ATI RN
ATI Nursing 137 Exam 3 Fall 2023 Questions
Extract:
Question 1 of 5
The nurse is taking a health history from a client. The client tells the nurse that. "It feels like the room is spinning." How should the nurse document this finding?
Correct Answer: A
Rationale: Vertigo is the sensation of spinning or movement when stationary, often linked to inner ear issues. Seizure activity involves brain electrical issues, dizziness is broader and less specific, and syncope is fainting.
Question 2 of 5
The nurse has completed a peripheral vascular assessment on a client. Which of the following would the nurse document as expected findings?
Correct Answer: B
Rationale: Radial pulses 2+ bilaterally indicate normal circulation. Capillary refill <5 seconds is normal but typically <2-3 seconds; pale feet or edema suggest issues.
Question 3 of 5
The nurse tests the function of Cranial Nerve XI while performing a physical examination on a client. Which statement best describes the response the nurse should expect if Cranial Nerve XI is intact?
Correct Answer: D
Rationale: CN XI (accessory) controls head and shoulder movement against resistance.
Tongue, eye, and hearing tests assess other nerves.
Question 4 of 5
The nurse is performing a neurological assessment on a client with a history of Diabetes. When testing the ability to feel the vibrations of a tuning fork, the nurse notices that the client is unable to feel vibrations on the great toe or ankle bilaterally, but is able to feel vibrations on both patellae. What should the nurse suspect from these assessments?
Correct Answer: B
Rationale: Peripheral neuropathy, common in diabetes, causes distal sensory loss, like inability to feel vibrations in toes and ankles, while proximal sensation (patellae) remains.
Question 5 of 5
During an assessment of the cranial nerves (CNS), the nurse finds the following asymmetry when the client smiles or frowns, uneven lifting of the eyebrows, and escape of air when the nurse presses against the right puffed cheek. The nurse recognized that these findings indicate dysfunction of which cranial nerve(s)?
Correct Answer: D
Rationale: CN VII (facial nerve) motor dysfunction causes facial asymmetry and air escape due to weak muscles, unlike CN X, XI, or IV which affect other functions.