ATI RN
foundations of nursing practice questions Questions
Question 1 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 2 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.
Question 3 of 5
A patient with ovarian cancer is admitted to the hospital for surgery and the nurse is completing the patients health history. What clinical manifestation would the nurse expect to assess?
Correct Answer: B
Rationale: The correct answer is B: Increased abdominal girth. In ovarian cancer, a common clinical manifestation is the accumulation of fluid in the abdomen, leading to increased abdominal girth. This is known as ascites. The presence of ascites can be observed through physical examination and abdominal imaging. A: Fish-like vaginal odor is not typically associated with ovarian cancer. It may be a symptom of other gynecological conditions. C: Fever and chills are not specific to ovarian cancer and can be seen in various infectious or inflammatory conditions. D: Lower abdominal pelvic pain is a common symptom in many gynecological conditions but is not a specific manifestation of ovarian cancer.
Question 4 of 5
The nurse is planning health education for a patient who has experienced a vaginal infection. What guidelines should the nurse include in this program regarding prevention?
Correct Answer: C
Rationale: The correct answer is C: Avoid feminine hygiene products, such as sprays. This is because feminine hygiene products can disrupt the natural balance of vaginal flora, leading to an increased risk of vaginal infections. Tight-fitting synthetic underwear (choice A) can trap moisture and promote bacterial growth. Using bubble bath (choice B) can irritate the genital area and disrupt the pH balance. Restricting daily bathing (choice D) is not recommended as regular hygiene practices are important for preventing infections. In summary, choice C is correct as it promotes maintaining the natural vaginal flora and pH balance to prevent infections, while the other choices can contribute to an increased risk of vaginal infections.
Question 5 of 5
A patient has been diagnosed with endometriosis. When planning this patients care, the nurse should prioritize what nursing diagnosis?
Correct Answer: B
Rationale: The correct answer is B: Acute pain related to misplaced endometrial tissue. This nursing diagnosis should be prioritized because endometriosis commonly presents with severe pelvic pain. Managing pain is crucial for the patient's comfort and quality of life. Anxiety (choice A) is not the priority as pain management takes precedence. Ineffective tissue perfusion (choice C) is not a priority unless the patient is actively hemorrhaging. Excess fluid volume (choice D) is not typically associated with endometriosis. Prioritizing pain management will address the immediate and most distressing symptom for the patient.