ATI RN
ATI Nur258 Med Surg 2 Final Exam Questions
Extract:
Question 1 of 5
A nurse is caring for a client who reports a throbbing headache after a lumbar puncture. Which of the following actions is most likely to facilitate resolution of the headache?
Correct Answer: B
Rationale: Increasing fluid intake is effective in managing a headache after a lumbar puncture because it helps replenish cerebrospinal fluid (CSF) and reduces the risk of post-lumbar puncture headache, which often results from CSF leakage.
Question 2 of 5
A nurse is caring for a client with a history of rheumatoid arthritis who takes corticosteroids on a regular basis. The client asks the nurse about the potential complications of taking corticosteroids. What is the nurse's best response?
Correct Answer: C
Rationale: Corticosteroids cause immunosuppression by inhibiting the function of various immune cells and reducing the production of inflammatory cytokines. This increases the risk of infections.
Question 3 of 5
A client arrives in the emergency department with an ischemic stroke. What is the priority for the nurse to assess in relation to the administration of tissue plasminogen activator (t-PA) as treatment?
Correct Answer: A
Rationale: Assessing current anticoagulant use is a priority because t-PA (tissue plasminogen activator) can increase the risk of bleeding, especially if the client has been on anticoagulant medications. It is crucial to determine if there are any contraindications or increased risks for bleeding.
Question 4 of 5
A nurse in an emergency department is caring for a client who has anaphylaxis following a bee sting. Which of the following actions should the nurse take first?
Correct Answer: C
Rationale: Administering epinephrine is the first-line treatment for anaphylaxis. Epinephrine rapidly reverses the symptoms of anaphylaxis, such as airway constriction and low blood pressure, making it the highest priority intervention.
Question 5 of 5
A nurse is caring for a client who experienced a right-hemispheric stroke and has extreme muscle weakness on the affected side. Which nursing intervention is most appropriate for this client?
Correct Answer: A
Rationale: A client with extreme muscle weakness on the affected side should use a cane or other assistive devices to aid in mobility and ensure safety. This intervention helps the client maintain stability and prevent falls.