ATI RN
Nursing Process Practice Questions Quizlet Questions
Question 1 of 5
A client is receiving chemotherapy for cancer. The nurse reviews the client’s laboratory report and notes that he has thrombocytopenia. To which nursing diagnosis should the nurse give the highest priority?
Correct Answer: D
Rationale: The correct answer is D: Ineffective tissue perfusion: Cerebral, cardiopulmonary, GI. Thrombocytopenia is a low platelet count, which can lead to impaired blood clotting and potential bleeding. Ineffective tissue perfusion is the most critical concern as it can lead to life-threatening complications like hemorrhage. Activity intolerance, impaired tissue integrity, and impaired oral mucous membranes are important but do not pose an immediate threat to the client's life compared to the risk of hemorrhage from thrombocytopenia.
Question 2 of 5
When evaluating the effectiveness of nursing interventions for sinusitis discomfort, which of the following does the nurse assess?
Correct Answer: C
Rationale: The correct answer is C: Amount and color of sinus drainage. Assessing the amount and color of sinus drainage is crucial in evaluating the effectiveness of nursing interventions for sinusitis discomfort as it indicates the presence of infection or inflammation. Changes in color or amount can signify improvement or worsening of the condition. WBC count (A) may indicate infection but doesn't directly reflect sinusitis discomfort. Capillary refill (B) assesses circulation, not sinusitis. Comfort level (D) is subjective and can vary among individuals, making it less reliable for assessing the effectiveness of interventions.
Question 3 of 5
A nurse caring for a patient with a herniated lumbar disk develops a plan of care for impaired mobility related to nerve compression. Which patient outcome indicates that the plan has been successful?
Correct Answer: D
Rationale: The correct answer is D: The patient is able to ambulate 25 feet without pain. This outcome indicates successful plan implementation for impaired mobility due to nerve compression. Ambulating without pain shows improved mobility and nerve compression relief. Choices A, B, and C do not directly address mobility improvement. Choice A focuses on pain level, which is important but not a direct measure of mobility. Choice B refers to upper extremities, not the lower extremities affected by lumbar disk herniation. Choice C addresses medication management, not mobility improvement.
Question 4 of 5
The nurse is caring for a client who is HIV positive. To prevent the spread of the HIV virus, what do the Centers for Disease Control and Prevention recommend?
Correct Answer: A
Rationale: The correct answer is A: Universal blood and body fluid precautions. This is recommended by the CDC to prevent the spread of HIV because the virus can be present in blood and certain body fluids. Universal precautions involve treating all blood and body fluids as potentially infectious. Incorrect choices: B: Body systems isolation - This is not specific to preventing the spread of HIV and is not recommended by the CDC. C: Laminar flow room during active infection - This is not a standard recommendation for preventing the spread of HIV. D: Needle and syringe precautions - While important in preventing needlestick injuries, it is not the primary method recommended by the CDC for preventing the spread of HIV.
Question 5 of 5
A patient is treated with IV methylprednisolone (Solu-medrol) for emphysema. What is the purpose of corticosteroid treatment in lung disease?
Correct Answer: D
Rationale: The correct answer is D: Reduce airway inflammation. Corticosteroids like methylprednisolone are used in emphysema to reduce inflammation in the airways, which can help improve lung function and symptoms. Corticosteroids work by suppressing the immune response that leads to inflammation in the airways. This can help decrease swelling, mucus production, and constriction of the airways, all of which contribute to the symptoms of emphysema. Dry secretions (choice A) and improving oxygen-carrying capacity (choice B) are not the primary purposes of corticosteroid treatment in emphysema. Treating infection that causes a low level of hemoglobin (choice C) is not relevant to corticosteroid treatment for emphysema.
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