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Actual ATI RN Adult Medical-Surgical (Med-Surg) Proctored Exam 2023-2025 with NGN – 100, Exams of Nursing

Actual ATI RN Adult Medical-Surgical (Med-Surg) Proctored Exam 2023-2025 with NGN – 100 Screenshot Questions & 100% Verified Answers # Ace Your 2025 RN ATI Med-Surg Proctored Exam Seizures and Epilepsy: Seizure precautions - --ANSWER---During a seizure: Position client on the floor and provide a patent airway, turn client to side and loosen restrictive clothing Cancer treatment options: Protective Isolation (999) - --ANSWER---If WBC drops below 1,000, place the client in a private room and initiate neutropenic precautions. - Have client remain in his room unless be needs to leave for a diagnostic procedure, in case of transport place a mask on him - Protect from possible sources of infection (plants, change water in equipment daily) - Have client, staff and visitors perform frequent hand hygiene, restrict ill visitors - Avoid invasive procedures (rectal temps, injections) - Administer (neupogen, neulasta) to stimulate WBC production

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Actual ATI RN Adult Medical-Surgical
(Med-Surg) Proctored Exam 2023-2025
with NGN – 100 Screenshot Questions &
100% Verified Answers # Ace Your 2025
RN ATI Med-Surg Proctored Exam
Seizures and Epilepsy: Seizure precautions - --ANSWER---During a seizure: Position
client on the floor and provide a patent airway, turn client to side and loosen restrictive
clothing
Cancer treatment options: Protective Isolation (999) - --ANSWER---If WBC drops below
1,000, place the client in a private room and initiate neutropenic precautions.
- Have client remain in his room unless be needs to leave for a diagnostic procedure, in
case of transport place a mask on him
- Protect from possible sources of infection (plants, change water in equipment daily)
- Have client, staff and visitors perform frequent hand hygiene, restrict ill visitors
- Avoid invasive procedures (rectal temps, injections)
- Administer (neupogen, neulasta) to stimulate WBC production
Infection control: Appropriate room assignment - --ANSWER---Standard Precautions:
1. applies to all patients
2. Hand washing
a. alcohol based preferred unless hands visually soiled
3. Gloves - when touching anything that has the potential to contaminate.
4. Masks, eye protection & face shields when care may cause splashing or spraying of
body fluids
Droplet:
1. private room or with someone with same illness
2. masks
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Download Actual ATI RN Adult Medical-Surgical (Med-Surg) Proctored Exam 2023-2025 with NGN – 100 and more Exams Nursing in PDF only on Docsity!

Actual ATI RN Adult Medical-Surgical

(Med-Surg) Proctored Exam 2023- 2025

with NGN – 100 Screenshot Questions &

100% Verified Answers # Ace Your 2025

RN ATI Med-Surg Proctored Exam

Seizures and Epilepsy: Seizure precautions - --ANSWER---During a seizure: Position client on the floor and provide a patent airway, turn client to side and loosen restrictive clothing Cancer treatment options: Protective Isolation (999) - --ANSWER---If WBC drops below 1,000, place the client in a private room and initiate neutropenic precautions.

  • Have client remain in his room unless be needs to leave for a diagnostic procedure, in case of transport place a mask on him
  • Protect from possible sources of infection (plants, change water in equipment daily)
  • Have client, staff and visitors perform frequent hand hygiene, restrict ill visitors
  • Avoid invasive procedures (rectal temps, injections)
  • Administer (neupogen, neulasta) to stimulate WBC production Infection control: Appropriate room assignment - --ANSWER---Standard Precautions:
  1. applies to all patients
  2. Hand washing a. alcohol based preferred unless hands visually soiled
  3. Gloves - when touching anything that has the potential to contaminate.
  4. Masks, eye protection & face shields when care may cause splashing or spraying of body fluids Droplet:
  5. private room or with someone with same illness
  6. masks

Airborne:

