ATI RN
foundation of nursing questions and answers Questions
Question 1 of 9
A junior nursing student is having an observation day in the operating room. Early in the day, the student tells the OR nurse that her eyes are swelling and she is having trouble breathing. What should the nurse suspect?
Correct Answer: C
Rationale: The correct answer is C: Anaphylaxis due to a latex allergy. Anaphylaxis is a severe allergic reaction that can be triggered by exposure to latex products such as gloves in the operating room. The symptoms of swelling of the eyes and difficulty breathing are classic signs of anaphylaxis. Rationale: 1. Swelling of the eyes and difficulty breathing are hallmark symptoms of anaphylaxis. 2. Latex is a common allergen that can cause severe allergic reactions like anaphylaxis. 3. The student's symptoms are occurring shortly after entering the operating room, suggesting an acute allergic reaction. 4. The other choices (A, B, D) do not align with the symptoms presented and are less likely in this scenario.
Question 2 of 9
A patient with a sudden onset of hearing loss tells the nurse that he would like to begin using hearing aids. The nurse understands that the health professional dispensing hearing aids would have what responsibility?
Correct Answer: A
Rationale: The correct answer is A: Test the patient's hearing promptly. This is because before dispensing hearing aids, it is crucial to accurately assess the patient's hearing ability. Testing the patient's hearing promptly allows the healthcare professional to determine the type and degree of hearing loss, which is essential for selecting the appropriate hearing aids. Performing an otoscopy (choice B) may be part of the assessment but does not provide information on hearing ability. Measuring the width of the patient's ear canal (choice C) is not necessary for dispensing hearing aids. Referring the patient to his primary care physician (choice D) may delay the process of obtaining hearing aids and is not directly related to the responsibility of the health professional dispensing hearing aids.
Question 3 of 9
A patient is being discharged home from the ambulatory surgery center after an incisional biopsy of a mass in her left breast. What are the criteria for discharging this patient home? Select all that apply.
Correct Answer: A
Rationale: Step-by-step rationale for why answer A is correct: 1. Ambulating is a crucial postoperative activity to prevent complications like blood clots. 2. Understanding when to ambulate ensures the patient follows proper recovery guidelines. 3. Proper ambulation aids in preventing postoperative complications and promotes healing. Summary of why other choices are incorrect: B. Having someone accompany the patient is important for support but not a strict criteria for discharge. C. While understanding activity restrictions is important, it is not a specific criteria for immediate discharge. D. Understanding care for the biopsy site is essential but not a strict criteria for immediate discharge. E. Removal of a urinary catheter is not typically related to discharge criteria for a breast biopsy.
Question 4 of 9
The nurse learns about cultural issues involvedin the patient’s health care belief system and enables patients and families to achieve meaningful and supportive care. Which concept is the nurse demonstrating?
Correct Answer: D
Rationale: The correct answer is D: Culturally congruent care. This concept refers to providing care that aligns with the patient's cultural beliefs and practices. By learning about cultural issues and enabling patients to receive care that is meaningful and supportive within their cultural context, the nurse is demonstrating culturally congruent care. A: Marginalized groups - This refers to groups in society who are disadvantaged and face discrimination. While understanding cultural issues may be important when caring for marginalized groups, it is not the main concept demonstrated in this scenario. B: Health care disparity - This refers to differences in access to healthcare and health outcomes among different populations. While cultural competence can help address healthcare disparities, it is not the concept being demonstrated here. C: Transcultural nursing - This refers to providing care across different cultures. While related, it does not specifically address the nurse's role in understanding and enabling culturally appropriate care for individual patients and families.
Question 5 of 9
A 76-year-old with a diagnosis of penile cancer has been admitted to the medical floor. Because the incidence of penile cancer is so low, the staff educator has been asked to teach about penile cancer. What risk factors should the educator cite in this presentation? Select all that apply.
