Questions 63

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ATI RN Test Bank

ATI Med Surg Adult Care 2 Questions

Extract:


Question 1 of 5

A nurse collects health history from a 65 year old client. Which of the following risk factors in the client's history put chồng at the highest risk for embolic stroke?

Correct Answer: D

Rationale: Mitral valve replacement is the highest risk factor for embolic stroke among the choices given.

Question 2 of 5

A nurse is assessing a client who has a traumatic head injury to determine motor function response. Which of the following client responses to painful stimulus is expected?

Correct Answer: B

Rationale: Pushing the painful stimulus away is a normal response that indicates intact motor function and voluntary movement.

Question 3 of 5

A nurse at a community health clinic is caring for a client who reports a headache and stiff neck. Which of the following actions should the nurse take first?

Correct Answer: D

Rationale: Evaluating the client's neurological status is the first and most important action for this client, who has two classic signs of meningitis: headache and stiff neck.

Question 4 of 5

A nurse enters a client's room and finds the client on the floor having a seizure. Which of the following is not an appropriate action for the nurse to take?

Correct Answer: B

Rationale: Placing the client's head on the nurse's lap may obstruct his airway and increase the risk of aspiration.

Question 5 of 5

A nurse is assessing a client who has a concussion from a sports injury. Which of the following manifestations should the nurse expect?

Correct Answer: B

Rationale: A lingering headache that comes and goes is a common manifestation of concussion, as the brain tissue is bruised and inflamed.

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