  1. private room
  2. masks or respiratory protection devices a. use an N95 respirator for tuberculosis
  3. Negative pressure airflow
  4. full face protection if splashing or spraying is possible Contact:
  5. private room or room with same illness
  6. gloves & gowns
  7. disposal of infections dressing materials into a single, nonporous bag without touching the outside of the bag TB: Priority action for a client in the emergency department (249) - --ANSWER----Wear an N95 or HEPA respirator
  • Place client in negative airflow room and implement airborne precautions
  • use barrier protection when the risk of hand or clothing contamination exists Immunizations: Recommended vaccinations for older adult clients (943) - --ANSWER--- Adults age 50 or older:
  • Pneumococcal Vaccine (PPSV)
  • Influenza vaccine
  • Herpes Zoster Vaccine
  • Hepatitis A
  • Hepatitis B
  • Meningococcal Vaccine Pulmonary Embolism: Risk factors for DVT (258) - --ANSWER----Long term immobility
  • Oral contraceptives
  • Pregnancy
  • Tobacco use
  • Hypercoagulabilty
  • Obesity
  • Surgery
  • Heart failure or chronic A-Fib
  • Autoimmune hemolytic anemia (sickle cell)
  • Long bone fractures
  • Advanced age Disorders of the male reproductive system: Complications of continuous irrigation following Trans-urethral Resection (743) - --ANSWER----Urethral trauma
  • Urinary retention
  • Bleeding
  • Infection
  • Positive C-reactive protein
  • Positive ANA titier
  • Elevated WBC's Medications affecting coagulation: Heparin Contraindications - --ANSWER---Avoid NSAIDS while on heparin Antibiotics affecting protein synthesis: Adverse effects of gentamicin - --ANSWER---- Ototoxicity: cochlear damage (hearing loss) and vestibular damage (loss of balance).
  • Nephrotoxicity (proteinuria, elevated BUN, creatinine levels).
  • Hypersensitivity ( rash, pruritis, parathesia of hands and feet, and urticaria). Electrolyte imbalance: manifestations of hypokalemia - --ANSWER---Weak, irregular pulse, hypotension, respiratory distress Premature ventricular contractions, bradycardia, inverted T waves, ST depression Decreased GI motility, abdominal distension, constipation, n/v, anorexia, polyuria Decreased K (<3.5) ABG: Metabolic alkalosis (pH > 7.45) Electrolyte imbalance: Priority assessment for hypokalemia - --ANSWER---Assessing for a patent and open airway Blood and blood product transfusions: Administering Fresh Frozen Plasma - -- ANSWER---Initiate a large bore IV access: 20 gauge needle Complete transfusion withing 2-4 hours time frame If reaction occurs:
  • Stop transfusion immediately
  • Initiate 0.9% NaCl in a separate line
  • Save blood bag and blood tubing Cardiovascular Diagnostic and Therapeutic Procedures: Caring for a client who has a PICC - --ANSWER----Assessing site every 8 hours. Note redness, swelling, drainage, tenderness and condition of dressing
  • Change tube and positive pressure cap per facility protocol
  • Using 10mL or larger syringe to flush the line
  • Cleanse with alcohol for 3 seconds before accessing it
  • Use transparent dressing Cardiovascular Diagnostic and Therapeutic Procedures: Teaching about a PICC - -- ANSWER----Advise client not to immerse arm in water, to cover dressing site to avoid water exposure
  • Avoid BP in the arm with PICC

Cardiovascular Diagnostic and Therapeutic Procedures: PICC care - --ANSWER---- Apply an initial dressing of gauze and replace with transparent dressing within 24 hours

