ATI RN
Client Health and Safety Specifications Questions
Question 1 of 5
A client has been recently admitted to an inpatient psychiatric unit. Which intervention should the nurse plan to use to reduce the client's focus on delusional thinking?
Correct Answer: B
Rationale: The correct answer is B: Focus on feelings suggested by the delusion. This approach helps the nurse establish rapport with the client by acknowledging their emotions, fostering trust, and potentially reducing anxiety related to the delusion. By exploring the underlying feelings, the nurse can address the root cause of the delusion and work towards reducing its impact on the client's thinking. A: Presenting evidence may not be effective as clients with delusions often have fixed beliefs that are not easily swayed by logical reasoning or evidence. C: Addressing the delusion with logical explanations may reinforce the client's belief rather than reduce it as delusions are not based on logic. D: Exploring reasons behind the delusion is important but may not directly address the client's immediate focus on delusional thinking.
Question 2 of 5
Which of the following are nursing care guidelines when preparing a body for the morgue? Select all that apply.
Correct Answer: B
Rationale: The correct answer is B because leaving the hospital ID band in place ensures proper identification of the deceased individual. This step is crucial to prevent any mix-ups or confusion. Assessing vital signs (A) is unnecessary as the person is already deceased. Checking the death certificate (C) is not a nursing responsibility. Following institutional policies (D) is important but not specific to preparing the body for the morgue.
Question 3 of 5
A patient has pitting pedal edema, crackles, and an elevated blood pressure. The nurse concludes that the patient has fluid volume excess. Which type of reasoning did the nurse use?
Correct Answer: B
Rationale: The correct answer is B: Inductive reasoning. The nurse observed specific signs and symptoms (pitting pedal edema, crackles, elevated blood pressure) and made a general conclusion (fluid volume excess). Inductive reasoning involves drawing general conclusions from specific observations. The nurse did not use theoretical reasoning (A), as she did not rely on abstract principles. Deductive reasoning (C) involves drawing specific conclusions from general premises, which was not the case here. Conceptual reasoning (D) involves understanding abstract concepts, not directly applicable in this scenario. In summary, the nurse used inductive reasoning by inferring fluid volume excess based on specific clinical findings.
Question 4 of 5
Which step of the nursing process involves setting long-term goals and short-term expectations?
Correct Answer: B
Rationale: The correct answer is B: Planning. In the nursing process, Planning involves setting long-term goals and short-term expectations based on the assessment data gathered in the previous step. This step includes developing a care plan that outlines the interventions needed to achieve the desired outcomes. Assessment (choice A) involves collecting and analyzing data, Implementation (choice C) is the actual carrying out of the care plan, and Evaluation (choice D) involves assessing the outcomes achieved compared to the goals set during the planning phase. Planning is essential for effective nursing care as it guides the interventions and ensures the patient's needs are addressed appropriately.
Question 5 of 5
The nurse is filling out an incident report after an older adult client fell while attempting to transfer this person from bed to a commode. Which health problem should the nurse consider when client falls occur?
Correct Answer: D
Rationale: The correct answer is D: Orthostatic hypotension. This condition is characterized by a drop in blood pressure when moving from lying down to standing up, leading to dizziness and falls. In the scenario provided, the older adult client fell while attempting to transfer to a commode, indicating a sudden drop in blood pressure upon standing. Bradypnea (A) refers to abnormally slow breathing rate and is not directly related to falls. Palpitations (B) are rapid or irregular heartbeats and do not directly cause falls. Primary hypertension (C) is high blood pressure that is typically asymptomatic and does not directly lead to falls. Therefore, the most likely health problem to consider in this scenario is orthostatic hypotension due to its association with falls during position changes.