ATI RN
ATI Nur211 Capstone Questions
Extract:
Progress Notes
Day 1
Client presents with abrupt onset of stroke-like manifestations with right facial droop, slurred speech, ataxia, and decrease in level of consciousness.
CT scan indicates ischemic stroke. Thrombolytic therapy with alteplase 90 mg IV over 1 hr given without incident.
Day 2
Client alert and oriented to person, place, and time; speech slightly slurred, but comprehendible. Smile asymmetrical, right side of mouth drooping. Weakness to right arm and leg. Muscle strength with unequal grips, right hand weaker, muscle strength to right leg weaker. Swallow study reports reviewed.
Day 3
Client to be discharged with prescriptions for home health including speech, physical, and occupational therapy.
Client instructed on lifestyle changes to decrease stroke risk including medication therapy for atrial fibrillation, hypertension, hyperlipidemia. Client instructed on Level 3 dysphagia diet, as well as safe practices during mealtimes. On this diet the client can eat bite-sized pieces of moist foods with near- normal textures. They should avoid very hard, sticky, or crunchy foods, such as dried fruit or nuts.
Medical History
Atrial fibrillation Hypertension Obesity Hyperlipidemia
Diagnostic Results
Day 1
CT Scan:
Non-contrast CT of client who presents with facial droop, ataxia, and decrease in level of consciousness. No evidence of acute bleeding or lesions. Slight loss of normal gray matter/white matter differentiation may indicate early ischemic changes consistent with acute infarction.
Day 2
Swallow study.
Swallow study co texture. Results it
Question 1 of 5
A nurse is providing discharge teaching. Which of the following client statements indicate an understanding of the teaching?
Correct Answer: B,C,E,F
Rationale:
Correct Answer: B, C, E, F
Rationale:
B: Stopping watching TV while eating promotes mindful eating, aiding in digestion.
C: Having food consistency of pudding may be required for easier swallowing post-discharge.
E: Not drinking liquids with food prevents choking risk and aids digestion.
F: Avoiding nuts can prevent choking, especially if the client has swallowing difficulties.
Summary of Incorrect
Choices:
A: Looking up at the ceiling during swallowing is incorrect as it can lead to aspiration.
D: Having cream soups may not be suitable for certain conditions and can cause swallowing issues.
G: Incomplete information provided.
Extract:
Question 2 of 5
A nurse is providing care for a group of clients in the emergency department. Which of the following clients is at risk for developing neurogenic shock?
Correct Answer: C
Rationale:
Rationale: Guillain-Barré syndrome affects the peripheral nervous system, potentially leading to autonomic dysfunction causing neurogenic shock. This client is at risk due to nerve damage affecting blood vessel tone regulation. Chronic kidney disease (
A) is not directly related to neurogenic shock. Asthma (
B) does not typically lead to neurogenic shock. Severe burn injury (
D) can cause hypovolemic shock, not neurogenic shock. Other choices (E, F, G) are not provided.
Question 3 of 5
A nurse is reviewing the EKG strip of a client who has prolonged vomiting. Which of the following abnormalities on the client's EKG should the nurse interpret as a sign of hypokalemia?
Correct Answer: A
Rationale: The correct answer is A: Abnormally prominent U wave. Hypokalemia leads to low potassium levels, affecting cardiac function. This can manifest as U wave prominence on EKG due to delayed repolarization of ventricles. Inverted P wave (choice
B) is seen in conditions like atrial ischemia, not specific to hypokalemia. Elevated ST segment (choice
C) indicates myocardial injury, not typically seen in hypokalemia. Wide QRS (choice
D) is seen in conditions like bundle branch blocks, not specific to hypokalemia. The other choices are not directly related to hypokalemia and are therefore incorrect.
Question 4 of 5
A nurse cares for a client who is experiencing status epilepticus. Which medication would the nurse prepare for administration?
Correct Answer: A
Rationale: The correct answer is A: Lorazepam. In status epilepticus, immediate treatment is crucial to stop ongoing seizures. Lorazepam is a fast-acting benzodiazepine that helps terminate seizures quickly. It acts by enhancing the effect of GABA, an inhibitory neurotransmitter, leading to sedation and seizure control. Atenolol (
B) is a beta-blocker used for hypertension, not seizures. Phenytoin (
C) and Levetiracetam (
D) are antiepileptic drugs used for long-term seizure management but are not ideal for acute seizure control like in status epilepticus.
Question 5 of 5
A nurse is preparing to administer verapamil by IV bolus to a client who is having cardiac dysrhythmias. For which of the following adverse effects should the nurse monitor when giving this medication?
Correct Answer: A
Rationale: The correct answer is A: Hypotension. Verapamil is a calcium channel blocker that can cause vasodilation, leading to a decrease in blood pressure. Administering it by IV bolus can result in a rapid drop in blood pressure, causing hypotension. Monitoring for hypotension is crucial to prevent complications such as dizziness, syncope, or inadequate perfusion to vital organs. Muscle pain (
B), ototoxicity (
C), and hyperthermia (
D) are not commonly associated with verapamil administration. Monitoring for these adverse effects would not be relevant in this scenario.