ATI RN
ATI Custom MS Nurse Questions
Extract:
Client at risk for stroke
Question 1 of 5
A nurse is planning care for several clients and is considering the clients' risk for stroke. Which of the following conditions places the client at risk for an ischemic embolic stroke?
Correct Answer: C
Rationale: A client who has chronic atrial fibrillation is at risk for an ischemic embolic stroke. An ischemic embolic stroke occurs when a blood clot that forms in one part of the body travels to the brain and blocks blood flow. Atrial fibrillation is a type of irregular heart rhythm that can cause blood to pool, thicken, and clot in the heart or arteries near it.
Extract:
Client with an ankle sprain
Question 2 of 5
A nurse is reinforcing teaching with a client who has an ankle sprain. Which of the following instructions should the nurse include?
Correct Answer: C
Rationale: The nurse should instruct the client to elevate the affected ankle to the level of the heart. Elevation helps to reduce swelling and pain by promoting venous return and decreasing blood flow to the injured area.
Extract:
Client with a short arm cast for a fractured wrist
Question 3 of 5
A nurse is collecting data from a client who has a short arm cast for a fractured wrist. Which of the following findings indicates impaired venous return in the affected arm?
Correct Answer: D
Rationale: Pain that is unrelieved by opioid analgesics can be a sign of compartment syndrome, which is a serious complication that can result from impaired venous return and increased pressure within the muscle compartments.
Extract:
Client with increased intracranial pressure demonstrating decorticate posturing
Question 4 of 5
A nurse is collecting data from a client who has increased intracranial pressure and is informed by the charge nurse that the client demonstrates decorticate posturing. Which of the following findings should the nurse expect to observe?
Correct Answer: D
Rationale: In decorticate posturing, the lower extremities typically exhibit plantar flexion. Additionally, the upper extremities show flexion of the arms, wrists, and fingers with adduction of the arms.
Extract:
Client in halo traction to immobilize cervical spine
Question 5 of 5
A nurse is caring for a client who has been placed in halo traction to immobilize his cervical spine. Which of the following actions should the nurse take?
Correct Answer: B
Rationale: Elevating the head of the bed can help improve the patient's comfort and reduce the risk of complications such as aspiration in a client with halo traction.