ATI RN
ATI Capstone Adult Medical Surgical Assessment 2
1. What are the expected symptoms in a patient with a thrombotic stroke?
- A. Gradual loss of function on one side of the body
- B. Sudden loss of consciousness
- C. Severe headache and confusion
- D. Loss of sensation in the affected limb
Correct answer: A
Rationale: A thrombotic stroke typically presents with a gradual loss of function on one side of the body. This gradual onset distinguishes it from a hemorrhagic stroke, which often manifests with sudden and severe symptoms like loss of consciousness (choice B), severe headache and confusion (choice C), or loss of sensation in the affected limb (choice D). Therefore, choices B, C, and D are not typically associated with thrombotic strokes.
2. A nurse is administering insulin to a patient after misreading their glucose as 210 mg/dL instead of 120 mg/dL. What should the nurse monitor for?
- A. Monitor for hypoglycemia
- B. Monitor for hyperkalemia
- C. Administer glucose IV
- D. Document the incident
Correct answer: A
Rationale: The correct answer is to monitor for hypoglycemia. Insulin administration based on a misread glucose level can lead to hypoglycemia due to the unnecessary lowering of blood sugar levels. Monitoring for hypoglycemia involves assessing the patient's blood glucose levels frequently, observing for signs and symptoms such as shakiness, confusion, sweating, and administering glucose if hypoglycemia occurs. Choice B, monitoring for hyperkalemia, is incorrect as insulin administration typically lowers potassium levels. Choice C, administering glucose IV, is not the immediate action needed as the patient could potentially develop hypoglycemia from the excess insulin. Choice D, documenting the incident, is important but not the immediate priority when dealing with a potential hypoglycemic event.
3. What is a typical symptom of a hemorrhagic stroke in a patient?
- A. Sudden, severe headache
- B. Gradual onset of numbness
- C. Loss of consciousness
- D. Loss of speech ability
Correct answer: A
Rationale: A sudden, severe headache is a common symptom of a hemorrhagic stroke due to brain bleeding. This headache is often described as the worst headache of one's life. Gradual onset of numbness (choice B) is more characteristic of an ischemic stroke, where a blood clot blocks an artery in the brain. Loss of consciousness (choice C) can occur in severe cases of stroke but is not specific to hemorrhagic strokes. Loss of speech ability (choice D) is more associated with ischemic strokes affecting language centers of the brain.
4. What are the expected symptoms of a thrombotic stroke?
- A. Gradual loss of function on one side of the body
- B. Sudden loss of consciousness
- C. Severe headache and confusion
- D. Loss of sensation in the affected limb
Correct answer: A
Rationale: The correct answer is A: 'Gradual loss of function on one side of the body.' In a thrombotic stroke, a clot blocks a cerebral artery, leading to a gradual onset of symptoms such as weakness, numbness, or paralysis on one side of the body. Choice B, 'Sudden loss of consciousness,' is more characteristic of a hemorrhagic stroke. Choice C, 'Severe headache and confusion,' are often associated with subarachnoid hemorrhage rather than thrombotic stroke. Choice D, 'Loss of sensation in the affected limb,' is not a typical symptom pattern for a thrombotic stroke, which usually presents with motor deficits.
5. What are the common manifestations of compartment syndrome?
- A. Unrelieved pain, pallor, pulselessness
- B. Redness and swelling
- C. Fever and infection
- D. Swelling and redness
Correct answer: A
Rationale: The correct manifestations of compartment syndrome are unrelieved pain, pallor, and pulselessness. These symptoms indicate compromised blood flow and neurovascular compromise, necessitating immediate medical intervention. Redness and swelling (Choice B) are more commonly associated with inflammation or infection rather than compartment syndrome. Fever and infection (Choice C) are not typical manifestations of compartment syndrome. Swelling and redness (Choice D) are general signs that can be seen in various conditions and are not specific to compartment syndrome.
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