Practice Question
A nurse is planning care for a group of clients. Which of the following clients should the nurse plan to see first?
Answer Choices:
Correct Answer:
A client who has a closed head injury and is vomiting
Rationale:
⚠️Vomiting following a head injury is a key warning sign of increased intracranial pressure (ICP) or a potential intracranial bleed.
⚠️Rising ICP compromises cerebral perfusion, leading to brain herniation and neurological decline if untreated.
⚠️This client is the highest priority based on the ABC and neurological assessment framework, as airway and cerebral function are at risk.
⚠️The nurse should immediately assess neurological status, elevate the head of bed 30 degrees, and notify the provider.
⚠️ Early intervention may prevent permanent brain injury or death.
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This question is from RN ATI Capstone Proctored Pre- Assessment 2025 which contains 86 questions.
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From Exam
RN ATI Capstone Proctored Pre- Assessment 2025
86 Questions
View Full Exam Start PracticingQuestion Details
- Category: RN Nursing Exam(s)
- Subcategory: ATI Exam(s)
- Domain: RN ATI Capstone Exam(s)
- Answer Choices: 4