ATI RN
ATI RN Custom Nursing 221 Exam 4 Questions
Extract:
Question 1 of 5
A nurse suspects that a client admitted for treatment of bacterial meningitis is experiencing increased intracranial pressure (ICP). Which of the following assessment findings by the nurse supports this suspicion?
Correct Answer: D
Rationale: Restlessness can indicate increased ICP due to changes in mental status.
Question 2 of 5
A nurse is planning care for a female client who has a T4 spinal cord injury and is at risk for acquiring urinary tract infections. Which of the following actions should the nurse include in the client's plan of care?
Correct Answer: D
Rationale: Adequate hydration flushes bacteria, reducing UTI risk.
Question 3 of 5
A nurse is teaching about risk factors for developing a stroke with a group of older adult clients. Which of the following nonmodifiable risk factors should the nurse include?
Correct Answer: C
Rationale: Genetics is a nonmodifiable risk factor for stroke.
Question 4 of 5
A nurse in a clinic is interviewing a client who has a possible diagnosis of endometriosis. Which of the following findings in the client's history should the nurse recognize as consistent with a diagnosis of endometriosis?
Correct Answer: A
Rationale: Dysmenorrhea unresponsive to NSAIDs is a hallmark of endometriosis.
Extract:
Nurses' Notes
0800: Client is 3 days postoperative.
Currently disoriented to time and place, oriented to self.
Client is displaying disorganized thinking, a lack of attention when spoken to, and rambling speech that is incoherent at times.
Client attempts to get out of bed without assistance.
Changes in client's behavior began the prior evening, and the client has been awake most of the night.
Client has refused to eat or drink since the previous day.
Intake and output from the previous day: 250 mL intake, 2,500 mL output.
A call placed to the provider to report findings.
0830: IV fluids initiated by RN. Urine and blood samples collected per the provider's prescription.
The client continues to be restless.
Vital Signs
• Heart rate 115/min
• Respiratory rate 20/min
• BP 90/65 mm Hg
• Temperature 38.6°C (101.5°F)
Question 5 of 5
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to collect data about the client's progress.
Correct Answer: C, D, E, B, E
Rationale: Condition: Delirium due to acute confusion and fever. Actions: Monitor fluid intake/output for dehydration; encourage family presence for reorientation. Parameters: Sleep-wake cycle and fall risk to assess delirium and safety.