ATI RN
ATI Neurological System Questions Questions
Question 1 of 5
When is a diagnosis of cholinergic crisis made?
Correct Answer: B
Rationale: In diagnosing a cholinergic crisis, it is essential to understand the pharmacological effects of edrophonium (Tensilon). The correct answer is B) Administration of edrophonium (Tensilon) increases muscle weakness. Edrophonium is a cholinesterase inhibitor that temporarily increases the levels of acetylcholine at the neuromuscular junction. In patients experiencing a cholinergic crisis, which is an overdose of cholinergic medication like pyridostigmine, administration of edrophonium exacerbates muscle weakness due to the excess acetylcholine causing overstimulation of nicotinic receptors. Option A is incorrect because impaired respiration due to muscle weakness is a general symptom that can occur in various neuromuscular conditions, not specific to a cholinergic crisis. Option C is incorrect because improved muscle contractility would be expected in conditions where acetylcholine levels are low, not in a cholinergic crisis where there is an excess. Option D is incorrect because EMG findings in a cholinergic crisis would typically show increased response to repeated stimulation due to the excess acetylcholine. Understanding these nuances is crucial for healthcare professionals, especially nurses and nurse educators, to accurately assess and manage patients with neurological conditions and medication overdoses.
Question 2 of 5
A patient is discharged from the outpatient clinic following application of a synthetic fiberglass long arm cast for a fractured ulna. Before discharge, the nurse instructs the patient to do what?
Correct Answer: B
Rationale: The correct answer is B) Move the shoulder and fingers frequently. This instruction is important to prevent joint stiffness, muscle atrophy, and promote circulation in the arm while it is immobilized in the cast. Moving the shoulder and fingers frequently within the limits of the cast helps maintain joint mobility and prevents complications like frozen shoulder or muscle weakness. Option A) Never get the cast wet is incorrect because it is important to keep the cast dry to prevent skin irritation, infection, or weakening of the cast material. Option C) Placing tape petals around the edges of the cast when it is dry is incorrect as it does not serve any therapeutic purpose and may actually interfere with the integrity of the cast. Option D) Using a sling to support the arm at waist level for the first 48 hours is incorrect as it may lead to shoulder stiffness and muscle weakening due to lack of movement. Educationally, it is crucial to teach patients proper care and instructions for cast management to promote optimal healing and prevent complications. Encouraging movement within the limits of the cast is an essential aspect of patient education in orthopedic care.
Question 3 of 5
Priority Decision: Twenty-four hours after a below-the-knee amputation, a patient uses the call system to tell the nurse that his dressing (a compression bandage) has fallen off. What is the first action that the nurse should take?
Correct Answer: B
Rationale: The correct answer is B) Cover the incision with dry gauze. This is the first action the nurse should take because the patient's dressing has fallen off, exposing the incision site. By covering the incision with dry gauze, the nurse can protect the wound from contaminants and promote healing by maintaining a clean and dry environment. Option A) Apply ice to the site is incorrect because applying ice to the amputation site can cause vasoconstriction, which may compromise blood flow and delay wound healing. Option C) Reapply the compression dressing is incorrect because the compression dressing may need to be reapplied by a healthcare provider to ensure proper fit and pressure on the residual limb. Option D) Elevate the extremity on a couple of pillows is incorrect because while elevation is important for reducing swelling and promoting circulation, the immediate priority is to cover the exposed incision to prevent infection. In an educational context, it is crucial for nurses to prioritize patient safety and wound care management post-amputation. Understanding the importance of wound dressing integrity and infection prevention is essential in providing quality care for patients undergoing surgical procedures like amputations. Nurses must be able to quickly assess and respond to changes in patient condition to prevent complications and promote optimal healing outcomes.
Question 4 of 5
A patient who experienced an open fracture of the humerus 2 weeks ago is having increased pain at the fracture site. To identify a possible causative agent of osteomyelitis at the site, what should the nurse expect testing to include?
Correct Answer: C
Rationale: The correct answer is C) Bone biopsy. When a patient with an open fracture experiences increased pain at the fracture site, it raises suspicion for osteomyelitis, an infection of the bone. To definitively diagnose osteomyelitis, a bone biopsy is necessary to identify the causative agent, such as bacteria, which helps determine the appropriate treatment plan, including antibiotic therapy. Option A) X-rays can show changes in bone density or structure but may not definitively diagnose osteomyelitis. Option B) CT scans provide detailed images of the bones and surrounding tissues, but they are not typically used as the primary diagnostic tool for osteomyelitis. Option D) WBC count and ESR can indicate inflammation or infection in the body, but they are not specific to osteomyelitis and cannot identify the causative agent. Educationally, understanding the diagnostic process for osteomyelitis is crucial for nurses caring for patients with fractures or suspected bone infections. Proper assessment, including ordering the appropriate tests like a bone biopsy, is essential for accurate diagnosis and timely treatment to prevent complications.
Question 5 of 5
A 60-year-old woman has pain on motion in her fingers and asks the nurse whether this is just a result of aging. The best response by the nurse should include what information?
Correct Answer: D
Rationale: The correct answer is D: Changes in the cartilage and bones of joints may cause symptoms of pain and loss of function in some people as they age. Rationale: - This response is correct because it acknowledges the physiological changes that occur in joints as people age, such as degeneration of cartilage and bones leading to pain and reduced function. - Age-related joint pain is often attributed to osteoarthritis, a common condition characterized by wear and tear on the joints over time. - Understanding these age-related changes can help individuals manage their symptoms effectively through lifestyle modifications, exercise, and medical interventions. Why other options are incorrect: - Option A is incorrect because while joint pain can be common with aging, it is not always associated with functional limitations for all individuals. - Option B is incorrect as age-related joint pain is not always solely related to previous trauma or infection but can also be due to natural degenerative processes. - Option C is incorrect as not all cases of joint pain in older adults are indicative of a systemic arthritis affecting all joints progressively. Educational context: Educating patients about the normal changes that occur in the musculoskeletal system as they age is crucial for promoting self-awareness and proactive management of symptoms. By understanding the factors contributing to joint pain, individuals can make informed decisions about lifestyle choices, seek appropriate medical advice, and engage in strategies to maintain joint health and mobility as they grow older.