ATI RN
ATI Nurs 2000 Fundamentals Questions
Extract:
Question 1 of 5
In the context of an initial assessment for a client admitted to rule out Guillain-Barre syndrome which of the following symptoms would the nurse expect to observe?
Correct Answer: A
Rationale: Ascending muscle weakness is a classic symptom of Guillain-Barre syndrome. It often starts in the feet and legs before spreading to the upper body and arms. Difficulty with urination is not a typical symptom of Guillain-Barre syndrome. Ptosis (drooping of the upper eyelid) and diplopia (double vision) are not common symptoms of Guillain-Barre syndrome. Ear distortion and pain are not associated with Guillain-Barre syndrome.
Question 2 of 5
A nurse is teaching a group of older adults about risk factors for developing a stroke. Which non-modifiable risk factors should the nurse include in the teaching?
Correct Answer: B
Rationale: While hypertension is a risk factor for stroke it is a modifiable risk factor. This means it can be controlled and managed through lifestyle changes and medication. Family history is a non-modifiable risk factor for stroke. If a close family member like a parent or sibling has had a stroke a person's risk of stroke is slightly higher. Smoking is a modifiable risk factor for stroke. Quitting smoking can significantly reduce the risk of stroke. Obesity is a modifiable risk factor for stroke. Maintaining a healthy weight through diet and regular exercise can help reduce the risk of stroke.
Question 3 of 5
In the context of outpatient care for a client diagnosed with Bell's palsy which of the following statements if made by the client would indicate the need for further education?
Correct Answer: B
Rationale: Analgesics can be used to manage pain associated with Bell's palsy.
Therefore this statement does not indicate a need for further education. This is the correct answer. Chewing on the affected side can actually exacerbate swallowing issues.
Therefore this statement indicates a need for further education. Brushing teeth should not be affected by Bell's palsy.
Therefore this statement does not indicate a need for further education. Applying a protective eye shield before going to bed is a recommended practice for patients with Bell's palsy. This helps to protect the eye from injury and keep it moist as Bell's palsy can cause difficulty in blinking or closing the eye.
Question 4 of 5
A nurse is conducting a mobility assessment on a patient. The patient can stand up from a seated position using a cane for support. Which of the following activity levels should the nurse assign to the patient?
Correct Answer: C
Rationale: Minimal assistance implies that the patient needs some help but can do most of the task on their own. In this case the patient is able to stand up from a seated position using a cane for support which suggests that they do not need assistance. Moderate assistance implies that the patient needs more help to perform the task. The patient in the scenario is able to perform the task independently with the help of a cane. No assistance means that the patient can perform the task independently. This is the most fitting answer because the patient is able to stand up from a seated position using a cane for support. Maximum assistance implies that the patient is unable to perform the task without substantial help. This does not apply to the patient in the scenario as they are able to stand up independently with the help of a cane.
Question 5 of 5
A nurse is getting ready to conduct a cranial nerve examination on a patient. What steps should the nurse take to examine cranial nerve XI (Spinal Accessory)?
Correct Answer: C
Rationale: Checking the patient's visual acuity using a Snellen chart is used to assess cranial nerve II (Optic) not cranial nerve XI (Spinal Accessory). Whispering in one of the patient's ears while blocking the other is a method used to assess cranial nerve VIII (Vestibulocochlear) not cranial nerve XI. Observing the patient's ability to turn their head from side to side is a correct method to assess cranial nerve XI. This nerve innervates the sternocleidomastoid and trapezius muscles which are responsible for turning the head and shrugging the shoulders respectively. Asking the patient to identify specific smells is used to assess cranial nerve I (Olfactory) not cranial nerve XI.