ATI RN
Cardiovascular Conditions Pediatrics Test Bank Questions Free Nursing Questions
Question 1 of 5
A fair-skinned female client who is an avid runner is diagnosed with malignant melanoma, located on the lateral surface of the lower leg. After wide margin resection, the nurse provides discharge teaching. It is most important for the nurse to emphasize the need to observe for changes in which characteristic?
Correct Answer: B
Rationale: In this scenario, the correct answer is B) Appearance of any moles. It is crucial for the nurse to emphasize the need to observe for changes in moles because in a client with a history of malignant melanoma, monitoring for any new or changing moles is essential for early detection of skin cancer recurrence or new lesions. Changes in the appearance of moles, such as asymmetry, border irregularity, color variation, diameter increase, or evolving features, can signify malignant transformation. Elasticity of the skin (Option A) is important for assessing hydration status and skin health but is not directly related to melanoma recurrence monitoring. Muscle aches and pains (Option C) are not specific indicators of malignant melanoma recurrence and are more likely related to other causes in an avid runner. Pigmentation of the skin (Option D) may change over time due to various factors but is not the primary indicator for monitoring melanoma recurrence. Educationally, this question highlights the importance of ongoing surveillance and patient education in the management of malignant melanoma. Nurses play a critical role in teaching patients about self-assessment and early detection practices to promote optimal outcomes in skin cancer management.
Question 2 of 5
The nurse is assessing clients in an outpatient diabetic clinic. Which entry provides the best evidence that the client is adhering to the prescribed diabetic regimen?
Correct Answer: A
Rationale: In this scenario, option A, "Hemoglobin A1C of 6.2%," provides the best evidence that the client is adhering to the prescribed diabetic regimen. Hemoglobin A1C is a valuable indicator of long-term glucose control, reflecting average blood glucose levels over the past 2-3 months. A level of 6.2% indicates good glycemic control and suggests that the client has been consistently following their prescribed diabetic regimen. Option B, "Fasting blood glucose of 130 mg/dL," is a single point-in-time measurement and may not accurately represent the client's overall glucose control. It can fluctuate throughout the day based on various factors. Option C, "Positive urine ketones," indicates the presence of ketones in the urine, which typically signifies poor diabetes management and potential complications like diabetic ketoacidosis. It is not a reliable indicator of adherence to the prescribed regimen. Option D, "Self-reported daily blood glucose monitoring," while a positive behavior, relies on self-reporting, which may not always be accurate. Objective measures like A1C provide more reliable evidence of adherence. Educationally, it is crucial for nurses to understand the significance of different parameters in assessing diabetic control. Teaching patients the importance of regular monitoring, medication adherence, and lifestyle modifications can help improve outcomes and prevent complications in pediatric patients with diabetes.
Question 3 of 5
A client returns to the unit following a suprapubic prostatectomy. He has a three-way catheter in place with a continuous bladder irrigation infusing. Which assessment finding warrants immediate intervention by the nurse?
Correct Answer: D
Rationale: In this scenario, the correct answer is option D: Urine leaking around the meatus. This finding warrants immediate intervention by the nurse because it indicates a potential complication such as urinary leakage, which could lead to infection or disruption of the surgical site. Addressing this issue promptly is crucial to prevent further complications and ensure the client's recovery. Option A (True urinary output of 50ml/hr) is not the most concerning finding in this context. While monitoring urinary output is important postoperatively, a consistent output of 50ml/hr may not immediately indicate a critical issue. Option B (Lower abdominal tenderness) is a common postoperative finding and may be expected after a suprapubic prostatectomy. While it should be monitored, it does not require immediate intervention unless it is severe or accompanied by other concerning symptoms. Option C (Blood urine output with clots) is also a serious finding that should be addressed, but in this case, the presence of clots alone may not always warrant immediate intervention unless it is causing obstruction or significant bleeding. This scenario is crucial for nursing students to understand the immediate postoperative assessment of clients undergoing genitourinary surgeries. Recognizing and prioritizing critical assessment findings can help prevent complications and promote optimal patient outcomes in clinical practice.
Question 4 of 5
A male client is recovering from an episode of urinary tract calculi. During discharge teaching, the client asks about the dietary restriction he should follow. In discussing fluid intake, the nurse should include which type of fluid limitation?
Correct Answer: C
Rationale: The correct answer is C) Tea and hot chocolate. When a client is recovering from urinary tract calculi, especially if they were calcium oxalate stones, they should limit their intake of foods and drinks high in oxalates, such as tea and hot chocolate. Oxalates can contribute to the formation of these types of stones, so restricting them can help prevent recurrence. Option A, low-sodium soups, is not directly related to urinary tract calculi, so it is not the most appropriate choice. Option B, overall fluid intake, should not be limited as adequate hydration is important in preventing stone formation. Option D, citrus fruit juices, should not be restricted unless the client has a specific sensitivity to them. In an educational context, it is crucial for nurses to provide accurate and relevant dietary information to clients recovering from urinary tract calculi to help prevent recurrence and promote optimal health. Understanding the impact of specific foods and fluids on the formation of stones is essential in guiding dietary recommendations.
Question 5 of 5
A client uses triamcinolone (Kenalog), a corticosteroid ointment, to manage pruritus caused by a chronic skin rash. The client calls the clinic nurse to report increased erythema with purulent exudate at the site. Which action should the nurse implement?
Correct Answer: A
Rationale: In this scenario, the correct action for the nurse to implement is to schedule an appointment for the client to see the healthcare provider (Option A). The increased erythema with purulent exudate at the site indicates a possible infection, which is a common complication of corticosteroid use. By scheduling an appointment for the client to see the healthcare provider, the nurse ensures that the client receives a proper evaluation and appropriate treatment for the infection. This is crucial in preventing the infection from worsening and potentially leading to serious complications. Option B, advising the client to apply more corticosteroid cream, is incorrect as it can further exacerbate the infection by suppressing the immune response and promoting bacterial growth. Option C, recommending the use of an antibiotic ointment, is also incorrect as systemic antibiotics may be needed and should be prescribed by a healthcare provider after a thorough evaluation. Option D, instructing the client to stop using the medication for 24 hours, is not appropriate as the client needs prompt medical attention for the infection. Educationally, this scenario highlights the importance of recognizing potential complications of medication use and the need for timely intervention by healthcare providers. It emphasizes the role of nurses in assessing, triaging, and advocating for clients' health and well-being. Nurses play a crucial role in patient education, monitoring for adverse effects, and facilitating timely access to appropriate healthcare interventions.