Questions 9

ATI RN

ATI RN Test Bank

Adult Health Nursing Test Bank Questions

Question 1 of 5

A nurse is preparing to assist with a lumbar epidural steroid injection (LESI) procedure for a patient with chronic back pain. What action should the nurse prioritize to ensure procedural accuracy?

Correct Answer: A

Rationale: Correct Answer: A Rationale: 1. Confirming the patient's identity ensures the right patient is receiving the intended procedure. 2. Verifying the procedure site using two identifiers prevents errors in site selection. 3. This step aligns with the World Health Organization's Surgical Safety Checklist, reducing the risk of wrong-site procedures. 4. Positioning, sedation, and local anesthesia are important but secondary to ensuring the correct patient and site. Summary: - Option B: Positioning is essential but not the top priority for procedural accuracy. - Option C: Sedation aims to minimize discomfort but does not guarantee procedural accuracy. - Option D: Administering local anesthesia is crucial but not as critical as confirming patient identity and procedure site.

Question 2 of 5

A patient presents with recurrent episodes of brief, severe, stabbing pain in the distribution of the trigeminal nerve. Episodes are triggered by touch, chewing, or cold exposure. Which of the following neurological conditions is most likely responsible for these symptoms?

Correct Answer: D

Rationale: The correct answer is D: Trigeminal neuralgia. This condition is characterized by recurrent, severe, stabbing pain in the trigeminal nerve distribution triggered by touch, chewing, or cold exposure. The key feature is the characteristic lancinating pain, which is not typical of migraine (choice A), cluster headache (choice B), or tension-type headache (choice C). Migraine typically presents with pulsating, moderate to severe headache associated with nausea and sensitivity to light and sound. Cluster headache is characterized by severe, unilateral pain around the eye associated with autonomic symptoms. Tension-type headache presents with bilateral, pressing or tightening pain without specific triggers. Therefore, based on the description of the symptoms in the question, trigeminal neuralgia is the most likely diagnosis.

Question 3 of 5

The physician prescribes decongestant intranasal spray. The nurse instructs the client on the proper use of the spray. Which of the following procedures is the CORRECT method?

Correct Answer: D

Rationale: The correct answer is D: Tilt the head slightly forward and angle the bottle toward the side of the nostril. This method allows for proper administration of the spray into the nasal passage, ensuring effective delivery of the medication. Tilted head helps direct the spray towards the nasal cavity without causing discomfort or leakage. It also helps prevent the medication from dripping down the back of the throat. Choices A, B, and C are incorrect: A: Finishing instillation in one nostril before moving to the other can lead to uneven distribution of medication and reduced effectiveness. B: Inhaling quickly may cause irritation and discomfort to the mucous membranes due to the forceful intake of the spray. C: Blowing the nose after spraying can expel the medication before it has a chance to be absorbed, decreasing its efficacy.

Question 4 of 5

Which of the following would prove that the nursing action carried out met, the standards of care on falls ?

Correct Answer: A

Rationale: The correct answer is A: Utilizing the nursing process in providing safe, quality nursing care. This is because the nursing process involves assessment, diagnosis, planning, implementation, and evaluation, which ensures comprehensive and individualized care. Documenting procedures (B) is important but does not guarantee meeting standards of care. Simply carrying out doctor's orders (C) may not address all aspects of patient care. Performing physical assessment (D) is crucial but only one component of the nursing process. Ultimately, utilizing the nursing process ensures holistic and evidence-based care, meeting the standards of care on falls.

Question 5 of 5

A postpartum client presents with severe abdominal pain, nausea, and vomiting. Which nursing action is most appropriate?

Correct Answer: C

Rationale: In a postpartum client who presents with severe abdominal pain, nausea, and vomiting, it is crucial to assess for signs of peritonitis or surgical abdomen. These signs may include rebound tenderness, guarding, rigidity, and fever. Peritonitis is a serious condition that may require immediate surgical intervention. Administering antiemetic medication, encouraging clear fluids, or providing a heating pad may not address the underlying cause of the symptoms and delay appropriate treatment. Assessing for signs of peritonitis or surgical abdomen is crucial for prompt identification and management of the client's condition.

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