ati detailed answer key gi/neuro
medical surgical newest edition verified
questions and answers
1. a nurse is caring for a client who is receiving total parenteral nutrition (tpn). the pharmacy
get the in client’s next container of tpn. which of the following fluids should the nurse infuse
count it next arrives?
a. dextrose 5% in water
rationale: tpn contains high concentrations of certain nutrients. infusing dextrose
5% in water could cause rapid shifts in serum levels of some substances.
b. 0.9% sodium chloride
rationale: tpn contains high concentrations of certain nutrients. infusing 0.9% sodium chloride
could cause rapid shifts in serum levels of some substances.
c. dextrose 10% in water
rationale: tpn contains high concentrations of dextrose and proteins. to avoid hypoglycemia, the
nurse should infuse dextrose 10% or 20% in water until the next container of tpn solution
arrives.
d. lactated ringer’s solution
,rationale: tpn contains high concentrations of certain nutrients. infusing lactated ringer’s
solution could cause rapid shifts in serum levels of some substances.
2. a nurse is providing discharge teaching for a client who has chronic pancreatitis. which of the
following statements by the nurse is appropriate?
a. “you should decrease your caloric intake when abdominal pain is present.”
rationale: clients who have chronic pancreatitis are at risk for malnutrition and should increase
their caloric intake in order to maintain weight.
b. “you should increase your daily intake of protein.”
rationale: clients who have chronic pancreatitis should consume a diet that is high in protein.
c. “you should increase fat intake when experiencing loose stools.”
rationale: clients who have chronic pancreatitis should consume a low-fat diet to prevent
stimulation of the pancreas and steatorrhea.
d. “you should limit alcohol intake to 2-3 drinks per week.”
rationale: clients who have chronic pancreatitis should avoid alcohol intake to prevent
stimulation of the pancreas.
caa_detailedanswerkey created
page 1 of
,3. anurse monitors for increased intracranial pressure (icp) on a client who has a leaking
cerebral aneurysm the client manifests increased intracranial pressure, which of the following
findings should the nurse expe (select all that apply)
a. violent headache
b. neck pain and stiffness
c. slurred speech
d. projectile vomiting
e. rapid loss of consciousness
rationale: violent headache is correct. the client who manifests icp should display a violent
headache
neck pain and stiffness is incorrect. the client who manifests icp
should not display neck pain and stiffness
slurred speech is correct. the client who manifests icp may display slurred speech.
projectile vomiting is correct. the client who manifests icp may display sudden onset of
projectile vomiting.
rapid loss of consciousness is correct. the client who manifests icp may display a sudden rapid
loss of consciousness.
, 4. anurse is assessing an adult who has meningococcal meningitis. which of the following is an
appropriate finding by the nurse?
a. severe headache
rationale: the nurse should find as a sign of meningococcal meningitis severe headache due to
meningeal inflammation.
b. bradycardia
rationale: the nurse should find as a sign of meningococcal meningitis tachycardia not
bradycardia.
c. increased muscle tone
rationale: the nurse should find as a sign of meningococcal meningitis decreased not increased
muscle tone.
d. oriented to time, person, place
rationale: the nurse should find as a sign of meningococcal meningitis disorientation not
orientation to time, person, and place.
5. anurse admits a client who has a concussion for overnight observation. alert and oriented on
admission, client reports a headache along with neck pain and generalized muscle aches. the
medical surgical newest edition verified
questions and answers
1. a nurse is caring for a client who is receiving total parenteral nutrition (tpn). the pharmacy
get the in client’s next container of tpn. which of the following fluids should the nurse infuse
count it next arrives?
a. dextrose 5% in water
rationale: tpn contains high concentrations of certain nutrients. infusing dextrose
5% in water could cause rapid shifts in serum levels of some substances.
b. 0.9% sodium chloride
rationale: tpn contains high concentrations of certain nutrients. infusing 0.9% sodium chloride
could cause rapid shifts in serum levels of some substances.
c. dextrose 10% in water
rationale: tpn contains high concentrations of dextrose and proteins. to avoid hypoglycemia, the
nurse should infuse dextrose 10% or 20% in water until the next container of tpn solution
arrives.
d. lactated ringer’s solution
,rationale: tpn contains high concentrations of certain nutrients. infusing lactated ringer’s
solution could cause rapid shifts in serum levels of some substances.
2. a nurse is providing discharge teaching for a client who has chronic pancreatitis. which of the
following statements by the nurse is appropriate?
a. “you should decrease your caloric intake when abdominal pain is present.”
rationale: clients who have chronic pancreatitis are at risk for malnutrition and should increase
their caloric intake in order to maintain weight.
b. “you should increase your daily intake of protein.”
rationale: clients who have chronic pancreatitis should consume a diet that is high in protein.
c. “you should increase fat intake when experiencing loose stools.”
rationale: clients who have chronic pancreatitis should consume a low-fat diet to prevent
stimulation of the pancreas and steatorrhea.
d. “you should limit alcohol intake to 2-3 drinks per week.”
rationale: clients who have chronic pancreatitis should avoid alcohol intake to prevent
stimulation of the pancreas.
caa_detailedanswerkey created
page 1 of
,3. anurse monitors for increased intracranial pressure (icp) on a client who has a leaking
cerebral aneurysm the client manifests increased intracranial pressure, which of the following
findings should the nurse expe (select all that apply)
a. violent headache
b. neck pain and stiffness
c. slurred speech
d. projectile vomiting
e. rapid loss of consciousness
rationale: violent headache is correct. the client who manifests icp should display a violent
headache
neck pain and stiffness is incorrect. the client who manifests icp
should not display neck pain and stiffness
slurred speech is correct. the client who manifests icp may display slurred speech.
projectile vomiting is correct. the client who manifests icp may display sudden onset of
projectile vomiting.
rapid loss of consciousness is correct. the client who manifests icp may display a sudden rapid
loss of consciousness.
, 4. anurse is assessing an adult who has meningococcal meningitis. which of the following is an
appropriate finding by the nurse?
a. severe headache
rationale: the nurse should find as a sign of meningococcal meningitis severe headache due to
meningeal inflammation.
b. bradycardia
rationale: the nurse should find as a sign of meningococcal meningitis tachycardia not
bradycardia.
c. increased muscle tone
rationale: the nurse should find as a sign of meningococcal meningitis decreased not increased
muscle tone.
d. oriented to time, person, place
rationale: the nurse should find as a sign of meningococcal meningitis disorientation not
orientation to time, person, and place.
5. anurse admits a client who has a concussion for overnight observation. alert and oriented on
admission, client reports a headache along with neck pain and generalized muscle aches. the
