ATI RN
Introduction to Nursing Pdf Questions
Question 1 of 5
A client being treated for hypertension returns to the community clinic for follow up. The client says, I know these pills are important
Correct Answer: A
Rationale: The correct answer is A because the client's statement indicates a potential barrier to medication adherence due to their occupation. Selling fish requires being away from a bathroom, which conflicts with the need for frequent urination caused by water pills. This scenario aligns with the nursing diagnosis of Noncompliance related to medication side effects. Choice B is incorrect as it focuses on the inconvenience of bathroom breaks rather than the underlying issue of noncompliance. Choice D is incorrect as the client's statement does not suggest a lack of understanding about their disease state.
Question 2 of 5
Bathing a client provides an excellent opportunity to assess the client's integument. Which finding indicates the need for referral to another health care professional?
Correct Answer: D
Rationale: The correct answer is D: Cheilosis. Cheilosis refers to inflammation and fissuring at the corners of the mouth, which can indicate a vitamin deficiency or fungal infection. This finding may require referral to a healthcare professional for further evaluation and treatment. A, B, and C are incorrect choices because flaky skin, rough skin in exposed areas, and hirsutism of the chin, and pitting edema of the ankles and feet are common skin conditions that can be addressed by a nurse during bathing without the need for immediate referral to another healthcare professional.
Question 3 of 5
Which safeguard should the nurse take to ensure accuracy with a telephone order?
Correct Answer: A
Rationale: The correct answer is A because repeating the order to the prescriber ensures accurate communication and allows for verification of the order. This step helps prevent errors due to misinterpretation. Option B is incorrect as the nursing supervisor is not the prescriber. Option C is incorrect as waiting for the physician's signature delays timely administration. Option D is incorrect as the nursing supervisor's role is not to monitor telephone orders.
Question 4 of 5
A patient is ordered to receive an intravenous infusion of 3,000 cc 0.8% NaCl over 24 hours. The nurse observes that the rate is 150 cc/hr. If the infusion runs continuously at this rate, the nurse would expect the infusion to be completed in:
Correct Answer: B
Rationale: To calculate the total time for the infusion, you divide the total volume (3,000 cc) by the infusion rate (150 cc/hr). 3000 cc ÷ 150 cc/hr = 20 hours. Therefore, the correct answer is B: 20 hours. Choice A (12 hours) is incorrect as it underestimates the time needed. Choice C (24 hours) is incorrect as it is the total duration of the infusion, not the time to complete it. Choice D (50 hours) is incorrect as it overestimates the time required.
Question 5 of 5
A nurse in the ICU is caring for a patient with PEEP. The patient suddenly called the nurse, and said: “Nurse, my leg is severely aching!” What is your priority nursing action?
Correct Answer: C
Rationale: The correct answer is C: Check the balloon of the ET tube. This is the priority nursing action because PEEP (Positive End-Expiratory Pressure) is a mechanical ventilation setting that can lead to accidental migration of the endotracheal (ET) tube, causing pressure on surrounding structures like the vocal cords or trachea, leading to referred pain in the leg. Checking the balloon of the ET tube ensures proper placement and prevents complications. Choice A: Checking the condition of the leg is not the priority as the patient's complaint is likely related to the mechanical ventilation. Choice B: Checking for pain scale is not the priority as addressing the source of the pain is more critical. Choice D: Giving analgesic is not appropriate until the cause of the leg pain is identified.