Exam (elaborations)
ATI MED SURG RN CRITICAL NEUROLOGIC ASSESSMENT WITH CORRECT QUESTION AND ANSWER
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ATI MED SURG RN CRITICAL NEUROLOGIC ASSESSMENT WITH CORRECT QUESTION AND ANSWER
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ATI MED SURG RN CRITICAL NEUROLOGIC ASSESSMENT WITHCORRECT QUESTION AND ANSWER
@ CLOSE
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Question: 1 of 30 Fime Elepaed: 00:02:03
A nurse is caring for a client who has increased intracranial pressure. A nurse is caring for a dient who has increased intracranial pressure. Which of
the follovdng arLions should the nurse take?
Select all that apply.
Exhibit 1 Exhibit 2 £xFiibil 3
History and Phvstcal
1925: Maintain E’ystol c blocd ¿ressur e al›ove 50 mrTi Hi.
A client is admitted to the emergency department following a
severe motor vehicle crash. Client sustained head trauma. CT
shows brain edema. Client has increased intracranial pressure *’”" ""* ' '“" ""”""" ‘" ’**’ "“‘*’
and requlres intracranial monitoring. @ monitor for seizures.
PARTIALLY COnRECT
When taklng actions, the nurse should recognize that a client experiencing
increased intracranial pressure should have thelr systoiic blood pressure
maintained at 90 mm Hg and their MAP maintained above 80 mm Hg to
maintain perfusion of Lheir brain and organs. The niJrse should aJso recognize
that a client experiencing increased inFacranial pressure should have their
head kept midline to their body to encourage venous drainage and that seizure
monitorlng should be Initiated because the client 1s at increased risk of
developing seizures.
, RN Critical Neurologic Dysfunction Assessment @ CLOSE
all
£luestion: 2 of 30 Tlme[l$psed:0W:U2:12
A nurse is planning care for a client who has increased intracranial pressure (TCP). Which of the following should the nurse understand is a cause
of increased ICP?
Cephalosporin
Decreased cerebral blood flow
Hemorrhage
Decreased cerebrospi nal fluid production
, RN Critical Neurologic Dysfunction Assessment @ CLOSE
- “ ali.
Ouestion: 3 of 30 Time £lapied: oo:oz:Is
A nurse is performing the Glasgow Coma Scale (GCS) on a client who has increased intracranial pressure. Which of the following does the scale
assess?
Levl°l Of COKIS C iOuSn0sS
Level of sensory function
Level of spinal rord i njury
Level of pain
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