ATI RN
Adult Health Nursing Study Guide Answers Questions
Question 1 of 9
A patient presents with chest pain, dyspnea, and a friction rub heard on auscultation. An electrocardiogram (ECG) shows diffuse ST-segment elevation. Which cardiovascular disorder is most likely responsible for these symptoms?
Correct Answer: D
Rationale: The clinical presentation of chest pain, dyspnea, and a friction rub heard on auscultation is suggestive of pericarditis. The diffuse ST-segment elevation seen on the electrocardiogram (ECG) is a classic finding in pericarditis, known as the "universal sign." In contrast, stable angina typically presents with chest pain on exertion that is relieved by rest or nitroglycerin, while unstable angina presents with chest pain at rest or with minimal exertion. Acute myocardial infarction would typically present with ST-segment elevation in specific leads correlating with the area of myocardial ischemia/infarction. However, in the context of diffuse ST-segment elevation and symptoms suggestive of inflammation (friction rub), the most likely diagnosis is pericarditis.
Question 2 of 9
Nurse Edna admits a patient from the ER to the medical unit. The patient is very restless with IV lines and a urinary catheter. She was put to bed and the nurse applied a body restraint without the doctor's order. Nurse Edna's action can be liable for _____.
Correct Answer: C
Rationale: Battery occurs when there is an intentional harmful or offensive contact with a person without their consent. In this scenario, Nurse Edna applied a body restraint to the patient without the doctor's order, which constitutes unauthorized physical contact. The patient did not give consent for the restraint, and Nurse Edna's action could be considered battery. It is important for healthcare providers to obtain proper authorization before using any form of physical restraint on a patient to avoid legal implications such as battery.
Question 3 of 9
One of the members of the Research Committee wishes to conduct a study involving an interdisciplinary team of colleagues. This study is termed as _________.
Correct Answer: B
Rationale: The term "collaborative" best fits the situation where a member of the Research Committee wishes to conduct a study involving an interdisciplinary team of colleagues. Collaboration refers to individuals, in this case, researchers or professionals from different disciplines coming together, sharing their expertise, and working collectively towards a common goal or project. In an interdisciplinary study, involving a collaborative approach enhances the diversity of perspectives, skills, and knowledge brought to the research, leading to more comprehensive and well-rounded outcomes. This type of study fosters cooperation, communication, and synergy among team members, thereby promoting innovation and understanding across different areas of expertise.
Question 4 of 9
A patient presents with recurrent episodes of deep vein thrombosis (DVT) and pulmonary embolism (PE). Laboratory tests reveal elevated levels of antiphospholipid antibodies (anticardiolipin and lupus anticoagulant). Which of the following conditions is most likely to cause these findings?
Correct Answer: D
Rationale: Antiphospholipid syndrome is characterized by abnormal antiphospholipid antibodies, which can lead to an increased risk of blood clots such as deep vein thrombosis (DVT) and pulmonary embolism (PE). The two most common antiphospholipid antibodies are anticardiolipin and lupus anticoagulant. Patients with antiphospholipid syndrome can present with recurrent thrombotic events, such as DVT and PE, due to the pro-thrombotic effects of these antibodies. Protein C deficiency, Protein S deficiency, and Antithrombin III deficiency are other causes of hypercoagulability but would not typically present with elevated antiphospholipid antibodies.
Question 5 of 9
While preparing the surgical instruments for sterilization, the nurse notices visible residue on some of the instruments. What action should the nurse take?
Correct Answer: A
Rationale: If visible residue is noticed on the surgical instruments, it is crucial to re-sterilize them before using them for any procedure. Visible residue may indicate that the instruments are not sterile and could potentially introduce contaminants into the patient during the procedure, leading to infection or other complications. It is essential to maintain the highest standards of cleanliness and sterility in healthcare settings to ensure patient safety. Therefore, the nurse should take immediate action to re-sterilize the instruments before proceeding with any surgical procedure.
Question 6 of 9
Which of the following immune cells is primarily responsible for coordinating and regulating immune responses by producing cytokines that direct the activities of other immune cells?
Correct Answer: A
Rationale: T helper cells (Th cells) are primarily responsible for coordinating and regulating immune responses by producing cytokines that direct the activities of other immune cells. These cytokines help in activating cytotoxic T cells, B cells, macrophages, and other cells involved in the immune response. Th cells play a crucial role in mounting an effective immune response against infections and diseases by providing the necessary signals to activate and control various immune cells. Thus, T helper cells are considered the central coordinators of the immune system.
Question 7 of 9
A 70- year-old has been rushed to the hospital due to bradycardia and palpitation. The physician suggested that a pacemaker be inserted to correct the symptoms. The patient voluntarily decides not to have the pacemaker Inserted. This is respected by the family. This is an example of what ethical principles
Correct Answer: C
Rationale: Autonomy is the ethical principle that upholds an individual's right to make decisions about their own medical treatment, free from coercion or undue influence. In this scenario, the 70-year-old patient has voluntarily decided not to have the pacemaker inserted despite the physician's recommendation. The fact that the decision is respected by the family further highlights the importance of autonomy in this situation. Respecting the patient's right to make choices regarding their own healthcare, even if it goes against medical advice, demonstrates a commitment to autonomy as an ethical principle.
Question 8 of 9
Signs such as using tissues to doorknobs develop because the patient is ________.
Correct Answer: A
Rationale: Signs such as using tissues to doorknobs suggest that the patient is unconsciously controlling unacceptable impulses or feelings. This behavior falls under the category of defense mechanisms, specifically displacement, where the individual redirects their emotions from a threatening target to a safer one. In this case, the patient may be experiencing anxiety or fear related to contamination or germs, leading them to use tissues to avoid touching doorknobs directly. It is a way for the patient to manage their underlying emotions, albeit unconsciously, through this compulsive behavior.
Question 9 of 9
It a medicine is unavailable and therefore not given to the patient, how is it charted?
Correct Answer: B
Rationale: When a medication is unavailable and therefore not given to the patient, it is important to document this in the Nurses Notes along with an explanation. Leaving it blank (Option A) may lead to confusion or errors as the reason for not administering the medication would not be clear. Using an asterisk or mark as per hospital protocol (Option C) may not provide enough information about why the medication was missed. Writing the letter (Option D) without any explanation would not suffice in terms of documentation and accountability. Therefore, signing and making an explanation in the Nurses Notes (Option B) is the correct way to chart when a medication is unavailable. This ensures proper documentation of the situation and helps in maintaining the continuity of care for the patient.