Questions 48

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ATI Nsg 234 Med Surg Exam Neurologyendocrine And Sensory Questions

Extract:


Question 1 of 5

A nurse is caring for a client in an induced coma for increased intracranial pressure (ICP). What should the nurse assess next to determine this client's cerebral function?

Correct Answer: B

Rationale: Assessing pupillary size and reaction provides critical information on brainstem function and can indicate changes in ICP. Changes in pupil size and reaction can signify worsening cerebral function or brain herniation.

Question 2 of 5

A nurse is reviewing the medical record of a client who has been prescribed levothyroxine for several months. Which of the following findings indicates a therapeutic response to the medication?

Correct Answer: C

Rationale: Decreased thyroid-stimulating hormone (TSH) levels indicate that the body is responding well to levothyroxine, as TSH production decreases when thyroid hormone levels are adequate.

Question 3 of 5

A nurse is providing teaching to a client with Meniere's disease. The nurse recognizes that which of the following instructions should be given to the client regarding vertigo?

Correct Answer: B

Rationale: Instructing the client to get up slowly while turning their entire body helps to reduce vertigo symptoms by minimizing head movement, which can trigger or worsen dizziness in Meniere's disease.

Question 4 of 5

A nurse is caring for a client who has quadriplegia due to a spinal cord injury and reports having a severe headache. The nurse obtains a blood pressure reading of 210/108 mm Hg and suspects the client is experiencing autonomic dysreflexia. What should the nurse prioritize as the initial action?

Correct Answer: B

Rationale: Checking for a full bladder is the priority because bladder distension is a common trigger for autonomic dysreflexia in clients with spinal cord injuries, and relieving it can reduce the severe hypertensive response.

Question 5 of 5

A client is admitted for treatment of the Syndrome of Inappropriate Antidiuretic Hormone (SIADH). The nurse should initiate which of the following interventions?

Correct Answer: A

Rationale: In SIADH, excess ADH causes water retention and hyponatremia; fluid restriction helps to prevent further dilution of sodium and manage fluid balance.

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