ATI RN
ATI Nsg 234 Med Surg Exam Neurologyendocrine And Sensory Questions
Question 1 of 5
A nurse is caring for a client who has quadriplegia due to a spinal cord injury and reports having a severe headache. The nurse obtains a blood pressure reading of 210/108 mm Hg and suspects the client is experiencing autonomic dysreflexia. What should the nurse prioritize as the initial action?
Correct Answer: B
Rationale: Checking for a full bladder is the priority because bladder distension is a common trigger for autonomic dysreflexia in clients with spinal cord injuries, and relieving it can reduce the severe hypertensive response.
Question 2 of 5
The nurse is providing teaching on the miotic medication the client has been prescribed for glaucoma. The client asks the nurse about the purpose of the medication. Which response should the nurse provide to the client?
Correct Answer: A
Rationale: Miotic medications work by constricting the pupil, which opens the trabecular meshwork and facilitates the drainage of aqueous humor, thus lowering intraocular pressure in clients with glaucoma.
Question 3 of 5
A nurse is caring for a client who has a mild traumatic brain injury (TBI). Which of the following manifestations should the nurse immediately report to the provider?
Correct Answer: C
Rationale: A change in the Glasgow Coma Scale score from 13 to 11 indicates a worsening level of consciousness and necessitates immediate reporting, as it may suggest increased intracranial pressure or other complications.
Question 4 of 5
A nurse is screening clients for adrenal insufficiency. The nurse recognizes that which client is at greatest risk for adrenal insufficiency?
Correct Answer: C
Rationale: Prolonged daily steroid use, especially in an older adult, poses the greatest risk for adrenal insufficiency due to suppression of the hypothalamic-pituitary-adrenal (HP
A) axis.
Question 5 of 5
A nurse is preparing information about eye health for a community health fair. Which of the following information related to risk factors for cataracts should the nurse include? SELECT ALL THAT APPLY.
Correct Answer: A,B,C,E
Rationale: Hypertension, family history, obesity, and increasing age are all risk factors for cataracts due to their effects on vascular health, genetic predisposition, metabolic changes, and natural aging processes. Wearing sunglasses is a preventive measure, not a risk factor.