  • An initial x-ray should be taken to ensure proper placement Cardiovascular and Hematologic Disorders: teaching client about food interaction with Warfarin - --ANSWER----Kale, spinach
  • Brussels sprouts
  • collard greens, mustard greens
  • green tea
  • grapefruit juice, alcohol Angina and MI: Client teaching about nitroglycerin - --ANSWER---Nitrogylcerin prevents coronary artery vasospasm and reduces preload and afterload. Used to treat angina and help with BP.
  • Place nitro under tongue to dissolve
  • Take up to two more doses of nitro at 5-min intervals
  • Stop activity and rest Headache is a common side effect Orthostatic hypotension Osteoporosis: Teaching about self administration of Alendronate - --ANSWER---Take with 8oz water in the early morning before eating Remain upright for 30 minutes after taking medication Diabetes Mellitus Management: teaching about self administration of insulin - -- ANSWER---- Rotate injection sites
  • Inject at a 90 degree angle. Aspiration is not necessary
  • Advise client to eat at regular intervals, avoid alcohol intake and adjust insulin to exercise and diet to avoid hypoglycemia
  • When mixing insulin's, draw up the shorter acting insulin into the syringe first and then the longer acting insulin. IV therapy: Performing Venipuncture on an older adult client - --ANSWER---a 22- 24 gauge catheter is best to use on older adults Tie the tourniquet sparingly and try to avoid veins in the hand Dosage calculations: Calculating IV infusion rate - --ANSWER---Ex: nurse is preparing to administer dextrose 5% in water 500 mL IV to infuse over 4 hours. The nurse should set the IV infusion pump to deliver how many mL/hr>
  • Volume (mL)/Time (hr) = X
  • 500 mL/5hr = 125 mL/hr IV therapy: Medication administration - --ANSWER---Know
  • Right Patient
  • Attach one electrode to each of the clients extremities by applying electrodes to flat surfaces above the wrist and ankles and the other 6 electrodes to the chest, avoiding chest hair. Instruct client to remain still Neurologic Diagnostic Procedures: Preparing for a lumbar puncture - --ANSWER---- Instruct client to void before procedure and have them stretch over an overbed table if sitting is preferred
  • Monitor the puncture site for several hours to ensure the site clots and to decrease the risk of post lumbar puncture headaches COPD: Expected ABG results - --ANSWER---Hypoxemia (decreased PaO2, less than

Hypercarbia (increased PaO2, greater than 45) Respiratory acidosis, metabolic alkalosis compensation Hematologic Diagnostic Procedures: Laboratory findings to report - --ANSWER---RBC: 4.2-5.4 and 4.7-6. WBC: 5-10, Platelets: 150-400, Hgb: 12-16 and 14- 18 Hct: 37-47% and 42-52% PT: 11-12.5 sec aPPT: 1.5-2 times normal range of 30- 40 INR: 2-3 on warfarin Acid base imbalance: Interpreting ABG results - --ANSWER---1) Look at pH <7.35 acidosis

7.45 Alkalosis

  1. PaCo2 and HCO <35 or >45 PaCO2 is respiratory <22 or >26 is metabolic Diabetes Mellitus Management: Evaluating Glycemic Control - --ANSWER---Monitor with HbA1c expected reference range is 4-6% acceptable target for clients with diabetes 6.5-8% indicator of average blood glucose for the past 120 days Electrolyte Imabalances: Increasing the risk for digoxin toxicity - --ANSWER--- Hypokalemia and client receiving digoxin increases the risk for digoxin toxicity

Respiratory Diagnostic Procedures: Client positioning for thoracentesis - --ANSWER--- Position the client sitting upright with his arms and shoulders raised and supported on pillows and/or on an overbed table and with his feet and legs well supported Hepatitis and Cirrhosis: Client positioning following a biopsy - --ANSWER---Assist the client into a supine position with the upper right quadrant of the abdomen exposed Cushing Disease/ Syndrome: Priority Actions - --ANSWER---Daily weights Monitor I&O assess for hypervolemia monitor for skin breakdown Fractures and Immobilization devices: Assessing for complications (795) - --ANSWER--- Fat embolism: Dyspnea, chest pain and decreased oxygen saturation Decreased mental acuity Respiratory distress Tachycardia Tachypnea Fever Osteomyelitis: Constant bone pain Edema Fever Possible elevated sedimentation rate Gastrointestinal Therapeutic Procedures: Ostomy complications - --ANSWER--- Necrosis: pale pink or bluish/purple in color intestinal obstruction: abdominal pain, absent bowel sounds, distention, n/v Burns: Priority action during resuscitation phase - --ANSWER---Maintain airway and ventilation rapid fluid resuscitation (0.9% NaCl or LR's) Inflammatory Disorders: Assessing a client who has a friction rub - --ANSWER---Assess lung sounds in all fields Friction rub occurs from

