ATI RN Adult Medical Surgical 2023 IV

Extract:

Question 1 of 5

A nurse in the PACU is caring for a client. Which of the following assessments is the nurse's priority?

A. Level of consciousness B. Pain level C. Respiratory status D. Surgical site

Correct Answer: C

Rationale: Respiratory status (
C) is critical in PACU to ensure airway patency and oxygenation post-anesthesia. Consciousness (
A), pain (
B), and surgical site (
D) are assessed but are secondary to breathing.

Question 2 of 5

A nurse is caring for a client who is experiencing an increase in intracranial pressure (ICP). The nurse should expect which of the following as an early manifestation of increased ICP?

A. Restlessness B. Papilledema C. Projectile vomiting D. Decorticate posturing

Correct Answer: A

Rationale: Restlessness (
A) is an early sign of increased ICP due to cerebral irritation. Papilledema (
B), vomiting (
C), and posturing (
D) are later manifestations.

Question 3 of 5

A nurse on a medical-surgical unit is planning care for a client who has dementia and a history of wandering. Which of the following actions should the nurse plan to implement?

A. Use chemical restraints at bedtime. B. Use a bed alarm. C. Move client to a double room. D. Encourage participation in activities that provide excessive stimulation.

Correct Answer: B

Rationale: A bed alarm (
B) enhances safety for wandering dementia clients. Chemical restraints (
A) are avoided, double rooms (
C) may confuse, and overstimulation (
D) can worsen behavior.

Question 4 of 5

A nurse is completing discharge teaching with a client who has a new diagnosis of AIDS. Which of the following statements by the client indicates an understanding of the teaching?

A. I will wipe up areas soiled with body fluids with alcohol and immediately dispose of the trash, B. I will need to take my clothes to the dry cleaners to sterilize them. C. I will increase the amount of fresh fruits and vegetables I consume. D. I will be sure to wear gloves and wash my hands when I change my cat's litter box.

Correct Answer: D

Rationale: Wearing gloves for cat litter (
D) prevents toxoplasmosis, critical in AIDS. Alcohol cleaning (
A) is insufficient, dry cleaning (
B) is unnecessary, and diet changes (
C) are not specific to infection prevention.

Question 5 of 5

A nurse is providing dietary instructions to a client who has cardiovascular disease. The nurse should identify that which of following statements by the client indicates an understanding of the teaching?

A. I will use canola oil when making salad dressing. B. I will drink whole milk with my cereal. C. I will increase my intake of canned vegetables. D. I will limit my portions of meat to 8 ounces.

Correct Answer: A

Rationale: Canola oil (
A) is heart-healthy with low saturated fat. Whole milk (
B) is high in fat, canned vegetables (
C) have sodium, and 8 oz meat (
D) exceeds recommended portions.

ATI RN Adult Medical Surgical 2023 IV | Nurselytic

Nurselytic

ATI RN

ATI RN