ATI RN
ATI Med Surg Nursing 300 Final Exam Questions
Extract:
Question 1 of 5
The nurse is caring for a patient in the acute care setting with a spinal cord injury (SCI) at the level of C-3. What is the main cause of complications or death related to this level of injury?
Correct Answer: A
Rationale: A spinal cord injury at C-3 affects the phrenic nerve (C3-C5), which controls the diaphragm, leading to respiratory compromise. This is the primary cause of complications or death due to the risk of respiratory failure, often requiring mechanical ventilation.
Question 2 of 5
The nurse is caring for a client who is postoperative following a transurethral resection of the prostate (TURP). The client's urine in the catheter bag is bright red with clots. Which action should the nurse take first?
Correct Answer: A
Rationale: Bright red urine with clots indicates possible bleeding or clot obstruction. Irrigating the catheter clears clots, maintaining patency and preventing complications.
Question 3 of 5
The nurse is caring for a patient with an acute head injury. Which assessment finding would first alert the nurse that the patient is developing an increase in intracranial pressure (ICP)?
Correct Answer: C
Rationale: Altered level of consciousness is the earliest sign of increased ICP, reflecting brain compression. Sluggish pupils and widening pulse pressure are later signs, and tachycardia with hypotension is not typical.
Question 4 of 5
The nurse is caring for client who is four days post-operative open repair of an abdominal aortic aneurysm the abdomen is distended. The client is complaining abdominal pain and the abdomen is distended. What action should the nurse take at this time?
Correct Answer: B
Rationale: Abdominal pain and distension post-AAA repair suggest complications like bleeding or ischemia, requiring immediate provider notification and testing.
Question 5 of 5
The Emergency Department (ED) nurse is assessing an 80-year-old patient who has superficial, partial thickness and deep partial thickness scald burns on bilateral anterior and posterior hands and forearms. The nurse estimates that the total body surface Tire CTBSA) burned is 27%. What should the nurse include in the emergent plan of care?
Correct Answer: A
Rationale: 27% TBSA burns require fluid resuscitation to prevent shock and transfer to a burn center for specialized care.