  • Pericarditis
  • Myocarditis
  • Rheumatic endocarditis Diabetes mellitus management: Recognizing Hypoglycemia - --ANSWER---Confusion Shaking (tremors)
  • Maintain safety and seizure precautions Chest tube insertion and monitoring: Maintaining drainage system - --ANSWER---First Chamber: Drainage collection Second Chamber: Water seal Third Chamber: Suction control Position client in semi-fowlers to high-fowlers position to promote optimal lung expansion
  • Tidaling with movement is expected in the water seal chamber
  • Cessation of tidaling in the water seal chamber signals lung reexpansion
  • Continuous bubbling in the water seal chamber (air leak finding) Diabetes Mellitus Management: Sick Day Management - --ANSWER---Monitor blood glucose every 3-4 hours Continue to take insulin or oral hypoglycemia agents consume 4oz sugar free liquid every 30 minutes meet carb needs with soft foods Test urine for ketones Head Injury: indications of increased intracranial pressure - --ANSWER----Severe headache
  • Deteriorating LOC
  • Dilated, pinpoint or asymmetric pupils
  • Alteration in breathing pattern
  • Abnormal posturing
  • cerebrospinal fluid leakage Hemodialysis and Peritoneal Dialysis: Intervening for decreased dialysate flow rate - -- ANSWER----Reposition client
  • milk tubing
  • check tubing for kinks or closed clamps
  • Tell client to avoid constipation by taking stool softeners and consuming a diet high in fiber Respiratory management and mechanical ventilation: caring for a client who has an ET tube - --ANSWER---Maintain a patent airway
  • assess the position and placement of tube
  • Suction oral and tracheal secretions to maintain tube patency
  • Soft wrist restraints
  • Maintain cuff pressure below 20mm Hg TB: Discharge teaching about TB - --ANSWER----Continue medication therapy for its full duration of 6-12 months
  • continue with follow-up care for 1 year
  • Sputum samples every 2-4 weeks, no longer contagious after 3 neg samples
  • proper hand hygiene
  • wear N Electrolyte imbalances: Treatment of hypokalemia - --ANSWER---IV potassium supplement Never administer IV bolus Encourage foods high in K Fluid imbalances: Assessment findings - --ANSWER---Hypo: Increased Hct Increased urine specific gravity increased serum sodium Hyper: Decreased Hct Normal sodium decreased electrolytes, BUN and creatinine Respiratory alkalosis Fluid Imbalances: Clinical manifestations of hypervolemia - --ANSWER---Tachycardia bounding pulse hypertension muscle weakness headache ascites orthopnea crackeles distended neck veins Fluid Imbalances: Clinical manifestations of Dehydration - --ANSWER---Hyperthermia tachycardia thready pulse hypotension decreased CVP tachypneic hypoxia dizziness syncope confusion thirst decreased cap refill Hyperthyroidism: Caring for a client following a thyroidectomy - --ANSWER---Client in high fowlers position, support head and neck with pillow and avoid neck extension

Dry Macular Degeneration: Smokers HTN Female Short body stature Family History Diet lacking carotene and Vitamin A

  • Lack of depth perception
  • Distorted objects
  • Blurred vision
  • Loss of central vision
  • Blindness Disorders of the eye: Indications of Glaucoma - --ANSWER---Open Angle
  • Headache
  • Mild eye pain
  • loss of peripheral vision
  • decreased acommodation
  • Elevated IOP (>21) Angle- Closure
  • Rapid onset of elevated IOP
  • Decreased or blurred vision
  • Halos around lights
  • non reactive pupils
  • severe pain and nausea
  • photophobia Posterior Pituitary Disorders: Medications to treat diabetes insipidus - --ANSWER--- Desmopressin acetate (DDAVP)
  • Notify weight gain >2 lbs in 24 hours Cabamazepine (Tegretol)
  • Notify sore throat, fever or bleeding Vasopressin (Pitressin)
  • Notify headache or confusion Head injury: Identification of altered respiratory patterns - --ANSWER---Cheyne stokes respirations central neurogenic hyperventilation apnea Emergency Nursing principles and management: Priority action for abdominal trauma (9) - --ANSWER---ABCDE (Airway, breathing, circulation, disability and exposure)

Hemodynamic Shock: Priority intervention for hypovolemic shock - --ANSWER--- Continuously monitor airway and vital signs Administer fluids (0.9% NaCl or Lactated Ringers) Have resuscitation equipment available Hypertension: Action for hypertensive crisis - --ANSWER---Administer IV anti- hypertensives therapies, such as nitroprusside, nicardipine and labetaolol Monitor BP every 5-15 minutes Assess neurological status Monitor Cardiac status Emergency Nursing principles and management: Emergency Illness management (9) - -

