ATI RN
ATI Custom MS Nurse Questions
Extract:
Client with a spinal cord injury suspected of autonomic dysreflexia
Question 1 of 5
A nurse is caring for a client who has a spinal cord injury. The nurse suspects that the client has autonomic dysreflexia. Which of the following actions should the nurse take first?
Correct Answer: A
Rationale: If a nurse is caring for a client who has a spinal cord injury and suspects that the client has autonomic dysreflexia, the first action the nurse should take is to raise the head of the bed. This can help to lower the client's blood pressure and reduce the risk of complications such as stroke.
Extract:
Client who fell and injured her ankle, ankle appears swollen and ecchymotic
Question 2 of 5
A nurse in an urgent care centre is caring for a client who fell and injured her ankle. The ankle appears swollen and ecchymotic. Which of the following interventions should the nurse take?
Correct Answer: A,D,E
Rationale: Applying a compression bandage to the client's ankle can help reduce swelling and provide support. Elevating the client's foot can also help reduce swelling by promoting venous return. Checking the client's toes for color, temperature, and sensation is important to assess for any potential nerve or vascular damage.
Extract:
Client with multiple sclerosis learning four-point alternate gait with crutches
Question 3 of 5
A nurse is reinforcing teaching with a client who has multiple sclerosis and is learning how to use the four-point alternate gait with crutches. Identify the order of the steps the nurse should give to the client.
Order the Items
Source Container
Correct Answer: A,B,C,D
Rationale: The order of the steps for the four-point alternate gait with crutches is as follows: move the right crutch about 10 to 15 cm (4 to 6 in), move the left foot forward, move the left crutch forward, and move the right foot forward. This gait pattern provides maximum stability and support for the client by keeping three points of contact on the ground at all times.
Extract:
Client who had an open reduction internal fixation surgery
Question 4 of 5
A nurse is completing a neurovascular check for a client who had an open reduction internal fixation surgery. Which of the following findings should the nurse identify as possible manifestations of compartment syndrome?
Correct Answer: A,B,C
Rationale: The nurse should identify absence of pulse, altered sensation of the toes, and cool skin as possible manifestations of compartment syndrome. Compartment syndrome is a serious condition that can occur following surgery or injury, characterized by increased pressure within a muscle compartment that can lead to decreased blood flow and nerve damage.
Extract:
Client with an exacerbation of gout
Question 5 of 5
A nurse is collecting data from a client who has an exacerbation of gout. Which of the following findings should the nurse expect?
Correct Answer: B,C,E
Rationale: A nurse collecting data from a client who has an exacerbation of gout should expect to find edema, tophi, and erythema. Gout is a type of arthritis that occurs when urate crystals accumulate in the joints, causing inflammation and intense pain.