ATI RN
foundations of nursing practice questions Questions
Question 1 of 9
A nurse is caring for a male patient with urinaryretention. Which action should the nurse takefirst?
Correct Answer: C
Rationale: The correct answer is C: Assist to a standing position. This action helps utilize gravity to aid in emptying the bladder and may help the patient void without the need for invasive measures like catheterization or medications. It is a non-invasive and natural approach to promote urination. Limiting fluid intake (A) could worsen the situation by concentrating urine and worsening retention. Inserting a urinary catheter (B) should be considered only if other measures fail. Asking for a diuretic medication (D) does not address the immediate need for bladder emptying and may not be necessary if the patient can void naturally.
Question 2 of 9
A patient has just returned to the unit from the PACU after surgery for a tumor within the spine. The patient complains of pain. When positioning the patient for comfort and to reduce injury to the surgical site, the nurse will position to patient in what position?
Correct Answer: B
Rationale: The correct answer is B: In a flat side-lying position. Rationale: 1. A flat side-lying position helps reduce pressure on the surgical site, promoting comfort and preventing injury. 2. This position minimizes strain on the spine and supports proper alignment. 3. High Fowlers position may increase pressure on the surgical area due to increased intra-abdominal pressure. 4. Trendelenberg position and reverse Trendelenberg position are not appropriate for spine surgery patients as they can cause increased blood flow to the surgical site, leading to potential complications.
Question 3 of 9
In providing diet education for a patient on a low-fat diet, which information is important for the nurse to share?
Correct Answer: D
Rationale: The correct answer is D because saturated fats are primarily found in animal sources such as red meat, poultry, and dairy products. It is important to limit the intake of saturated fats on a low-fat diet to reduce the risk of heart disease and other health issues. A: Polyunsaturated fats are actually considered healthy fats and should not be restricted to less than 7% of total calories. B: Transfat is a type of unhealthy fat that should be avoided altogether, not just limited to 7% of total calories. C: Unsaturated fats are actually found mostly in plant-based sources like nuts, seeds, and avocados, not animal sources. In summary, choice D is correct because it provides accurate information about the source of saturated fats in animal products, while the other choices provide incorrect or misleading information about different types of fats.
Question 4 of 9
The patient has just started on enteral feedings, and the patient is reporting abdominal cramping. Which action will the nurse takenext?
Correct Answer: A
Rationale: Correct Answer: A Rationale: Abdominal cramping in a patient on enteral feedings could indicate feeding intolerance. The nurse's initial action should be to slow down the rate of the tube feeding to allow the patient's gastrointestinal tract to adjust gradually. This helps reduce the risk of further complications and allows for better tolerance. Slowing the rate is a safe and effective intervention that can help alleviate the abdominal cramping without causing additional stress on the patient's digestive system. Summary of Incorrect Choices: B: Instilling cold formula is not a recommended practice and can potentially cause harm or discomfort to the patient. C: Changing to a high-fat formula may exacerbate the abdominal cramping as it can be harder to digest for some patients. D: Consulting with the healthcare provider about prokinetic medication should come after trying less invasive interventions such as slowing the rate of tube feeding.
Question 5 of 9
A nurse is using Campinha-Bacote’s model of cultural competency to improve cultural care. Which actions describe the components the nurse is using?
Correct Answer: A
Rationale: Step 1: In Campinha-Bacote's model, the first component is "cultural awareness," which involves an in-depth self-examination of one's own background. Step 2: This self-examination helps nurses recognize their biases and assumptions, enabling them to provide culturally competent care. Step 3: By understanding their own culture, nurses can better understand and respect the cultural beliefs and practices of their patients. Step 4: This component is crucial for building trust and rapport with patients from diverse backgrounds. Step 5: Choices B, C, and D do not directly align with the cultural awareness component of Campinha-Bacote's model. B focuses on assessment, C on understanding diverse groups, and D on motivation, but they do not address the foundational self-examination required for cultural competency.
Question 6 of 9
The nurse is planning the care of a patient with a diagnosis of vertigo. What nursing diagnosis risk should the nurse prioritize in this patients care?
Correct Answer: C
Rationale: The correct answer is C: Risk for falls. Patients with vertigo experience a false sensation of spinning or movement, which can lead to imbalance and increased risk of falls. Prioritizing the risk for falls is crucial to prevent injuries and ensure patient safety. Other choices are incorrect as they do not directly address the immediate safety concern of falls associated with vertigo. A: Risk for disturbed sensory perception may be present, but the priority is preventing falls. B: Risk for unilateral neglect is not typically associated with vertigo. D: Risk for ineffective health maintenance is important but falls take precedence due to the immediate risk of injury.
Question 7 of 9
A family member of a patient diagnosed with Huntington disease calls you at the clinic. She is requesting help from the Huntingtons Disease Society of America. What kind of help can this patient and family receive from this organization? Select all that apply.
Correct Answer: A
Rationale: The correct answer is A: Information about this disease. The Huntington's Disease Society of America provides valuable resources such as educational materials, support groups, and updates on research. This information can help patients and families understand the disease better and navigate available treatment options. Referrals, public education, individual assessments, and appraisals of research studies are not typically services provided directly by the organization, making them incorrect choices in this context.
Question 8 of 9
A nurse is explaining that each breast contains 12 to 20 cone-shaped lobes. The nurse should explain that each lobe consists of what elements?
Correct Answer: C
Rationale: The correct answer is C: Lobules and ducts. Each lobe of the breast consists of lobules, which are responsible for milk production, and ducts, which transport the milk to the nipple. This is essential for breastfeeding. Modified tendons and ligaments (choice A) are not present in the lobes of the breast. Connective tissue and smooth muscle (choice B) are important components of the breast but do not specifically make up the lobes. Endocrine glands and sebaceous glands (choice D) are not the primary elements within the lobes of the breast responsible for milk production and transport. The lobules and ducts are vital components for the functioning of the breast in lactation.
Question 9 of 9
For which of the following population groups would an annual clinical breast examination be recommended?
Correct Answer: C
Rationale: The correct answer is C: Women over age 40. Annual clinical breast examinations are recommended for this population group because they have an increased risk of developing breast cancer compared to younger age groups. Regular screenings starting at age 40 can help in early detection and improve survival rates. A: Women over age 21 - This age group is generally recommended to start clinical breast examinations every 1-3 years, not necessarily annually. B: Women over age 25 - While it's important to be vigilant about breast health, the risk of breast cancer increases with age, making annual exams more crucial for older women. D: All post-pubescent females with a family history of breast cancer - While family history is a risk factor, the recommendation for annual clinical breast examinations typically begins at age 40, regardless of family history.