Questions 70

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ATI RN Test Bank

ATI Med Surg Custom N235 Final Summer 2023 Questions

Extract:


Question 1 of 5

A nurse in an emergency department is preparing to care for a client who is being brought in with multiple system trauma following a motor vehicle crash. Which of the following should the nurse identify as the priority focus of care?

Correct Answer: B

Rationale: In trauma situations, the priority is to ensure a patent airway (airway protection) as per the ABCs (Airway, Breathing, Circulation) of emergency care, since oxygenation is critical for survival.

Question 2 of 5

A nurse in the emergency department is caring for a client who has sustained a head injury. The nurse notes the client's IV fluids are infusing at 125 mL/hr. Which of the following is an appropriate action by the nurse?

Correct Answer: C

Rationale: In head injury, rapid fluid infusion (125 mL/hr) can worsen ICP; slowing to 20 mL/hr is safer.

Question 3 of 5

A nurse is caring for a client who has a traumatic brain injury. The nurse notes that the client has a widening pulse pressure. Which of the following actions should the nurse take?

Correct Answer: B

Rationale: Widening pulse pressure suggests increased ICP; elevating the head to 30° reduces it.

Question 4 of 5

A nurse is monitoring the fluid replacement of a client who has sustained burns. The nurse should administer which of the following fluids in the first 24 hr following a burn injury?

Correct Answer: D

Rationale: Lactated Ringer's is preferred for burn resuscitation to replace fluid losses effectively.

Question 5 of 5

A nurse in an emergency department is reviewing the medical record of a client who has an extensive burn injury. Which of the following laboratory results should the nurse expect?

Correct Answer: C

Rationale: Extensive burns cause hemolysis and fluid shifts, leading to low hemoglobin.

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