ATI RN
foundations of nursing practice questions Questions
Question 1 of 5
A patient has just returned to the floor following a transurethral resection of the prostate. A triple- lumen indwelling urinary catheter has been inserted for continuous bladder irrigation. What, in addition to balloon inflation, are the functions of the three lumens?
Correct Answer: A
Rationale: The correct answer is A: Continuous inflow and outflow of irrigation solution. The first lumen inflates the balloon to secure the catheter in place. The second lumen allows continuous inflow of irrigation solution to prevent clot formation. The third lumen allows continuous outflow to ensure the bladder is continuously irrigated. Choices B, C, and D are incorrect because they do not accurately describe the functions of the three lumens in a transurethral resection of the prostate procedure.
Question 2 of 5
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 3 of 5
A public health nurse has formed an interdisciplinary team that is developing an educational program entitled Cancer: The Risks and What You Can Do About Them. Participants will receive information, but the major focus will be screening for relevant cancers. This program is an example of what type of health promotion activity?
Correct Answer: C
Rationale: The correct answer is C: Secondary prevention. This program focuses on screening for relevant cancers, which is a key component of secondary prevention aimed at early detection and treatment to reduce the impact of the disease. Secondary prevention aims to identify and treat health conditions in their early stages. Disease prophylaxis (A) focuses on preventing the occurrence of a disease, while risk reduction (B) aims to lower the chances of developing a disease. Tertiary prevention (D) involves managing and improving outcomes for individuals already diagnosed with a disease. In this scenario, the emphasis on screening aligns closely with the goals of secondary prevention, making it the most appropriate choice.
Question 4 of 5
Traditionally, nurses have been involved with tertiary cancer prevention. However, an increasing emphasis is being placed on both primary and secondary prevention. What would be an example of primary prevention?
Correct Answer: C
Rationale: The correct answer is C: Teaching patients to wear sunscreen, which is an example of primary prevention. Primary prevention aims to prevent the occurrence of a disease before it occurs by addressing risk factors. In this case, teaching patients to wear sunscreen helps prevent skin cancer by reducing exposure to harmful UV rays. Yearly Pap tests (A) are a secondary prevention measure for cervical cancer, detecting precancerous changes. Testicular self-examination (B) is a form of secondary prevention for testicular cancer, aiming to detect any abnormalities early. Screening mammograms (D) are also a secondary prevention measure for breast cancer, detecting tumors at an early stage.
Question 5 of 5
The nurse is caring for a patient with Huntington disease who has been admitted to the hospital for treatment of malnutrition. What independent nursing action should be implemented in the patients plan of care?
Correct Answer: C
Rationale: The correct answer is C: Encourage the patient to keep his or her feeding area clean. This is the most appropriate independent nursing action as it promotes hygiene and reduces the risk of infection. Keeping the feeding area clean is essential in preventing complications in a patient with malnutrition. Rationales for why the other choices are incorrect: A: Firmly redirect the patient's head when feeding - This is incorrect because forceful redirection can cause distress and discomfort to the patient, potentially leading to aspiration or choking. B: Administer phenothiazines after each meal as ordered - This is incorrect as phenothiazines are not typically used for malnutrition treatment and should not be administered without a specific indication. D: Apply deep, gentle pressure around the patient's mouth to aid swallowing - This is incorrect because applying pressure around the mouth can pose a choking hazard and should not be done without proper assessment and intervention by a speech therapist or swallowing specialist.
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