ATI RN
ATI Med Surg Exam 9 Questions
Extract:
Question 1 of 5
A nurse is caring for a client following cataract surgery. Which of the following comments from the client should the nurse report to the client's provider?
Correct Answer: D
Rationale: Severe pain in the eye post-cataract surgery may indicate complications such as infection, inflammation, bleeding, or increased intraocular pressure, necessitating immediate reporting to the provider.
Question 2 of 5
The nurse is reviewing the record of a client with a diagnosis of cirrhosis and notes that there is documentation of the presence of asterixis. How should the nurse assess for its presence?
Correct Answer: B
Rationale: Reason: Measuring the abdominal girth is not related to asterixis, which is a tremor of the hand when the wrist is extended. It may indicate ascites, which is a complication of cirrhosis, but not asterixis. Reason: This is the correct choice. Asterixis is a flapping tremor of the hand when the wrist is extended, sometimes said to resemble a bird flapping its wings. It is caused by abnormal function of the diencephalic motor centers that regulate the muscles involved in maintaining posture. It is a sign of hepatic encephalopathy, which is a neuropsychiatric disorder that occurs in patients with liver disease. Reason: Having the client flex and extend their foot is not related to asterixis, which affects the hand and wrist. It may test for ankle clonus, which is a rhythmic contraction of the calf muscles when the foot is dorsiflexed. It indicates an upper motor neuron lesion, but not hepatic encephalopathy. Reason: Asking the client to walk heel to toe is not related to asterixis, which affects the hand and wrist. It may test for balance and coordination, which can be impaired in patients with hepatic encephalopathy, but it is not a specific sign of asterixis.
Question 3 of 5
A client arrives to the clinic after spending the day at the beach. She reports extreme pain and the nurse observes red skin on her face and upper body. There are no blisters present. What degree of burn has the client suffered?
Correct Answer: A
Rationale: First degree burns affect only the epidermis, causing redness and pain without blisters, as described. Second degree burns cause blisters, third degree burns destroy all skin layers, and the burn can be classified based on the symptoms.
Question 4 of 5
A nurse is teaching a client about diagnostic vision tests. The nurse should include that which of the following tests is performed to diagnose macular degeneration?
Correct Answer: A
Rationale: The Amsler grid test is used to diagnose macular degeneration by detecting distortions or missing areas in the grid, indicating damage to the macula.
Question 5 of 5
A client who recently suffered a stroke suffers from right-sided homonymous hemianopsia. What is the best action for the nurse to take when caring for the client during meal time?
Correct Answer: A
Rationale: Placing food trays on the left side helps the client see and access food due to right-sided vision loss. Other actions are inappropriate or unnecessary during meals.