ATI RN
foundation of nursing questions Questions
Question 1 of 9
A nurse is caring for a teenage girl who has had an anaphylactic reaction after a bee sting. The nurse is providing patient teaching prior to the patients discharge. In the event of an anaphylactic reaction, the nurse informs the patient that she should self-administer epinephrine in what site?
Correct Answer: B
Rationale: The correct answer is B: Thigh. When administering epinephrine during an anaphylactic reaction, the thigh is the recommended site due to its large muscle mass and quick absorption rate. Steps: 1. Remove safety cap. 2. Firmly push the auto-injector against the thigh until it clicks. 3. Hold in place for a few seconds. 4. Seek medical help immediately. Rationale for incorrect choices: A: Forearm - Not recommended due to smaller muscle mass and slower absorption. C: Deltoid muscle - Not preferred as it may not provide as rapid absorption as the thigh. D: Abdomen - Not ideal due to potential fat layers that could affect absorption speed.
Question 2 of 9
The nurse is planning care for a group of patients. Which task will the nurse assign to the nursing assistive personnel?
Correct Answer: A
Rationale: The correct answer is A because measuring capillary blood glucose level is a task that can be safely delegated to nursing assistive personnel. This task is within their scope of practice and does not require specialized nursing knowledge. Nursing assistive personnel can perform this task accurately with proper training and supervision. Incorrect choices: B: Measuring nasoenteric tube for insertion requires specialized training and assessment skills that nursing assistive personnel may not possess. C: Measuring pH in gastrointestinal aspirate involves interpretation and clinical judgment that should be done by a licensed nurse. D: Measuring the patient's risk for aspiration involves critical thinking and assessment skills that are beyond the scope of nursing assistive personnel.
Question 3 of 9
A male patient presents at the free clinic with complaints of impotency. Upon physical examination, the nurse practitioner notes the presence of hypogonadism. What diagnosis should the nurse suspect?
Correct Answer: A
Rationale: The correct answer is A: Prolactinoma. Hypogonadism is often associated with decreased testosterone levels, which can be caused by excessive prolactin secretion from a prolactinoma. Prolactin inhibits the secretion of gonadotropin-releasing hormone (GnRH), leading to decreased production of testosterone. Angioma, glioma, and ACTH-producing adenoma are not typically associated with hypogonadism. Angiomas are benign tumors of blood vessels, gliomas are tumors of the brain or spinal cord, and ACTH-producing adenomas are associated with Cushing's disease, not hypogonadism.
Question 4 of 9
A patient requests the nurse’s help to the bedside commode and becomes frustrated when unable to void in front of the nurse. How should the nurse interpret the patient’s inability to void?
Correct Answer: A
Rationale: The correct answer is A: The patient can be anxious, making it difficult for abdominal and perineal muscles to relax enough to void. Rationale: Anxiety can lead to tension in the abdominal and perineal muscles, inhibiting the ability to relax and urinate. The sympathetic nervous system response to anxiety can cause urinary retention. So, the patient's frustration in voiding in front of the nurse may be due to anxiety hindering muscle relaxation. Summary of other choices: B: The patient not recognizing physiological signals is less likely as the patient requested assistance to void, indicating awareness of the need to urinate. C: The patient being lonely and seeking attention is not relevant to the inability to void in front of the nurse. D: Inadequate fluid intake may contribute to decreased urine output but is not directly related to the inability to void in front of the nurse.
Question 5 of 9
A nurse is teaching about the energy needed at rest to maintain life-sustaining activities for a specific period of time. What is the nurse discussing?
Correct Answer: B
Rationale: The correct answer is B: Basal metabolic rate (BMR). BMR refers to the minimum amount of energy required to maintain basic physiological functions at rest. It accounts for about 60-75% of total energy expenditure. It is essential for sustaining life-sustaining activities such as breathing, circulating blood, and maintaining body temperature. Incorrect Choices: A: Resting energy expenditure (REE) is the total amount of energy expended by the body while at rest, including BMR and additional energy for daily activities. C: Nutrient density refers to the amount of nutrients per calorie in a food item, not the energy needed at rest. D: Nutrients are essential substances in food required for growth, maintenance, and repair, but they do not specifically refer to the energy needed at rest.
Question 6 of 9
The nurse is reviewing the instructions given to a patient at 24 weeks’ gestation for a glucose challenge test (GCT). The nurse determines that the patient understands the teaching when she makes which statement?
Correct Answer: C
Rationale: The correct answer is C: “I will have blood drawn at 1 hour after I drink the glucose solution.” This statement demonstrates understanding of the GCT procedure. The glucose challenge test involves drinking a sugary solution, followed by blood drawn 1 hour later to measure blood glucose levels. This timing is crucial for assessing the body's ability to metabolize glucose, which helps in diagnosing gestational diabetes. Explanation of why the other choices are incorrect: A: “I have to fast the night before the test.” - This is incorrect as fasting is not required for the GCT. B: “I will drink a sugary solution containing 100 g of glucose.” - This is incorrect as the GCT typically involves drinking a solution with a standardized amount of glucose, usually 50 g, not 100 g. D: “I should keep track of my baby’s movements between now and the test.” - This is unrelated to the GCT procedure and does not demonstrate understanding of the
Question 7 of 9
The nurse on the medicalsurgical unit is reviewing discharge instructions with a patient who has a history of glaucoma. The nurse should anticipate the use of what medications?
Correct Answer: B
Rationale: The correct answer is B: Cholinergics. Glaucoma is a condition characterized by increased intraocular pressure due to impaired drainage of aqueous humor. Cholinergics help to constrict the pupil and improve the outflow of aqueous humor, thus reducing intraocular pressure. This medication class is commonly used to manage glaucoma. A: Potassium-sparing diuretics are not typically used in the treatment of glaucoma. They are mainly used to manage conditions like hypertension and heart failure. C: Antibiotics are not indicated for the routine management of glaucoma. They are used to treat infections. D: Loop diuretics are not commonly used in the treatment of glaucoma. They are primarily used to manage conditions like edema and hypertension.
Question 8 of 9
The registered nurse taking shift report learns that an assigned patient is blind. How should the nurse best communicate with this patient?
Correct Answer: A
Rationale: The correct answer is A because providing instructions in simple, clear terms is crucial when communicating with a blind patient. This method allows the patient to understand information effectively without visual cues. Choice B is incorrect because a firm, loud voice may startle the patient. Choice C is incorrect as touching a patient without consent may be inappropriate. Choice D is incorrect because stating name and role without context may confuse the patient.
Question 9 of 9
A nurse has assessed that a patient is not yet willing to view her mastectomy site. How should the nurse best assist the patient is developing a positive body image?
Correct Answer: D
Rationale: Step 1: Providing encouragement is essential to building trust and rapport with the patient, which is crucial in supporting her emotional needs. Step 2: Empathy helps the patient feel understood and supported, fostering a positive therapeutic relationship. Step 3: Thoughtful encouragement acknowledges the patient's feelings and validates her experiences, empowering her to gradually accept her body changes. Step 4: By offering empathic and thoughtful encouragement, the nurse helps the patient develop a positive body image at her own pace. Choice A focuses on physical appearance, Choice B generalizes experiences, and Choice C overlooks the patient's emotional journey.