ATI RN
test bank foundations of nursing Questions
Question 1 of 9
A nurse knows of several patients who have achieved adequate control of their allergy symptoms using over-the-counter antihistamines. Antihistamines would be contraindicated in the care of which patient?
Correct Answer: B
Rationale: The correct answer is B. Antihistamines are generally considered safe during pregnancy, but it is recommended to avoid unnecessary medications, especially in the third trimester. Antihistamines should be used cautiously in pregnant women due to potential effects on the fetus. Choice A is incorrect because previous treatment for tuberculosis does not contraindicate the use of antihistamines. Choice C is incorrect as estrogen-replacement therapy does not interact significantly with antihistamines. Choice D is incorrect as a severe allergy to eggs does not directly contraindicate the use of antihistamines.
Question 2 of 9
The nurse is assessing a 73-year-old patient who was diagnosed with metastatic prostate cancer. The nurse notes that the patient is exhibiting signs of loss, grief, and intense sadness. Based on this assessment data, the nurse will document that the patient is most likely in what stage of death and dying?
Correct Answer: A
Rationale: The correct answer is A: Depression. In the context of the stages of death and dying proposed by Elisabeth Kübler-Ross, a patient exhibiting signs of loss, grief, and intense sadness is likely in the depression stage. This stage involves feelings of hopelessness, despair, and sorrow as the patient comes to terms with the reality of their situation. Denial (choice B) is characterized by a refusal to accept the diagnosis, anger (choice C) involves feelings of resentment and frustration, and resignation (choice D) signifies a sense of acceptance and peace. In this scenario, the patient's emotional state aligns most closely with depression, indicating a deep sense of sadness and mourning.
Question 3 of 9
Spontaneous termination of a pregnancy is considered to be an abortion if
Correct Answer: A
Rationale: The correct answer is A because spontaneous termination of a pregnancy is considered an abortion if it occurs before 20 weeks gestation. This is based on the medical definition of abortion as the termination of a pregnancy before the fetus is able to survive outside the womb. Choices B, C, and D are incorrect as they do not accurately reflect the criteria for defining abortion. B and D are specific conditions related to the fetus and the presence of infection, while C refers to passing products of conception intact, which can happen in both spontaneous and induced abortions.
Question 4 of 9
A nurse knows of several patients who have achieved adequate control of their allergy symptoms using over-the-counter antihistamines. Antihistamines would be contraindicated in the care of which patient?
Correct Answer: B
Rationale: The correct answer is B. Antihistamines are generally considered safe during pregnancy, but it is recommended to avoid unnecessary medications, especially in the third trimester. Antihistamines should be used cautiously in pregnant women due to potential effects on the fetus. Choice A is incorrect because previous treatment for tuberculosis does not contraindicate the use of antihistamines. Choice C is incorrect as estrogen-replacement therapy does not interact significantly with antihistamines. Choice D is incorrect as a severe allergy to eggs does not directly contraindicate the use of antihistamines.
Question 5 of 9
A 5-year-old boy has been diagnosed with a severe food allergy. What is an important parameter to address when educating the parents of this child about his allergy and care?
Correct Answer: A
Rationale: The correct answer is A: Wear a medical identification bracelet. This is important because in case of an emergency, such as an allergic reaction, medical professionals need to be aware of the child's severe food allergy quickly. The bracelet provides crucial information that can help in providing timely and appropriate medical care. B: Knowing how to use the antihistamine pen is also important in managing allergic reactions, but wearing a medical identification bracelet takes precedence as it provides immediate identification of the allergy. C: Knowing how to give injections of lidocaine is not relevant to managing a food allergy in a child. D: Avoiding live attenuated vaccinations may be necessary for individuals with certain allergies, but it is not directly related to educating parents about managing the child's food allergy.
Question 6 of 9
A nurse is planning discharge education for a patient who underwent a cervical diskectomy. What strategies would the nurse assess that would aid in planning discharge teaching?
Correct Answer: A
Rationale: Correct Answer: A - Care of the cervical collar Rationale: 1. Care of the cervical collar is essential post-cervical diskectomy to ensure proper immobilization and support. 2. Proper care prevents complications and promotes healing. 3. It is a crucial aspect of discharge education to prevent injury and promote recovery. Summary of other choices: B: Technique for performing neck ROM exercises - Important for rehabilitation but not directly related to discharge education post-cervical diskectomy. C: Home assessment of ABGs - Irrelevant to post-cervical diskectomy discharge education. D: Techniques for restoring nerve function - Important for recovery but not a primary focus of discharge education.
Question 7 of 9
As the triage nurse in the emergency room, you are reviewing results for the high-risk obstetric patient who is in labor because of traumatic injury experienced as a result of a motor vehicle accident (MVA). You note that the Kleihauer–Betke test is positive. Based on this information, you anticipate that
Correct Answer: A
Rationale: The correct answer is A: immediate birth is required. The Kleihauer–Betke test is used to detect fetal-maternal hemorrhage in situations where there is a risk of fetal blood entering the maternal circulation, such as trauma during pregnancy. A positive result indicates a significant fetal-maternal hemorrhage, which can lead to Rh incompatibility and severe fetal anemia. Immediate birth is required to prevent complications and ensure the safety of both the mother and the baby. Choice B is incorrect as transferring the patient to the critical care unit does not address the underlying issue of fetal-maternal hemorrhage. Choice C is incorrect as RhoGAM is typically administered to prevent Rh sensitization in Rh-negative mothers carrying Rh-positive babies, which is not the primary concern in this scenario. Choice D is incorrect as a tetanus shot is not directly related to the positive Kleihauer–Betke test result indicating fetal-maternal hemorrhage.
Question 8 of 9
A patient is postoperative day 6 following tympanoplasty and mastoidectomy. The patient has phoned the surgical unit and states that she is experiencing occasional sharp, shooting pains in her affected ear. How should the nurse best interpret this patients complaint?
Correct Answer: A
Rationale: The correct answer is A. Postoperative day 6 following tympanoplasty and mastoidectomy is still within the early phase of recovery, where occasional sharp, shooting pains in the affected ear can be expected due to the healing process. Here's a step-by-step rationale: 1. Timing: It is only day 6 post-surgery, so it is normal to experience some pain as part of the healing process. 2. Nature of pain: Sharp, shooting pains are common post-surgery due to tissue healing and nerve regeneration. 3. Lack of other symptoms: The patient did not report any other concerning symptoms like fever or discharge, which would be more indicative of an infection. 4. Unlikely complications: Spontaneous rupture of the tympanic membrane or unsuccessful surgery would typically present with more severe and consistent symptoms. Summary: - B: Unlikely as there are no other signs of infection. - C: Unlikely as the pain is described as occasional and sharp. - D:
Question 9 of 9
A patient has fallen several times in the pastweek when attempting to get to the bathroom. The patient gets up 3 or 4 times a night to urinate. Which recommendation by the nurse ismostappropriate in correcting this urinaryproblem?
Correct Answer: A
Rationale: The correct answer is A: Limit fluid and caffeine intake before bed. This recommendation addresses the issue of nocturia (frequent urination at night) by reducing the amount of urine produced before bedtime, therefore decreasing the need to get up during the night. Caffeine is a diuretic, so limiting its intake can also help reduce the frequency of urination. Choices B, C, and D do not directly address the underlying cause of nocturia and falling. Leaving the bathroom light on (choice B) may help with visibility but does not address the urinary problem. Kegel exercises (choice C) focus on pelvic floor muscles, not bladder muscles. Clearing the path to the bathroom (choice D) can prevent falls but does not address the urinary issue.