ATI RN
ATI Nursing 137 Exam 3 Fall 2023 Questions
Extract:
Question 1 of 5
The nurse is educating a client on different areas of the brain. The nurse recognizes that which of the following statements concerning areas of the brain is correct?
Correct Answer: D
Rationale: The correct answer is D: The hypothalamus controls body temperature and regulates sleep. The hypothalamus plays a crucial role in maintaining homeostasis by regulating body temperature, hunger, thirst, and circadian rhythms, including sleep-wake cycles. It contains specialized nuclei that respond to internal and external stimuli to maintain a balanced internal environment. The other choices are incorrect because:
A) The basal ganglia are primarily involved in motor control and not voluntary movement.
B) Motor pathways synapse in the thalamus for sensory processing, not motor control.
C) The cerebellum is responsible for coordination, balance, and muscle tone, not speech and emotions.
Question 2 of 5
During an abdominal assessment,the nurse is unable to hear bowel sounds in a client's abdomen. How long should the nurse listen before reporting absent bowel sounds?
Correct Answer: D
Rationale: The correct answer is D: 5 minutes in each quadrant. It is important to listen for at least 5 minutes in each quadrant during an abdominal assessment to accurately assess for bowel sounds. Bowel sounds can be subtle and may take time to detect, especially if the client has gastrointestinal issues or is on medications that affect bowel motility. Listening for a longer duration increases the likelihood of hearing any present bowel sounds. Option A (1 minute in the center of the abdomen) is too brief and may not capture bowel sounds in all quadrants. Option B (10 minutes in each quadrant) is excessive and not necessary for a routine assessment. Option C (1 minute in each quadrant) may not be sufficient to detect bowel sounds, especially if they are diminished. Listening for 5 minutes in each quadrant allows for a thorough assessment without being overly time-consuming.
Question 3 of 5
A nurse is assessing a client's cranial nerves as part of a neurological examination. Which of the following actions should the nurse take to assess cranial nerve III?
Correct Answer: B
Rationale:
To assess cranial nerve III (oculomotor nerve), the nurse should check the pupillary response to light. This is because cranial nerve III controls the constriction of the pupil in response to light. By shining a light into the client's eyes, the nurse can observe the pupillary response, looking for equal and brisk constriction. This assessment helps to determine the integrity of cranial nerve III function. Observing for facial symmetry (choice
A) is related to cranial nerve VII (facial nerve). Testing visual acuity (choice
C) is related to cranial nerves II (optic nerve) and V (trigeminal nerve). Eliciting the gag reflex (choice
D) is related to cranial nerves IX (glossopharyngeal nerve) and X (vagus nerve).
Question 4 of 5
The physician comments that the client has abdominal borborygmic. The nurse recognizes that which of the following is the best description of borborygmic?
Correct Answer: D
Rationale: The correct answer is D: Loud gurgling bowel sounds. Borborygmi are loud, prolonged, high-pitched gurgling bowel sounds caused by increased gastrointestinal motility. This indicates hyperactive bowel sounds.
A: A peritoneal friction rub is a sign of peritoneal inflammation, not related to bowel sounds.
B: Loud continual humming bowel sounds do not describe borborygmi, which are gurgling sounds.
C: Hypoactive bowel sounds are decreased or absent bowel sounds, opposite of borborygmi.
Question 5 of 5
The nurse is assessing a client who reports cessation of menses. The nurse should document the cessation of menses in the client's record as:
Correct Answer: D
Rationale: The correct answer is D: menopause. Menopause is the natural process where a woman's menstrual periods stop permanently due to aging. Cessation of menses is a key characteristic of menopause. Salpingitis (
A) is inflammation of the fallopian tubes, adnexa (
B) refers to the accessory structures of the uterus, and menarche (
C) is the onset of menstruation in a young girl.
Therefore, these choices are incorrect as they do not relate to the cessation of menses.