ATI RN
ATI Med Surg Custom N235 Final Summer 2023 Questions
Extract:
Question 1 of 5
A nurse in an emergency room is caring for a client who sustained partial-thickness burns to both lower legs, chest, face Hokkaido, and both forearms. Which of the following is the priority action the nurse should take?
Correct Answer: D
Rationale: Face burns raise concern for inhalation injury; inspecting the mouth assesses airway risk.
Question 2 of 5
A nurse in an emergency department is caring for a client who had a seizure and became unresponsive after stating she had a sudden, severe headache and vomiting. The client's vital signs are as follows: blood pressure of 198/110 mm Hg, pulse of 82/min, respirations of 24/min, and a temperature of 38.2°C (100.8°F). Which of the following neurologic disorders should the nurse suspect?
Correct Answer: D
Rationale: Sudden headache, seizure, and hypertension suggest a hemorrhagic stroke, likely from a ruptured vessel.
Question 3 of 5
A nurse is assessing the depth and extent of injury on a client who has severe burns to the face, neck, and upper extremities. Which of the following factors is the nurse's priority when assessing the severity of the client's burns?
Correct Answer: D
Rationale: The location of the burn is the priority because burns to the face and neck can compromise the airway, making it the most immediate threat to life.
Question 4 of 5
A nurse is caring for a client who has a deep vein thrombosis and is prescribed heparin by continuous IV infusion at 1,200 units/hr. Available is heparin 25,000 units in 500 mL D5W. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest tenth/whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Correct Answer: 24
Rationale: Calculation: (1,200 units/hr ÷ 25,000 units) × 500 mL = 24 mL/hr. This is the correct infusion rate for the prescribed dose.
Question 5 of 5
A nurse is caring for a client who has hypovolemic shock. Which of the following should the nurse recognize as an expected finding?
Correct Answer: C
Rationale: Oliguria is expected in hypovolemic shock due to decreased renal perfusion.