cleanse the area with an antiseptic solution.
C. Instruct the client to take deep breaths during insertion of the needle.
D. Position the client laterally on the affected side.
E. Apply pressure to the site after the needle is withdrawn. - A. Wear goggles and mask
during the procedure.
B. Cleanse the area with an antiseptic solution.
E. Apply pressure to the site after the needle is withdrawn.
A nurse is caring for a client who has active tuberculosis. Which of the following
isolation precautions should the nurse implement?
A. Airborne
B. Neutropenic
C. Contact
Answer Key 2024
A nurse is caring for four clients. Which of the following clients is at greatest risk for
pulmonary embolism?
A. A client who is 48 hr postoperative following a total hip arthroplasty
B. A client who is 8 hr postoperative following an open surgical appendectomy
C. A client who is 2 hr postoperative following an open reduction external fixation of the
right radius
D. A client who is 4 hr postoperative following a laparoscopic cholecystectomy - A. A
client who is 48 hr postoperative following a total hip arthroplasty
A nurse is caring for a client who is 1 hr postoperative following a thoracentesis. Which
of following is the priority assessment finding?
A. Pallor
B. Insertion site pain
C. Persistent Cough
D. Temperature 37.3 (99.1) - C. Persistent Cough
When using the airway, breathing, circulation approach to client care, the nurse should
determine that the priority finding is a persistent cough because this can indicate a
tension pneumothorax, which is a medical emergency.
A nurse working in the emergency department is caring for a client following a chest
trauma. Which of the following findings indicates a tension pneumothorax?
A. Collapsed neck veins on the affected side
B. Collapsed neck veins on the unaffected side
C. Tracheal deviation to the affected side
D. Tracheal deviation to the unaffected side - D. Tracheal deviation to the unaffected
side
A nurse is assessing a client who has lung cancer. Which of the following
manifestations should the nurse expect?
A. Blood-tinged Sputum
B. Decreased Tactile Fremitis
C. Resonance with percussion
d. Peripheral edema - A. Blood-tinged Sputum
A nurse in an emergency department is caring for a client who is experiencing acute
respiratory failure. Which of the following laboratory findings should the nurse expect?
A. Arterial pH 7.5
, PaCo2 25 mm Hg
SaO2 92%
PaO2 58 mm Hg - PaO2 58 mm Hg
A nurse is preparing a client for discharge following a bronchoscopy with the use of
moderate (conscious) sedation. Which of the following assessments by the nurse is the
priority?
A. Gag reflex
B. Pain level
C. Dehydration
D. Redness at the IV insertion site - A. Gag reflex
A nurse is caring for a client who is in respiratory distress and requires endotracheal
suctioning. Which of the following actions should the nurse take?
A. Use clean technique to suction the client's endotracheal tube.
B. Use a rotating motion to remove the suction catheter.
C. Suction the oropharyngeal cavity prior to suctioning the endotracheal tube.
D. Suction the client's endotracheal tube every 2 hr. - B. Use a rotating motion to
remove the suction catheter.
A nurse is caring for who has a chest tube following a lobectomy. Which of the following
items should the nurse keep easily accessible for the client?
A. Extra drainage system
B. Suture removal set
C. container of sterile water
D. Nonadherent pads - C. container of sterile water.
The nurse should have a container of sterile water in a location that is easily accessible
for this client. The nurse should plan to place the open end of the tubing into the sterile
water if the tubing becomes disconnected to prevent a pneumothorax.
A nurse is assisting with a thoracentesis. Which of the following actions is appropriate
for the nurse to take when assisting with this procedure? (Select all that apply.)
A. Wear goggles and mask during the procedure.
B. Cleanse the area with an antiseptic solution.
C. Instruct the client to take deep breaths during insertion of the needle.
D. Position the client laterally on the affected side.
E. Apply pressure to the site after the needle is withdrawn. - A. Wear goggles and mask
during the procedure.
B. Cleanse the area with an antiseptic solution.
E. Apply pressure to the site after the needle is withdrawn.
A nurse is caring for a client who has active tuberculosis. Which of the following
isolation precautions should the nurse implement?
A. Airborne
B. Neutropenic
C. Contact
