ATI RN Adult Medical Surgical 2023 | Nurselytic

Questions 87

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ATI RN Adult Medical Surgical 2023 Questions

Extract:


Question 1 of 5

A nurse is caring for a client who has left-sided heart failure. Which of the following manifestations should the nurse expect?

Correct Answer: C

Rationale: Left-sided heart failure leads to pulmonary congestion, which can cause daytime oliguria due to decreased renal perfusion.

Question 2 of 5

A nurse in the emergency department is managing the care of a client who has an electrical shock injury. Which of the following actions should the nurse take first?

Correct Answer: D

Rationale: Obtaining an ECG first assesses for cardiac arrhythmias caused by electrical injury.

Question 3 of 5

A nurse is performing a cranial nerve assessment on a client following a head injury. Which of the following findings should the nurse expect if the client has impaired function of the vestibulocochlear nerve (cranial nerve VIII)?

Correct Answer: C

Rationale: The vestibulocochlear nerve (cranial nerve VIII) is responsible for balance and hearing; impaired function leads to disequilibrium with movement.

Extract:

Vital Signs
1000
Temperature 37.1° C (98.8° F)
Heart rate 110/min and irregular Respiratory rate 24/min Blood pressure 164/80 mm Hg
Oxygen saturation 93% on room air


Question 4 of 5

A nurse is admitting a client who reports tightness in their chest that radiates to left arm. The nurse is reviewing the client's medical record. Select the four findings that require immediate follow-up.

Correct Answer: C,D,E,G

Rationale: Elevated BP, pain, ECG changes, and troponin levels indicate a potential myocardial infarction.

Extract:

Findings upon admission:
Vital Signs

Blood pressure 106/64 mm Hg

Heart rate 95/min

Respiratory rate 20/min

Temperature 37.8° C (100° F)

Oxygen saturation 95% on O, at 3 L/min via nasal cannula


Question 5 of 5

A nurse is caring for an older adult client who was admitted with a urinary tract infection. The nurse is assessing the client 12 hr later. How should the nurse interpret the findings? For each finding, click to specify whether the finding is unrelated to the diagnosis, a sign of potential improvement, or a sign of potential worsening condition.

Options Unrelated to diagnosis Indication of potential improvement Indication of potential worsening condition
Disoriented to person, place, and time
Oxygen saturation 96% at 2 L/min via nasal cannula
Hct 45%
Butterfly rash
Blood pressure 100/50 mm Hg

Correct Answer:

Rationale: Disorientation and low BP worsen UTI; improved O2 is a sign of improvement; Hct is normal; rash is unrelated.

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