ATI RN
Nursing Process Practice Questions Questions
Question 1 of 9
.A client complains of urinary discomfort and a burning sensation while urinating. A urethral smear shows evidence of urethritis, and the client is prescribed antibiotics and instructed to drink 2-3 L of water daily. For which of the ff reasons is the client advised to drink the specified amount of water?
Correct Answer: B
Rationale: Step 1: Antibiotics are prescribed to treat urethritis, indicating a bacterial infection in the urinary tract. Step 2: Increasing water intake (2-3 L daily) promotes renal blood flow, dilutes urine, and helps flush out bacteria from the urinary tract, aiding in the elimination of infection. Step 3: Adequate hydration helps prevent the formation of concentrated urine, reducing the risk of recurrent urinary tract infections. Step 4: Therefore, choice B is correct as it directly addresses the underlying cause of the client's symptoms. Summary: Choices A, C, and D are incorrect as they do not directly target the bacterial infection causing the urinary discomfort. Drinking water will not specifically help with incontinence, eliminate odors, or provide pain relief.
Question 2 of 9
During an ophthalmic assessment, which of the ff are the nurses expected to observe carefully? Choose all that apply
Correct Answer: B
Rationale: The correct answer is B: Pupil responses. During an ophthalmic assessment, observing pupil responses is crucial as it provides information on the function of the cranial nerves and potential neurological issues. Pupil size, shape, symmetry, and reaction to light are key indicators of eye health. A: Level of central vision - While important, assessing the level of central vision is typically done by the ophthalmologist and not within the scope of the nurse's role in a routine assessment. C: External eye appearance - Although external eye appearance can give some clues about eye health, it is not as direct and crucial as observing pupil responses. D: Eye movements - While eye movements can provide information on ocular motor function, it is not as critical as assessing pupil responses in an ophthalmic assessment.
Question 3 of 9
Which of the ff. medications might be ordered to help control symptoms of multiple sclerosis, and possibly induce a remission?
Correct Answer: C
Rationale: Correct Answer: C - ACTH Rationale: 1. ACTH (adrenocorticotropic hormone) can help control symptoms and induce remission in multiple sclerosis by reducing inflammation. 2. ACTH stimulates the production of cortisol, a natural anti-inflammatory hormone. 3. By reducing inflammation in the central nervous system, ACTH can help manage symptoms and promote remission. Summary of other choices: A: Acyclovir - Antiviral medication used to treat herpes infections, not effective for multiple sclerosis. B: Thyrotropin - Hormone that stimulates thyroid function, not used in the treatment of multiple sclerosis. D: Benadryl - Antihistamine used for allergies and itching, not indicated for multiple sclerosis management.
Question 4 of 9
Nurse Lina gives discharge instructions to Aling Maria, who is experiencing an exacerbation of COPD because of an upper respiratory tract infection, regarding her diet at home. Which of the following food choices would be appropriate?
Correct Answer: D
Rationale: The correct answer is D: high calorie high protein. In COPD exacerbation, the body requires extra calories and protein for energy and muscle strength. High-calorie foods help combat weight loss and fatigue. High-protein foods aid in muscle repair and maintenance. Low-fat low-cholesterol (A) is not ideal as healthy fats are needed. Low-sodium (B) is not necessary unless there is concurrent heart failure. Bland soft diet (C) is not suitable as it does not provide enough calories and protein needed for COPD exacerbation.
Question 5 of 9
A client has an external fixation device on his leg due to a compound fracture. The client says that the device and swelling make his leg look ugly. Which nursing diagnosis should the nurse document in his care plan based on the client’s concern?
Correct Answer: B
Rationale: The correct answer is B: Disturbed body image. The client expressing concern about the external fixation device making his leg look ugly indicates a disturbance in how he perceives his body image. This can lead to feelings of low self-esteem and impact his overall psychological well-being. Impaired physical mobility (A) is not the priority as the concern is not related to limitations in movement. Risk for infection (C) may be a potential risk with the device but is not directly related to the client's current concern. Risk for social isolation (D) is not directly indicated by the client's statement about the appearance of the leg. Therefore, the most appropriate nursing diagnosis is Disturbed body image (B) based on the client's expressed concern.
Question 6 of 9
A nurse is providing nursing care to a group of patients. Which actions are direct care interventions? (Select all that apply.)
Correct Answer: A
Rationale: The correct answer is A: Ambulating a patient. Direct care interventions involve hands-on activities directly impacting patient outcomes. Ambulating a patient is a direct care intervention as it involves physically assisting the patient to move, promoting circulation, preventing complications, and improving overall well-being. Inserting a feeding tube (B) and performing resuscitation (C) are also direct care interventions as they involve immediate patient care actions. Documenting wound care (D) is not a direct care intervention as it involves recording information about a care activity rather than physically performing the care itself.
Question 7 of 9
Which finding will alert the nurse that the goal has been met?
Correct Answer: A
Rationale: The correct answer is A because it meets the goal of maintaining a heart rate of 78 beats/min. This specific date ensures the consistency of the heart rate within the desired range. Choices B, C, and D do not align with the goal as they either have a different heart rate or occur on a different date. Therefore, A is the only option that accurately reflects the goal being met on the specified date.
Question 8 of 9
During a breast examination, which finding most strongly suggests that the client has breast cancer?
Correct Answer: B
Rationale: The correct answer is B because a fixed nodular mass with dimpling of the overlying skin is highly indicative of breast cancer. This finding suggests an invasive tumor pulling on the skin, causing dimpling. Other choices are incorrect because slight breast asymmetry (A) is common, bloody nipple discharge (C) can be benign or due to other conditions, and multiple freely movable masses (D) are more indicative of benign breast conditions like fibrocystic changes.
Question 9 of 9
A patient has iron deficiency anemia. Which of the following foods will best help provide dietary iron?
Correct Answer: C
Rationale: The correct answer is C: Lean red meats. Lean red meats are a rich source of heme iron, which is more easily absorbed by the body compared to non-heme iron found in plant-based foods. Heme iron helps improve iron levels more effectively in individuals with iron deficiency anemia. Fresh fruits (A) and dairy products (B) contain minimal iron, while breads and cereals (D) provide non-heme iron which is not as readily absorbed.