  • ANSWER---Always assess airway, breathing and circulation FIRST Fractures and immobilization devices: Assessing for compartment syndrome (795) - -- ANSWER---Compartment Syndrome assessment: Pain Paralysis Paresthesia Pallor Pulselessness Intense pain with movement numbness, burning and tingling are early signs Asthma: Identifying pathophysiology - --ANSWER---Chronic inflammatory disorder of the airways
  • Mucosal edema
  • Bronchoconstriction
  • Excessive mucus production
  • Dyspnea
  • Chest tightness
  • Anxiety/Stress
  • Wheezing
  • Coughing
  • Poor O Parkinsons disease: Expected findings - --ANSWER---- Stooped posture
  • Slow, Shuffling gait
  • Slow speech
  • Tremors
  • Muscle rigidity
  • Bradykinesia/ Akinesia
  • Autonomic Symptoms
  • Check for thrill or bruit
  • Eat well balanced meals that include foods high in folate (beans, green vegetables) and increase protein A nurse is receiving report on a client who is postoperative following an open repair of Zenker's Diverticulum. The nurse should anticipate the surgical incision to be in which of the following locations? (You will find hot spots to select in the artwork below. Select only the hot spot that corresponds to your answer.) - --ANSWER---A.) Throat A nurse is caring for a client who has a potassium level of 3 mEq/L. Which of the following assessment findings should the nurse expect? - --ANSWER---Hypoactive bowel sounds A nurse is providing discharge instructions to a client who has a partial thickness burn of the hand. Which of the following instructions should the nurse include? - --ANSWER--- Wrap fingers with individual dressings A nurse is assessing a client following the administration of magnesium sulfate 1g IV bolus. For which of the following adverse effects should the nurse monitor? - -- ANSWER---Respiratory Paralysis A nurse is assessing a client's hydration status. Which of the following findings indicated fluid volume overload. - --ANSWER---Distended neck veins A nurse is assessing a client following the administration of IV penicillin G. Which of the following findings should indicate to the nurse that the client is experiencing an anaphylactic reaction? - --ANSWER---Flushing A nurse is providing teaching to a client who has a severe form of stage II Lyme disease. Which of the following statements made by the client reflects an understanding of the teaching? - --ANSWER---My joints ache because I have Lyme disease. A nurse is caring for a client who has portal hypertension. The client is vomiting blood mixed with food after a meal. Which of the following actions should the nurse take first?
  • --ANSWER---Obtain vital signs A nurse is assessing a client following IV urography. Which of the following findings is the priority? - --ANSWER---Swollen lips A nurse is providing teaching to a client who has hypertension and a new prescription for verapamil. Which of the following statements by the client indicates an understanding of the teaching? - --ANSWER---I will count my heart beats before taking this medication. A nurse is providing teaching to a client who is receiving chemotherapy and has a new prescription for epoetin alfa. Which of the following client statements indicates an

understanding of the teaching? - --ANSWER---I will monitor my blood pressure while taking this medication. A nurse is caring for a client who has diabetic ketoacidosis (DKA). Which of the following should the nurse plan to administer? - --ANSWER---Regular insulin 20 units IV bolus A nurse is reviewing the laboratory findings of a client who developed chest pain 6 hr ago. The nurse should identify which of the following findings as an indication of a myocardial infarction(MI)? - --ANSWER---Troponin I 8 ng/mL A nurse is preparing to administer a unit of packed RBCs to a client. Which of the following actions should the nurse take? - --ANSWER---Remain with the client for the first 15 min of the infusion. A nurse is assessing a client who had extracorporeal shock wave lithotripsy(ESWL) 6 hr ago. Which of the following findings should the nurse expect? - --ANSWER---Stone fragments in the urine A nurse is teaching a group of newly licensed nurses about pain management for older adult clients. Which of the following statements by a newly licensed nurse indicates an understanding of the teaching? - --ANSWER---Ibuprofen can cause gastrointestinal bleeding in older adult clients. A nurse is caring for a client who is experiencing a tonic-clonic seizure. Which of the following actions should the nurse take? - --ANSWER---Loosen restrictive clothing A nurse is assessing a client who has Cushing's disease. Which of the following findings should the nurse expect? - --ANSWER---muscle atrophy A nurse is planning to irrigate and dress a clean, granulating wound for a client who has a pressure ulcer. Which of the following actions should the nurse take? - --ANSWER--- Use a 30mL syringe A nurse is reviewing the laboratory results of a client who had a recent exposure to hepatitis C virus. Which of the following tests should the nurse identify as indicating the presence of hepatitis C antibodies? - --ANSWER---Enzyme immunoassay (EIA) A nurse in an emergency department is assessing a client who has a detached retina. Which of the following should the nurse expect the client to report? - --ANSWER---It's like a curtain closed over my eye. A nurse is assessing heart sounds of a client who reports substernal precordial pain. Identify which of the following sounds the nurse should document in the client's medical record by listening to audio clip. (Click on the audio button to listen to the clip.) Murmur

