ATI Med-Surg 2 Exam 4

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Sample questions from ATI Med-Surg 2 Exam 4

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.Refer to the client's chart. Which action should the nurse take first?

   • A.Repeat the neurologic assessment in 30 minutes
   • B.Assist the client to walk to assess coordination
   • C.Activate the facility's stroke response system
   • D.Give oral aspirin immediately

   Rationale: New facial droop, arm weakness, and slurred speech at 0910 require immediate stroke activation, especially because the client was neurologically intact at 0900. The glucose of 104 mg/dL does not suggest hypoglycemia as the cause. Waiting delays time-sensitive treatment, and aspirin should not be given before intracranial hemorrhage is excluded and swallowing safety is established. Walking creates an avoidable fall risk during an acute neurologic change.

2. 2.During a community blood pressure screening, a client reports that one arm became weak and speech became difficult for 10 minutes earlier today. The symptoms have resolved. Which instruction is most appropriate?

   • A.Begin daily aspirin without further evaluation
   • B.Obtain emergency evaluation now
   • C.Arrange a routine clinic appointment next month
   • D.Rest at home and seek care only if symptoms return

   Rationale: Transient focal neurologic symptoms can indicate a transient ischemic attack and require urgent evaluation because stroke risk is increased. Resolution does not make a routine appointment or observation at home safe. Self-starting aspirin is not a substitute for assessment and may be inappropriate before the cause is established. The key principle is to treat even resolved stroke-like symptoms as time-sensitive.

3. 3.A spouse asks which sudden changes should prompt an immediate call to emergency medical services for possible stroke. Which findings should the nurse include? Select all that apply.

   • A.New weakness of one side of the face
   • B.Sudden severe headache without a known cause
   • C.Gradually increasing knee stiffness over several months
   • D.New difficulty understanding spoken words
   • E.Sudden loss of vision in one eye

   Rationale: Sudden unilateral facial weakness and impaired language comprehension are focal neurologic warning signs. Sudden visual loss and an unexplained severe headache also warrant emergency evaluation for stroke. Gradually worsening knee stiffness is not a typical acute stroke manifestation. Teach families to call emergency services rather than wait for symptoms to improve.

4. 4.Following a left-hemispheric stroke, a client understands questions but struggles to produce words. Which communication approach is best?

   • A.Use short questions and allow time for a response
   • B.Ask several questions together to reduce conversation time
   • C.Speak loudly into the client's unaffected ear
   • D.Finish every sentence before the client becomes frustrated

   Answer and rationale are in the full material.

5. 5.At breakfast in a rehabilitation unit, a client with a recent stroke coughs after drinking water and develops a wet-sounding voice. Which action is the priority?

   • A.Continue the meal using smaller bites
   • B.Offer another sip through a straw
   • C.Place the client supine to rest
   • D.Stop oral intake and arrange swallowing evaluation

   Answer and rationale are in the full material.