ATI RN
ATI Med Surg Exam 1 2024 Questions
Extract:
Question 1 of 5
A nurse is assessing a client who reports manifestations of tinnitus. Which of the following actions should the nurse perform to determine if movement is causing the clients manifestations to worsen?
Correct Answer: A
Rationale: Asking the client to move their eyes side to side while keeping the head still can help identify if tinnitus worsens with movement, suggesting a vascular cause. Breathing through pursed lips is for respiratory issues, pulling the pinna is for ear canal visualization, and opening the mouth widely is for TMJ assessment, none of which assess tinnitus exacerbation.
Question 2 of 5
A nurse is admitting a client to the hospital unit. Which one of the following elements of the client's history and physical assessment increases the risk for the development of delirium?
Correct Answer: B
Rationale: B. A history of drug and alcohol use increases the risk of delirium by disrupting neurotransmitter function or through withdrawal effects, which can precipitate altered mental status.
Question 3 of 5
A nurse is teaching a group of nursing students about brain herniation. Which of the following interventions should the nurse include as a possible treatment for brain herniation?
Correct Answer: C
Rationale: Hyperventilation is a potential intervention for managing brain herniation as it helps temporarily lower intracranial pressure (ICP) by inducing cerebral vasoconstriction. By increasing the rate and depth of breathing, hyperventilation reduces the partial pressure of carbon dioxide (PaCO2) in the blood, leading to vasoconstriction of cerebral blood vessels and a decrease in cerebral blood flow. This can help alleviate symptoms associated with increased ICP and reduce the risk of further brain injury.
Question 4 of 5
A nurse is providing care to a client who has spent several weeks in the intensive care unit because of complications related to shock. What adverse psychological outcomes should the nurse educate the client about prior to transfer to the medical unit?
Correct Answer: D
Rationale: Disorientation and depression are common adverse psychological outcomes experienced by patients who have spent an extended period in the intensive care unit (ICU) due to complications related to shock. Prolonged ICU stays, medical interventions, sedation, and physical discomfort can contribute to feelings of confusion, disorientation, and depression.
Question 5 of 5
A nurse is assessing a client who has Lewy body dementia. The nurse should recognize that which of the following is responsible for changes in thinking, communication, movement, and emotional processing in Lewy body dementia?
Correct Answer: C
Rationale: Lewy bodies, which are abnormal aggregates of alpha-synuclein protein, are a hallmark pathology of Lewy body dementia. These protein aggregates disrupt neuronal function and are responsible for the cognitive, motor, and emotional symptoms seen in Lewy body dementia.