a nurse is assessing a client who has increased intracranial pressure icp which of the following findings should the nurse expect
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ATI RN

ATI Comprehensive Exit Exam 2023 With NGN Quizlet

1. A nurse is assessing a client who has increased intracranial pressure (ICP). Which of the following findings should the nurse expect?

Correct answer: C

Rationale: The correct answer is C: Tachycardia. In a client with increased intracranial pressure (ICP), tachycardia is a common finding. This is due to the body's compensatory mechanisms in response to the increased pressure. Bradycardia (choice A) is not typically associated with increased ICP and may indicate a different issue. Increased level of consciousness (choice B) is unlikely with increased ICP, as it often leads to altered mental status. Hyperactive bowel sounds (choice D) are not directly related to increased ICP and are more indicative of gastrointestinal issues.

2. A nurse is completing a dietary assessment for a client who is Jewish and observes kosher dietary practices. Which of the following behaviors should the nurse expect to find?

Correct answer: C

Rationale: The correct answer is C. Kosher dietary laws require the separation of meat and dairy products. Choice A is incorrect because leavened bread is not eaten during Passover in Jewish dietary practices. Choice B is incorrect as shellfish is not considered kosher and is not consumed in Jewish dietary practices. Choice D is incorrect as fasting from meat does not occur during Hanukkah.

3. A nurse is calculating a client's expected date of delivery. The client's last menstrual period began on April 12. Using Nagele's rule, what date should the nurse determine to be the client's expected delivery date?

Correct answer: A

Rationale: Nagele's rule is a method used to calculate the expected delivery date by subtracting 3 months from the first day of the last menstrual period and adding 7 days. In this case, April 12 minus 3 months is January 12, plus 7 days gives January 19. Therefore, the correct answer is A. Choices B, C, and D do not align with the application of Nagele's rule and are incorrect.

4. A nurse is teaching a client about the physiological changes that occur with aging. Which of the following findings should the nurse expect?

Correct answer: A

Rationale: The correct answer is A: Decreased sense of taste. As individuals age, they may experience a decrease in their sense of taste due to changes in taste buds and a decrease in saliva production. This can lead to a reduced ability to taste flavors or distinguish between different tastes. Choices B, C, and D are incorrect. Decreased blood pressure is not a consistent physiological change with aging; instead, blood pressure may increase or remain stable. Gastric secretions tend to decrease with age, leading to issues like decreased absorption of certain nutrients. Accommodation to near vision typically decreases with age, causing a condition known as presbyopia, where individuals have difficulty focusing on close objects.

5. A nurse is planning care for a group of clients. Which of the following clients should the nurse plan to assess first?

Correct answer: A

Rationale: The correct answer is A. A client with a fractured femur and reports feeling short of breath is at risk for a fat embolism, which is a medical emergency. The nurse should assess this client first to rule out this serious complication. Choice B may indicate paralytic ileus, which is important but not immediately life-threatening compared to a fat embolism. Choice C has a fever, which indicates infection but is not as urgent as a potential fat embolism. Choice D, a client receiving radiation therapy, is not experiencing an acute, life-threatening complication that requires immediate assessment compared to a fat embolism.

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