ATI RN
health assessment test bank jarvis Questions
Question 1 of 5
A nurse is assessing a patient's breath sounds and notes that the patient has a wheeze. This is most likely indicative of:
Correct Answer: B
Rationale: The correct answer is B: Asthma. Wheezing is a high-pitched whistling sound heard during expiration caused by narrowed airways in conditions like asthma. Pneumonia (
A) typically presents with crackles, not wheezes. Pulmonary embolism (
C) may cause sudden chest pain and shortness of breath but not wheezing. Pleural effusion (
D) results in decreased breath sounds, not wheezes.
Question 2 of 5
What is the primary concern for a nurse caring for a client who is post-operative and experiencing confusion?
Correct Answer: B
Rationale: The correct answer is B: Reorient the client. Reorientation helps the confused client regain awareness of their surroundings, time, and situation post-operatively. It can improve their cognition and reduce anxiety. Notifying the healthcare provider (
A) may be necessary but not the primary concern. Increasing circulation (
C) is important but not the first step for a confused post-op client. Assessing pain (
D) is important but addressing confusion takes precedence.
Question 3 of 5
What should the nurse do first when a client with a history of hypertension presents with severe headache?
Correct Answer: A
Rationale: The correct answer is A: Administer pain relief. The nurse should address the client's immediate symptom of severe headache to provide comfort and assess the severity of the condition. Pain relief can help decrease anxiety and prevent complications. Monitoring vital signs (
B) is important but treating the symptom should take priority. Monitoring ECG (
C) is not necessary for a headache presentation. Administering insulin (
D) is not indicated for a client presenting with a severe headache.
Question 4 of 5
What is the first action the nurse should take when a client presents with signs of respiratory distress?
Correct Answer: A
Rationale: The correct answer is A: Open the airway. This is the first action because in respiratory distress, ensuring a clear airway is crucial for adequate oxygenation. Opening the airway helps facilitate breathing and prevents further complications. Administering oxygen (choice
B) can be done after ensuring the airway is clear. Administering medication (choice
C) and pain relief (choice
D) are not the initial priority in managing respiratory distress.
Question 5 of 5
Which of the following foods is a complete protein?
Correct Answer: B
Rationale: The correct answer is A: Eggs. Eggs are considered a complete protein because they contain all 9 essential amino acids required by the human body. This makes them a high-quality protein source. Corn (
B), peanuts (
C), and sunflower seeds (
D) are not complete proteins as they lack one or more of the essential amino acids. Corn is deficient in lysine, peanuts are deficient in methionine, and sunflower seeds are deficient in lysine.
Therefore, only eggs provide all the essential amino acids necessary for optimal health and proper bodily functions.