A nurse is reviewing the health record of a client who is scheduled for allergy skin testing. The nurse should postpone the testing and report to the provider which of the following findings? (Click on the "Exhibit" button for additional information about the client. There are three tabs that contain separate categories of data.) Disease process Laboratory findings Current medications Family history - --ANSWER---Current medications A nurse is assessing a client who is receiving morphine via a PCA pump. Which of the following findings indicates an adverse effect of the medication? - --ANSWER---Urinary retention A nurse in an ICU is assessing a client who has a traumatic brain injury. Which of the following findings should the nurse identify as a component of Cushing's triad? - -- ANSWER---Bradycardia A nurse is providing teaching for a female client who has recurrent urinary tract infections. Which of the following information should the nurse include in the teaching? - --ANSWER---Void before and after intercourse A nurse is providing education to a client who has tuberculosis (TB) and his family. Which of the following information should the nurse include in the teaching? - -- ANSWER---Family members in the household should undergo TB testing A nurse is caring for a client 1 hr following a cardiac catheterization. The nurse notes the formation of a hematoma at the insertion site and a decreased pulse rate in the affected extremity. Which of the following interventions is the nurse's priority? - -- ANSWER---Apply firm pressure to the insertion site A nurse is caring for a client who has cirrhosis of the liver with esophageal varies. Which of the following activities should the nurse instruct the client to avoid? - -- ANSWER---Straining to have bowel movements A nurse is developing a teaching plan for a client who has gout. Which of the following recommendations should the nurse include? - --ANSWER---Decrease intake of purine meats A nurse is providing dietary teaching to a client who has celiac disease. Which of the following food choices should the nurse identify as an indication that the client understands the teaching? - --ANSWER---Grilled chicken breast A nurse is providing discharge instructions to a client following an upper gastrointestinal series with barium contrast. Which of the following information should the nurse provide? - --ANSWER---Increase fluid intake

A nurse in an emergency department is caring for a client who reports chest pain of 8 on a pain scale of 0 to 10. Which of the following actions should the nurse take first? - -- ANSWER---Administer morphine A nurse is assessing a client who has diabetes insipidus. Which of the following findings should the nurse expect? - --ANSWER---Low urine specific gravity A nurse is caring for a client who has a pneumothorax and a closed-chest drainage system. Which of the following findings is an indication of lung re-expansion. - -- ANSWER---Bubbling in the water-seal chamber has ceased. A nurse is caring for a client who has HIV. Which of the following findings indicates a positive response to the prescribed HIB treatment? - --ANSWER---Decreased viral load A nurse is caring for a client who is 4 hr postoperative following an open reduction internal fixation of the right ankle. Which of the following assessment findings should the nurse report to the provider? - --ANSWER---Extremity cool upon palpation A home health nurse is assigned to a client who was recently discharged from a rehabilitation center after experiencing a right-hemispheric cerebrovascular accident(CVA). Which of the following neurologic deficits should the nurse expect to find when assessing the client? (Select all that apply.) Expressive aphasia Visual spatial deficitis Left hemianopsia Right hemiplegia One-sided neglect - --ANSWER---Visual spatial deficits Left hemianopsia One-sided neglect A nurse in an ICU is planning care for a client who is in cariogenic shock. The nurse should prepare to administer which of the following medications to increase cardiac output? - --ANSWER---Dopamine A nurse is caring for a client who has viral pneumonia. The client's pulse oximeter readings have fluctuated between 79% and 88% for the last 30 min. Which of the following oxygen delivery systems should the nurse initiate to provide the highest concentration of oxygen? - --ANSWER---Nonrebreather mask A client who has emphysema is receiving mechanical ventilation. The client appears anxious and restless, and the high-pressure alarm is sounding. Which of the following actions should the nurse take first? - --ANSWER---Instruct the client to allow the machine to breathe for him.