ATI RN
ATI Advanced Med Surg Cohort 4 Exam Questions
Extract:
Question 1 of 5
A nurse is in a client's room when the client begins having a tonic-clonic seizure. Which of the following actions should the nurse take first?
Correct Answer: A
Rationale: Turning the client's head to the side prevents aspiration by allowing secretions or vomitus to drain, prioritizing airway protection during a seizure.
Question 2 of 5
A nurse is caring for a client who has an intracranial aneurysm and requires aneurysm precautions. Which of the following interventions should the nurse take?
Correct Answer: C
Rationale: Minimizing stimuli reduces stress and blood pressure, lowering the risk of aneurysm rupture.
Question 3 of 5
While the nurse is transporting a patient on a stretcher to the radiology department, the patient begins having a tonic-clonic seizure. Which action should the nurse take?
Correct Answer: B
Rationale: Timing and documenting seizure details are critical for accurate assessment and management, ensuring patient safety without harmful interventions like restraint or airway insertion.
Question 4 of 5
A nurse is caring for a client who has quadriplegia from 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. Which of the following actions should the nurse take first?
Correct Answer: D
Rationale: Assessing for bladder distention addresses the common trigger of autonomic dysreflexia, prioritizing the cause of the hypertensive crisis.
Question 5 of 5
A nurse is caring for a client who reports a throbbing headache and hypotension after a lumbar puncture. Which of the following actions is most likely to facilitate resolution of the headache?
Correct Answer: C
Rationale: A blood patch seals the puncture site to restore cerebrospinal fluid pressure, directly addressing the cause of post-lumbar puncture headache.