ATI RN
ATI Med Surg Adult Care 2 Questions
Extract:
Question 1 of 5
The nurse takes report on a client who was admitted with a severe headache, nausea, vomiting, photophobia, and a stiff neck. Which of the following is the priority intervention for the nurse to perform?
Correct Answer: C
Rationale: Administer penicillin. This is the priority intervention because it can treat bacterial meningitis, which is a life-threatening condition that requires immediate antibiotic therapy.
Question 2 of 5
A 70year old client diagnosed with a hemorrhagic stroke was admitted 1 day ago. His medical history includes hypertension, osteoarthritis, and type 2 diabetes. He has right sided paralysis, garbled speech, and a weak cough reflex. This morning he is restless. Vital signs are Blood Pressure 160/80, pulse 110, respirations 24, oxygen saturation 90% Which of the following Interventions will the nurse take to avoid complications? Select all that apply
Correct Answer: A,B,C
Rationale: Applying oxygen addresses low saturation, monitoring blood pressure prevents further bleeding, and seizure precautions are necessary due to stroke-related seizure risk.
Question 3 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: A
Rationale: A decrease in the Glasgow Coma Score indicates a deterioration in the level of consciousness, which is a sign of increased ICP.
Question 4 of 5
A nurse in the emergency department is caring for a client following an automobile crash in which the client was unrestrained and thrown from the vehicle. When assessing the client, the nurse observes clear fluid draining from the client's nose. Which of the following interventions should the nurse take?
Correct Answer: A
Rationale: This is correct because clear fluid draining from the nose could indicate a cerebrospinal fluid (CSF) leak, which is a serious complication of head trauma. Allowing the drainage to drip onto a sterile gauze pad can help confirm the presence of CSF by observing a halo sign.
Question 5 of 5
When considering the client with a neurocognitive deficit, the nurse understands that which of the following are excitatory neurotransmitters?
Correct Answer: B,C
Rationale: Norepinephrine and Dopamine are excitatory neurotransmitters that increase arousal, alertness, attention, motivation, reward, and movement.