Med Surgical on Respiratory and Endocrine Disorders ATI

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Sample questions from Med Surgical on Respiratory and Endocrine Disorders ATI

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.In the emergency department, a client with acute chest pressure has a 12-lead ECG showing ST-segment elevation in leads II, III, and aVF. Which action should the nurse anticipate first?

   • A.Give a sublingual dose of sildenafil
   • B.Administer prescribed chewable aspirin
   • C.Encourage the client to ambulate to assess tolerance
   • D.Schedule an exercise stress test

   Rationale: Chewable aspirin is given promptly for suspected acute myocardial infarction because it inhibits platelet aggregation and reduces further clot formation. An exercise stress test and ambulation are unsafe during an acute infarction, and sildenafil is not an appropriate treatment and can dangerously interact with nitrates that may be prescribed. The exam takeaway is to recognize acute coronary syndrome and prioritize time-sensitive antiplatelet therapy while preparing for reperfusion.

2. 2.Refer to the client's chart. Which findings require immediate follow-up by the nurse? Select all that apply.

   • A.The heart rate has decreased from 112/min to 104/min.
   • B.The oxygen saturation has decreased from 91% to 86% on room air.
   • C.The client reports new difficulty breathing while lying flat.
   • D.The client has produced 20 mL of urine during the past 2 hours.
   • E.The client has bilateral crackles and pink, frothy sputum.

   Rationale: The oxygen saturation decline, new orthopnea, low urine output, and crackles with pink, frothy sputum are concerning chart findings in a client with heart failure; together they suggest worsening pulmonary edema and impaired perfusion. A heart rate decrease from 112/min to 104/min is an improvement, although the rate still warrants monitoring. The exam takeaway is to act promptly on signs of respiratory compromise and reduced renal perfusion in acute heart failure.

3. 3.Which finding in a client taking digoxin for heart failure should the nurse report before administering the next dose?

   • A.Potassium level of 4.2 mEq/L
   • B.Blood pressure of 138/82 mm Hg
   • C.Apical pulse of 54/min
   • D.Respiratory rate of 18/min

   Rationale: An apical pulse of 54/min is bradycardic and warrants withholding digoxin and notifying the provider according to the prescription and facility parameters. The listed blood pressure and respiratory rate do not by themselves indicate digoxin toxicity, and a potassium level of 4.2 mEq/L is within the usual reference range. The exam takeaway is to assess the apical pulse before digoxin and recognize that hypokalemia increases the risk of toxicity.

4. 4.A client states, "My legs hurt when I walk, but the pain goes away when I stop." Which intervention is appropriate for a client with peripheral arterial disease?

   • A.Encourage a scheduled walking program with rest periods when pain occurs.
   • B.Cross the legs while sitting to reduce venous pooling.
   • C.Apply a heating pad to the feet to improve circulation.
   • D.Elevate the legs above heart level whenever the client is sitting.

   Answer and rationale are in the full material.

5. 5.At change of shift, the nurse receives report on four clients. Which client should the nurse assess first?

   • A.A client with atrial fibrillation whose ventricular rate is 88/min and who denies symptoms
   • B.A client with chronic heart failure who has 1+ ankle edema and no change in breathing
   • C.A client recovering from a myocardial infarction who reports fatigue after bathing
   • D.A client with a blood pressure of 188/110 mm Hg who reports a sudden severe headache and blurred vision

   Answer and rationale are in the full material.