Correct Answer: A
Rationale: The correct answer is A: Phimosis. Phimosis, the inability to retract the foreskin over the glans penis, is a significant risk factor for penile cancer. Phimosis can lead to poor hygiene, inflammation, and chronic irritation, increasing the risk of cancer development. The other choices (B: Priapism, C: Herpes simplex infection, D: Increasing age, E: Lack of circumcision) are not directly linked to penile cancer development. Priapism is prolonged and painful erection unrelated to penile cancer. Herpes simplex infection is a viral infection and not a primary risk factor for penile cancer. Increasing age is a general risk factor for many cancers, but it is not specific to penile cancer. Lack of circumcision has been associated with a slightly higher risk of penile cancer, but it is not as significant as phimosis.
Question 6 of 9
A nurse has included the nursing diagnosis of Risk for Latex Allergy Response in a patients plan of care. The presence of what chronic health problem would most likely prompt this diagnosis?
Correct Answer: D
Rationale: The correct answer is D: Hypogammaglobulinemia. This chronic health problem predisposes individuals to latex allergies due to reduced levels of immunoglobulins, increasing susceptibility to allergic reactions. Latex contains proteins that can trigger immune responses in individuals with compromised immune systems. Choice A: Herpes simplex is a viral infection and does not directly relate to latex allergies. Choice B: HIV weakens the immune system but is not specifically associated with latex allergies. Choice C: Spina bifida is a congenital condition affecting the spinal cord and does not directly impact the likelihood of latex allergies.
Question 7 of 9
A patient has had a sudden loss of vision after head trauma. How should the nurse best describe the placement of items on the dinner tray?
Correct Answer: A
Rationale: The correct answer is A because using clock cues helps the patient visualize the placement of items based on a familiar concept. This aids in compensating for the loss of vision after head trauma. Choice B does not provide specific guidance on how to describe the placement. Choice C may be confusing for the patient as it is not a common way to describe item placement. Choice D puts unnecessary burden on the patient to describe the location first before confirming, which may be challenging for someone with sudden loss of vision.
Question 8 of 9
A patient with HIV is admitted to the hospital because of chronic severe diarrhea. The nurse caring for this patient should expect the physician to order what drug for the management of the patients diarrhea?
Correct Answer: B
Rationale: The correct answer is B: Sandostatin. This drug is a somatostatin analog that can help manage HIV-related chronic severe diarrhea by reducing gastrointestinal secretions. Sandostatin works by inhibiting the release of various hormones and neurotransmitters in the gut, which can help control diarrhea in HIV patients. Rationale: A: Zithromax is an antibiotic that is not typically used to manage chronic severe diarrhea in HIV patients. C: Levaquin is also an antibiotic and not indicated for managing diarrhea in HIV patients. D: Biaxin is another antibiotic and not the appropriate choice for managing chronic severe diarrhea in HIV patients. In summary, Sandostatin is the correct choice as it specifically targets the underlying cause of diarrhea in HIV patients by reducing gastrointestinal secretions, whereas the other options are antibiotics that are not indicated for this purpose.
Question 9 of 9
During the admission assessment of an HIV-positive patient whose CD4+ count has recently fallen, the nurse carefully assesses for signs and symptoms related to opportunistic infections. What is the most common life-threatening infection?
Correct Answer: D
Rationale: The correct answer is D: Pneumocystis pneumonia. This is the most common life-threatening infection in HIV-positive patients with low CD4+ counts. Pneumocystis pneumonia is caused by the opportunistic pathogen Pneumocystis jirovecii, which can lead to severe respiratory distress and mortality in immunocompromised individuals. The other choices, A: Salmonella infection, B: Mycobacterium tuberculosis, and C: Clostridium difficile, can also cause infections in HIV-positive patients, but they are not as commonly associated with life-threatening complications in this population compared to Pneumocystis pneumonia. It is crucial for the nurse to prioritize assessment for signs and symptoms of Pneumocystis pneumonia in this patient to promptly intervene and prevent further complications.