ATI RN
foundation of nursing questions and answers Questions
Question 1 of 9
A patient is being discharged home from the ambulatory surgery center after an incisional biopsy of a mass in her left breast. What are the criteria for discharging this patient home? Select all that apply.
Correct Answer: A
Rationale: Step-by-step rationale for why answer A is correct: 1. Ambulating is a crucial postoperative activity to prevent complications like blood clots. 2. Understanding when to ambulate ensures the patient follows proper recovery guidelines. 3. Proper ambulation aids in preventing postoperative complications and promotes healing. Summary of why other choices are incorrect: B. Having someone accompany the patient is important for support but not a strict criteria for discharge. C. While understanding activity restrictions is important, it is not a specific criteria for immediate discharge. D. Understanding care for the biopsy site is essential but not a strict criteria for immediate discharge. E. Removal of a urinary catheter is not typically related to discharge criteria for a breast biopsy.
Question 2 of 9
The hospice nurse has just admitted a new patient to the program. What principle guides hospice care?
Correct Answer: A
Rationale: The correct answer is A because hospice care is centered on a holistic approach that considers the physical, emotional, social, and spiritual needs of both the patient and their family. This principle recognizes that caring for a terminally ill patient involves supporting the entire family unit. Choice B is incorrect because family support is integral to hospice care. Choice C is incorrect because hospice care extends beyond just the patient to include their loved ones. Choice D is incorrect because the care team should address all aspects of care for both the patient and their family, not prioritize one over the other.
Question 3 of 9
A patient, who delivered her third child yesterday, has just learned that her two school-age children have contracted chickenpox. What should the nurse tell her?
Correct Answer: D
Rationale: The correct answer is D: She must make arrangements to stay somewhere other than her home until the children are no longer contagious. 1. The patient's newborn is at risk of contracting chickenpox from the infected children. 2. Chickenpox can be severe in newborns due to their immature immune systems. 3. It is crucial to protect the newborn by ensuring they are not exposed to the virus. 4. Staying elsewhere until the children are no longer contagious will prevent transmission to the newborn. Incorrect choices: A: Acyclovir is not recommended for prophylactic treatment in this situation. B: Immunity is not automatically transferred from the mother to the baby for chickenpox. C: Allowing the infected children to visit with precautions is not sufficient to protect the newborn.
Question 4 of 9
Which factor is known to increase the risk of gestational diabetes mellitus?
Correct Answer: A
Rationale: The correct answer is A: Previous birth of large infant. This factor increases the risk of gestational diabetes mellitus due to a history of delivering a large baby, indicating a higher likelihood of insulin resistance in subsequent pregnancies. Maternal age younger than 25 years (B) is not a known risk factor for gestational diabetes. Being underweight prior to pregnancy (C) is actually associated with a decreased risk of gestational diabetes. A previous diagnosis of type 2 diabetes mellitus (D) is a separate condition and does not directly increase the risk of gestational diabetes.
Question 5 of 9
Fraternal twins are delivered by your Rh-negative patient. Twin A is Rh-positive and twin B is Rh-negative. Prior to administering Rho(D) immune globulin (RhoGAM), the nurse should determine the results of the
Correct Answer: C
Rationale: The correct answer is C: indirect Coombs test of the mother. This test is crucial to determine if the mother has developed antibodies against the Rh-positive blood of twin A, which could lead to hemolytic disease of the newborn in future pregnancies. A direct Coombs test of twin A or twin B is not relevant in this scenario as it does not provide information about the mother's antibody status. Transcutaneous bilirubin levels are used to monitor jaundice in newborns and not related to Rh incompatibility. In summary, the indirect Coombs test of the mother is the most relevant test to assess the risk of hemolytic disease in future pregnancies.
Question 6 of 9
A clinic nurse is providing patient education prior to a patients scheduled palliative radiotherapy to her spine. At the completion of the patient teaching, the patient continues to ask the same questions that the nurse has already addressed. What is the plausible conclusion that the nurse should draw from this?
Correct Answer: D
Rationale: The correct answer is D. The plausible conclusion the nurse should draw is that the patient has not achieved the desired learning outcomes. 1. The patient's repeated questions indicate a lack of understanding despite the nurse's teaching efforts. 2. This suggests that the patient has not grasped the information provided. 3. It does not necessarily mean the patient is not listening effectively, noncompliant, or has low intelligence. 4. The focus should be on reassessing the teaching methods and providing additional support to help the patient achieve the desired learning outcomes.
Question 7 of 9
You are caring for a patient who has just been told that her stage IV colon cancer has recurred and metastasized to the liver. The oncologist offers the patient the option of surgery to treat the progression of this disease. What type of surgery does the oncologist offer?
Correct Answer: A
Rationale: The correct answer is A: Palliative surgery. In this scenario, the patient's colon cancer has already progressed to stage IV with metastasis to the liver, indicating an advanced and incurable condition. Palliative surgery aims to alleviate symptoms, improve quality of life, and prolong survival without aiming for a cure. Reconstructive surgery (B) is typically done to restore form or function, which is not the primary goal in this case. Salvage surgery (C) is usually performed to rescue a situation where initial treatment has failed, which is not the case here. Prophylactic surgery (D) is preventive and is not appropriate in a situation where cancer is already present and advanced.
Question 8 of 9
The labor nurse is admitting a patient in active labor with a history of genital herpes. On assessment, the patient reports a recent outbreak, and the nurse verifies lesions on the perineum. What is the nurse’s next action?
Correct Answer: D
Rationale: The correct answer is D: Use electronic fetal surveillance to determine a baseline fetal heart rate. This is important in assessing the well-being of the fetus during labor, especially in the presence of genital herpes lesions. Monitoring the fetal heart rate helps in detecting any signs of distress or compromise due to maternal infection. A: Asking about the patient's last intake is important but not the immediate priority when managing a patient with active genital herpes lesions in labor. B: Taking a culture of the lesions might be helpful but not the immediate action needed in this situation. C: Asking about unprotected sex is relevant but not as critical as monitoring the fetal well-being during labor in this scenario. Overall, the most critical action is to monitor the fetal heart rate for any signs of distress related to the maternal herpes infection.
Question 9 of 9
A 16-year-old female patient experiences alopecia resulting from chemotherapy, prompting the nursing diagnoses of disturbed body image and situational low self-esteem. What action by the patient would best indicate that she is meeting the goal of improved body image and self-esteem?
Correct Answer: B
Rationale: The correct answer is B because discussing the future indicates acceptance and hope, a positive step towards improved body image and self-esteem. The patient is focusing on moving forward, which shows emotional growth and resilience. Choice A may provide temporary comfort but does not necessarily address underlying emotional issues. Choice C is related to pain management, not body image or self-esteem. Choice D suggests continued emotional distress rather than progress towards improved self-image.