ATI RN
health assessment test bank Questions
Question 1 of 5
What is the most appropriate action when a client experiences chest pain and has a history of myocardial infarction?
Correct Answer: A
Rationale: The correct answer is A: Administer nitroglycerin. Nitroglycerin is the recommended initial medication for chest pain in a client with a history of myocardial infarction. It helps dilate blood vessels, improving blood flow to the heart, and reducing chest pain. Aspirin (choice
B) is also usually given to reduce blood clot formation, but nitroglycerin is the priority for immediate relief. Morphine (choice
C) may be used if nitroglycerin is ineffective, and beta blockers (choice
D) are typically used for long-term management of heart conditions, not for immediate relief of chest pain.
Question 2 of 5
A 47-year-old woman who is a recent immigrant to Canada is being seen at the clinic today for her uncontrolled diabetes. The nurse knows that the patient lives with her husband and a large extended family. The nurse concludes that part of the patient's inability to maintain and comply with her diet and diabetic regime is the foods that this patient eats. This conclusion is an example of:
Correct Answer: D
Rationale: The correct answer is D: culturalism. The nurse's conclusion that the patient's inability to maintain her diet and diabetic regime is due to the foods she eats reflects culturalism. Culturalism refers to the belief that a person's behaviors and beliefs are solely determined by their culture. In this case, the nurse is attributing the patient's struggles solely to her cultural background without considering other factors.
A: Cultural sensitivity is about being aware and respectful of different cultures, but it does not involve making assumptions based on culture alone.
B: Cultural safety is about creating a safe and respectful environment for individuals from different cultures, but it does not involve making assumptions about behavior solely based on culture.
C: Cultural perspective involves understanding different cultural viewpoints, but it does not involve making assumptions about behavior solely based on culture.
In summary, the nurse's conclusion is an example of culturalism as it oversimplifies the patient's situation by attributing her struggles solely to her cultural background.
Question 3 of 5
Which intervention should the nurse implement for a client who is experiencing a seizure?
Correct Answer: D
Rationale: The correct answer is D, administering antiepileptic medications. This is because during an active seizure, the priority is to stop the seizure activity. Antiepileptic medications are specifically designed to prevent or reduce the frequency and intensity of seizures. Placing the client on their side and protecting their head (choice
A) is important for safety but does not address stopping the seizure. Loosening clothing and ensuring safety (choice
B) is also important but does not directly address the seizure itself. Monitoring airway and giving oxygen (choice
C) is crucial but does not actively stop the seizure.
Therefore, administering antiepileptic medications is the most appropriate intervention to address the root cause of the seizure.
Question 4 of 5
What is the most appropriate action when a parent crosses their arms and legs during an interview?
Correct Answer: D
Rationale: The correct answer is D because crossing arms and legs can indicate defensiveness or discomfort, which may suggest the parent is uneasy discussing their son's treatment. This nonverbal cue could signal a need for empathy and sensitivity in communication.
Choice A is incorrect as it overlooks the significance of body language.
Choice B assumes comfort without considering the context.
Choice C assumes tiredness without considering other possibilities. Understanding body language cues can help in building rapport and addressing concerns effectively.
Question 5 of 5
What should the nurse monitor when caring for a client receiving anticoagulant therapy?
Correct Answer: B
Rationale: The correct answer is B: Monitor INR levels. INR (International Normalized Ratio) is a crucial parameter to monitor for clients on anticoagulant therapy, as it measures the effectiveness of the medication in preventing blood clots. By monitoring INR levels, the nurse can ensure the client is within the therapeutic range to prevent both bleeding and clotting complications.
Choice A (Monitor platelet count) is incorrect because anticoagulant therapy does not directly affect platelet count, and monitoring platelets is more relevant for clients on antiplatelet therapy.
Choice C (Monitor bleeding) is partially correct, but focusing solely on monitoring bleeding may not provide a comprehensive assessment of the client's response to anticoagulant therapy.
Choice D (Monitor renal function) is incorrect as anticoagulant therapy primarily affects coagulation factors and not renal function. Renal function monitoring may be necessary for certain medications but is not a primary consideration for anticoagulant therapy.