ATI RN
foundations of nursing practice questions Questions
Question 1 of 5
A patient has been admitted to the emergency department with signs of anaphylaxis following a bee sting. The nurse knows that if this is a true allergic reaction the patient will present with what alteration in laboratory values?
Correct Answer: A
Rationale: The correct answer is A: Increased eosinophils. Eosinophils are a type of white blood cell involved in allergic reactions. During anaphylaxis, the body releases chemicals that stimulate the production and activation of eosinophils, leading to an increase in their count. This helps in the identification of an allergic reaction. Incorrect Choices: B: Increased neutrophils - Neutrophils are not specific to allergic reactions and are typically increased in bacterial infections. C: Increased serum albumin - Serum albumin levels are not directly affected by allergic reactions. D: Decreased blood glucose - Hypoglycemia is not a typical manifestation of an allergic reaction.
Question 2 of 5
A patient has been living with seasonal allergies for many years, but does not take antihistamines, stating, When I was young I used to take antihistamines, but they always put me to sleep. How should the nurse best respond?
Correct Answer: C
Rationale: Rationale for Correct Answer (C): 1. The newer antihistamines, such as second-generation antihistamines like loratadine or cetirizine, are designed to cause less sedation compared to older antihistamines like diphenhydramine. 2. These newer antihistamines have a lower affinity for crossing the blood-brain barrier, reducing the sedative effects. 3. Therefore, suggesting that the newer antihistamines are different and cause less sedation is the best response to address the patient's concerns. Summary of Incorrect Choices: A. While some newer antihistamines may be combined with decongestants to offset drowsiness, this is not a consistent feature of all newer antihistamines. B. Developing tolerance to sedation after a few months is not a common or reliable response to antihistamines. D. Taking antihistamines at bedtime may help with sedation, but it does not address
Question 3 of 5
A patient has sought care, stating that she developed hives overnight. The nurses inspection confirms the presence of urticaria. What type of allergic hypersensitivity reaction has the patient developed?
Correct Answer: A
Rationale: The correct answer is A: Type I hypersensitivity reaction. This type of reaction involves the release of histamine from mast cells and basophils, leading to symptoms like hives. It is characterized by the involvement of IgE antibodies. In this case, the patient developed hives quickly after exposure to the allergen, indicating an immediate hypersensitivity reaction typical of Type I. Choices B, C, and D are incorrect because they are associated with different mechanisms and timeframes of hypersensitivity reactions. Type II involves antibody-mediated cell destruction, Type III involves immune complex deposition, and Type IV is a delayed-type hypersensitivity reaction mediated by T cells, none of which are consistent with the rapid onset of hives seen in this patient.
Question 4 of 5
A patient is brought to the emergency department (ED) in a state of anaphylaxis. What is the ED nurses priority for care?
Correct Answer: B
Rationale: The correct answer is B: Protect the patient's airway. In anaphylaxis, airway compromise can lead to respiratory distress and even respiratory arrest. The priority is to ensure the patient has a patent airway to maintain oxygenation. This can be achieved through interventions such as positioning, oxygen therapy, and potentially intubation if needed. Monitoring the patient's level of consciousness (A) is important but secondary to ensuring airway patency. Providing psychosocial support (C) is not the immediate priority in anaphylaxis. Administering medications (D) is also important but only after ensuring the airway is protected.
Question 5 of 5
The nurse is providing preoperative education for a patient diagnosed with endometriosis. A hysterectomy has been scheduled. What education topic should the nurse be sure to include for this patient?
Correct Answer: D
Rationale: The correct answer is D because it addresses a crucial aspect of preoperative care for a patient undergoing a hysterectomy due to endometriosis. Emptying the bladder before surgery helps prevent urinary retention postoperatively. Placing a catheter during surgery ensures proper drainage and prevents bladder distention. This education topic is essential for the patient's comfort and well-being during and after the procedure. Choices A, B, and C are incorrect: A: Menstrual periods will not continue after a hysterectomy as the uterus is removed. B: Normal activity is usually restricted after a hysterectomy to promote healing. C: Hormone levels are affected after a hysterectomy, especially if the ovaries are also removed.