The patient has been admitted to the hospital with nausea and vomiting that started 5 days earlier. Blood pressure is 80/44 mm Hg and heart rate is 122 beats/min; the patient has not voided in 8 hours, and the bladder is not distended. The nurse anticipates a prescription for “stat” administration of

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Question 1 of 5

The patient has been admitted to the hospital with nausea and vomiting that started 5 days earlier. Blood pressure is 80/44 mm Hg and heart rate is 122 beats/min; the patient has not voided in 8 hours, and the bladder is not distended. The nurse anticipates a prescription for “stat” administration of

Correct Answer: B

Rationale: The correct answer is B: fluid replacement with 0.45% saline. The patient's low blood pressure, tachycardia, and lack of urine output indicate hypovolemia. Fluid replacement with saline will help restore circulating volume, improve blood pressure, and support renal perfusion. A: Blood transfusion is not indicated as the primary issue is hypovolemia, not anemia. C: Inotropic agents are used to increase cardiac contractility but are not the initial treatment for hypovolemia. D: Antiemetics may help with symptoms but do not address the underlying issue of fluid loss and hypovolemia.

Question 2 of 5

A client with osteoarthritis is given a new prescription for a nonsteroidal anti-inflammatory drug (NSAID). The client asks the nurse, 'How is this medication different from the acetaminophen I have been taking?' Which information about the therapeutic action of NSAIDs should the nurse provide?

Correct Answer: B

Rationale: The correct answer is B: Provide anti-inflammatory response. NSAIDs work by inhibiting the enzyme cyclooxygenase, thereby reducing inflammation, pain, and fever. This is different from acetaminophen, which primarily acts as a pain reliever and fever reducer but lacks significant anti-inflammatory properties. Explanation of why other choices are incorrect: A: Are less expensive - Cost is not related to the therapeutic action of NSAIDs. C: Increase hepatotoxic side effects - While NSAIDs can have adverse effects on the liver, hepatotoxicity is not a primary therapeutic action of these drugs. D: Cause gastrointestinal bleeding - While NSAIDs can increase the risk of gastrointestinal bleeding, this is a potential side effect rather than the primary therapeutic action.

Question 3 of 5

A 16-year-old male client is admitted to the hospital after falling off a bike and sustaining a fractured bone. The healthcare provider explains the surgery needed to immobilize the fracture. Which action should be implemented to obtain a valid informed consent?

Correct Answer: A

Rationale: The correct answer is A: Obtain the permission of the custodial parent for the surgery. In this scenario, the client is a minor (16 years old), which means they are not legally able to provide informed consent for medical procedures. The custodial parent holds legal responsibility for the minor's healthcare decisions. Thus, obtaining the permission of the custodial parent is crucial to ensure valid informed consent. Choice B is incorrect because the non-custodial parent's consent may not be legally required if the custodial parent is available to provide consent. Choice C is incorrect because obtaining consent should precede any administration of medications. Choice D is incorrect as the stepfather's consent may not hold legal weight unless designated as a legal guardian.

Question 4 of 5

Two unlicensed assistive personnel (UAP) are arguing on the unit about who deserves to take a break first. What is the most important basic guideline that the nurse should follow in resolving the conflict?

Correct Answer: D

Rationale: The correct answer is D: Deal with issues and not personalities. This guideline is important because it focuses on resolving the conflict based on the actual problem at hand, rather than personal biases or emotions. By addressing the issues causing the argument, the nurse can help the UAPs find a fair and logical solution. A: Requiring the UAPs to reach a compromise may not address the root cause of the conflict and could lead to further disagreements. B: Weighing the consequences is important but may not be as effective in resolving the conflict as directly addressing the issues. C: Encouraging humor may temporarily diffuse the situation but may not lead to a lasting resolution.

Question 5 of 5

A 6-year-old child is alert but quiet when brought to the emergency center with periorbital ecchymosis and ecchymosis behind the ears. The nurse suspects potential child abuse and continues to assess the child for additional manifestations of a basilar skull fracture. What assessment finding would be consistent with a basilar skull fracture?

Correct Answer: C

Rationale: The correct answer is C: Rhinorrhoea or otorrhoea with Halo sign. This finding is consistent with a basilar skull fracture because it indicates a cerebrospinal fluid (CSF) leak from the skull base. The Halo sign refers to a ring of CSF surrounded by blood, which can be seen on a white absorbent pad. This specific sign is a classic indicator of a basilar skull fracture, as the CSF leakage from the ears or nose can be tinged with blood due to the fracture disrupting nearby blood vessels. For the other choices: A: Hematemesis and abdominal distention are not typical manifestations of a basilar skull fracture. They are more indicative of gastrointestinal issues or internal bleeding. B: Asymmetry of the face and eye movements can be seen with facial nerve or orbital injuries, but it is not specific to a basilar skull fracture. D: Abnormal position and movement of the arm are not directly related to a

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