ATI RN
ATI Capstone Medical Surgical Assessment 1 Quizlet
1. What are the signs and symptoms of Increased Intracranial Pressure (IICP)?
- A. Irritability, confusion, restlessness
- B. Fatigue and SOB
- C. Changes in pupillary response
- D. Elevated blood pressure
Correct answer: A
Rationale: The correct answer is A: Irritability, confusion, restlessness. These are common signs of Increased Intracranial Pressure (IICP) as they result from the increased pressure on brain tissue. Choices B, C, and D are incorrect. Fatigue and shortness of breath (SOB) are not typical symptoms of IICP. Changes in pupillary response can be seen in other conditions but are not specific to IICP. Elevated blood pressure is not a common sign of IICP.
2. The client is four hours post-operative abdominal aortic aneurysm repair. Which nursing intervention should be implemented for this client?
- A. Assist the client in ambulating
- B. Assess the client’s bilateral pedal pulses
- C. Maintain a continuous IV heparin drip
- D. Provide clear liquids to the client
Correct answer: B
Rationale: Assessing the client’s bilateral pedal pulses is crucial at this point to monitor the perfusion to the lower extremities after abdominal aortic aneurysm repair surgery. Ambulation (Choice A) may be appropriate but should be guided by the assessment findings. Maintaining a continuous IV heparin drip (Choice C) is not typically indicated post-operatively for this type of surgery. Providing clear liquids (Choice D) may not be suitable immediately after the surgery, as the client needs time to recover before resuming oral intake.
3. A client reports taking Aspirin four times daily for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin?
- A. Digoxin
- B. Metformin
- C. Warfarin
- D. Nitroglycerin
Correct answer: C
Rationale: Aspirin inhibits platelet aggregation, which can increase the effect of anticoagulants like warfarin, leading to an elevated risk of bleeding. Therefore, the concurrent use of aspirin and warfarin is generally contraindicated due to this potential interaction. Digoxin is not contraindicated with aspirin in most cases. Metformin and nitroglycerin do not have significant interactions with aspirin, making them less likely to be contraindicated in this scenario.
4. A nurse recognizes which of the following as a primary goal of nursing?
- A. Assist patients to achieve a peaceful death.
- B. Improve personal knowledge and skills to enhance patient outcomes.
- C. Advocate for quality of life over the quantity of life.
- D. Work to control costs to enhance patients' quality of life.
Correct answer: A
Rationale: The correct answer is A: 'Assist patients to achieve a peaceful death.' One of the primary goals of nursing is to help patients experience a comfortable and peaceful passing when faced with terminal illness or at the end of life. This involves providing holistic care, managing symptoms, and ensuring that patients are as comfortable and pain-free as possible. Choices B, C, and D are incorrect because while improving knowledge and skills, advocating for quality of life, and controlling costs are important aspects of nursing care, they are not the primary goal related to end-of-life care.
5. According to Piaget, in which stage of cognitive development is four-year-old R’Monte who engages in make-believe play by stirring beads in a bowl and saying, “Soup is ready!�
- A. sensorimotor
- B. preoperational
- C. concrete operational
- D. sociocultural
Correct answer: B
Rationale: According to Piaget's theory of cognitive development, four-year-old R’Monte's engagement in make-believe play, such as pretending to stir beads in a bowl and creating imaginary soup, indicates that he is in the preoperational stage of cognitive development. This stage is characterized by symbolic thinking, pretend play, language development, and egocentrism. Choice A, sensorimotor, is incorrect as this stage occurs in infancy and focuses on sensory experiences and object permanence. Choice C, concrete operational, is incorrect as this stage occurs around ages 7-11 and involves logical reasoning about concrete events. Choice D, sociocultural, is incorrect as it does not correspond to Piaget's stages of cognitive development.
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