ATI RN
ATI RN Adult Medical Surgical 2023 III Questions
Extract:
Question 1 of 5
A nurse is caring for a client who is experiencing an increase in intracranial pressure (ICP). The nurse should expect which of the following as an early manifestation of increased ICP?
Correct Answer: C
Rationale: Restlessness is an early sign of increased ICP due to cerebral irritation before more severe symptoms appear.
Question 2 of 5
A nurse is caring for a client who has end-stage liver disease and is being placed on a transplant list. Which of the following statements by the client is the priority for the nurse to report to the provider?
Correct Answer: C
Rationale: Non-adherence to medications can affect transplant eligibility and post-transplant outcomes, making it a priority to report.
Extract:
Diagnostic Results
Day of Admission:
Brain Natriuretic Peptide (BNP): 450 pg/mL (Normal: <100 pg/mL)
Potassium: 4.8 mEq/L (Normal: 3.5-5 mEq/L)
Sodium: 132 mEq/L (Normal: 136-145 mEq/L)
BUN: 10 mg/dL (Normal: 10-20 mg/dL)
Day 2 of Hospitalization:
Brain Natriuretic Peptide (BNP): 110 pg/mL (Normal: <100 pg/mL)
Potassium: 3.3 mEq/L (Normal: 3.5-5 mEq/L)
Sodium: 135 mEq/L (Normal: 136-145 mEq/L)
BUN: 20 mg/dL (Normal: 10-20 mg/dL)
Medical Administration Record
Day of Admission:
• Medication: Furosemide 80 mg IV, 3 times per day
Vital Signs
Day of Admission:
Temperature: 36.6°C (97.8°F)
Heart Rate: 112/min
Respiratory Rate: 24/min
Blood Pressure: 186/84 mmHg
Oxygen Saturation: 93% on room air
Weight: 97.5 kg (215 lb)
Day 2 of Hospitalization:
Temperature: 36.6°C (97.8°F)
Heart Rate: 78/min
Respiratory Rate: 18/min
Blood Pressure: 102/78 mmHg
Oxygen Saturation: 98% on 2 L/min oxygen via nasal cannula
Weight: 90.7 kg (200 lb)
Question 3 of 5
The client is at risk for developing……. and……...
Correct Answer: B,D
Rationale: Heart failure increases the risk of fluid volume deficit and dysrhythmias due to cardiac strain and electrolyte imbalances.
Extract:
Question 4 of 5
A nurse is assessing a client who has increased intracranial pressure. The nurse should recognize that which of the following is the first sign of deteriorating neurological status?
Correct Answer: A
Rationale: Altered level of consciousness is the earliest sign of neurological deterioration due to increased ICP.
Question 5 of 5
A nurse is caring for a client who has a new diagnosis of type 2 diabetes mellitus and has a referral for dietary consult. The client tells the nurse, 'I will have to eat whatever the dietitian tells me.' Which of the following statements by the nurse encourages the client's involvement in their plan of care?
Correct Answer: B
Rationale: Assisting the client to list preferred foods encourages active participation in their dietary plan, enhancing adherence.