ATI RN
ATI Med Surg Exam 9 Questions
Extract:
Question 1 of 5
A nurse is assessing a client who has a score of 6 on the Glasgow Coma Scale. The nurse should expect which of the following outcomes based on this score?
Correct Answer: A
Rationale: The client needs total nursing care is the expected outcome for a client who has a score of 6 on the Glasgow Coma Scale, which is a tool that measures the level of consciousness based on eye opening, verbal response, and motor response. A score of 6 indicates severe brain injury and coma, meaning that the client is unresponsive and dependent on others for all activities of daily living. Indicates stable neurologic status is not the expected outcome for a client who has a score of 6 on the Glasgow Coma Scale, which indicates severe brain injury and coma. A stable neurologic status means that there are no changes in the level of consciousness, vital signs, or neurological signs. The client has a decline in level of consciousness but is able to protect his airway is not the expected outcome for a client who has a score of 6 on the Glasgow Coma Scale, which indicates severe brain injury and coma. A decline in level of consciousness means that the client is less alert and responsive than normal, but still able to respond to stimuli and maintain airway patency. The client is alert and oriented is not the expected outcome for a client who has a score of 6 on the Glasgow Coma Scale, which indicates severe brain injury and coma. Alert and oriented means that the client is fully awake and aware of person, place, time, and situation.
Question 2 of 5
Which of the following is a feature of complex partial seizures?
Correct Answer: C
Rationale: Having involuntary facial movements, such as lipsmacking, is a feature of complex partial seizures. Complex partial seizures often originate from the temporal lobe and can cause automatisms like chewing, swallowing, or picking. Fixed and dilated eyes are associated with brain death or severe brain injury, not complex partial seizures. Involuntary groaning sounds are more typical of simple partial seizures, which do not impair awareness or cause automatisms.
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
A nurse is caring for a client who reports a decrease in central vision. The nurse should identify that this is a manifestation of which of the following visual impairments?
Correct Answer: A
Rationale: Macular degeneration affects the macula, leading to blurred or lost central vision, which matches the client's symptoms of decreased central vision.
Question 5 of 5
A nurse is caring for a client who is experiencing a seizure. Which of the following actions should the nurse take? (Select all that apply)
Correct Answer: D,E
Rationale: Loosening restrictive clothing improves breathing and circulation, and placing a pillow under the head prevents injury. Placing the client supine risks aspiration, restraints can cause injury, and inserting a bite stick can damage teeth or obstruct the airway.