ATI RN
ATI Med Surg Exam 9 Questions
Extract:
Question 1 of 5
A nurse at an ophthalmology clinic is providing medication teaching to a client who has open angle glaucoma. Which of the following instructions should the nurse provide?
Correct Answer: D
Rationale: Open angle glaucoma requires lifelong medication to maintain normal intraocular pressure and prevent vision loss.
Question 2 of 5
A nurse is caring for a client who is experiencing Cushing's Triad following a subdural hematoma. Which of the following manifestations will the nurse expect to find? (Select all that apply.)
Correct Answer: B,D,F
Rationale:
Choice A Reason: Slow even breathing is not a sign of Cushing's Triad, which is a late indicator of increased intracranial pressure (ICP). The breathing pattern may be altered due to brainstem compression, but not necessarily slow or even.
Choice B Reason: This is a correct answer because bradycardia and bounding pulse are part of Cushing's Triad, which reflects an increased vagal tone and decreased cardiac output due to increased ICP.
Choice C Reason: Systolic hypotension with a narrowing pulse pressure is not a sign of Cushing's Triad, which involves an increased systolic blood pressure and a widened pulse pressure due to increased ICP. Hypotension may occur due to shock or hemorrhage, but not as a result of increased ICP.
Choice D Reason: This is a correct answer because irregular respirations are part of Cushing's Triad, which reflects impaired respiratory control due to brainstem compression from increased ICP. The respirations may be Cheyne-Stokes, central neurogenic hyperventilation, apneustic, or ataxic.
Choice E Reason: Tachycardia and bounding pulse are not signs of Cushing's Triad, which involves bradycardia and bounding pulse due to increased ICP. Tachycardia may occur due to pain, anxiety, fever, or hypoxia, but not as a result of increased ICP.
Choice F Reason: This is a correct answer because systolic hypertension with a widening pulse pressure are part of Cushing's Triad, which reflects an increased cerebral perfusion pressure due to increased ICP. The diastolic blood pressure remains stable or decreases, resulting in a widened pulse pressure.
Question 3 of 5
A client is diagnosed with a problem involving the inner ear. Which is the most common client complaint associated with a problem involving this part of the ear?
Correct Answer: A
Rationale: Hearing loss is the most common complaint with inner ear problems, as the cochlea is responsible for hearing. Tinnitus is a symptom, pruritus relates to the outer ear, and muffled sounds indicate middle ear issues.
Question 4 of 5
The primary health care provider has determined that a client has contracted hepatitis A based on flu-like symptoms and jaundice. Which statement made by the client supports this medical diagnosis?
Correct Answer: A
Rationale: I ate shellfish about 2 weeks ago at a local restaurant.' supports the medical diagnosis of hepatitis A, which is an infection of the liver caused by the hepatitis A virus (HAV). HAV is transmitted by fecal-oral route, meaning that it can be contracted by ingesting contaminated food or water, such as raw or undercooked shellfish from polluted waters. The incubation period for hepatitis A is about two to six weeks. 'I was an intravenous drug abuser in the past and shared needles.' does not support the medical diagnosis of hepatitis A, but may indicate exposure to hepatitis B or C, which are infections of the liver caused by the hepatitis B virus (HBV) or hepatitis C virus (HCV). HBV and HCV are transmitted by blood or body fluids, meaning that they can be contracted by sharing needles, syringes, or other injection equipment with infected people. 'I had a blood transfusion in 1980 after major abdominal surgery.' does not support the medical diagnosis of hepatitis A, but may indicate exposure to hepatitis B or C, which are infections of the liver caused by the hepatitis B virus (HBV) or hepatitis C virus (HCV). HBV and HCV are transmitted by blood or body fluids, meaning that they can be contracted by receiving blood transfusions or organ transplants from infected donors. However, since 1992, all donated blood in the United States has been screened for HBV and HCV. 'I have had unprotected sex with multiple partners.' does not support the medical diagnosis of hepatitis A, but may indicate exposure to hepatitis B or C, which are infections of the liver caused by the hepatitis B virus (HBV) or hepatitis C virus (HCV). HBV and HCV are transmitted by blood or body fluids, meaning that they can be contracted by having unprotected sex with infected people. However, sexual transmission of HAV is rare, unless there is contact with fecal matter.
Question 5 of 5
A nurse is caring for a client who is postoperative from glaucoma surgery in the right eye. Which of the following will the nurse include in the postoperative education to the client? (Select all that apply)
Correct Answer: C,E,F
Rationale: These instructions ensure proper recovery by monitoring for complications, avoiding activities that increase intraocular pressure, and reassuring about normal post-surgical phenomena.