ATI RN
health assessment exam 1 test bank Questions
Question 1 of 9
A patient tells the nurse that he is allergic to penicillin. Which of the following would be the nurse's best response to this information?
Correct Answer: D
Rationale: The correct answer is D: "Please describe what happens to you when you take penicillin." This response allows the nurse to gather detailed information about the patient's allergic reaction to penicillin, which is crucial for assessing the severity of the allergy and determining appropriate treatment options. By understanding the specific symptoms experienced by the patient, the nurse can help prevent potential adverse reactions in the future. Choices A, B, and C are incorrect because: A: This question does not address the immediate concern of the patient's penicillin allergy and does not help in understanding the nature of the allergic reaction. B: The frequency of penicillin usage is not as relevant as understanding the nature and severity of the allergic reaction. C: While recording allergy information is important, it does not address the need for understanding the patient's specific allergic response to penicillin.
Question 2 of 9
A nurse is caring for a patient who has a history of myocardial infarction. The nurse should prioritize which of the following assessments?
Correct Answer: A
Rationale: The correct answer is A: Blood pressure and heart rate. This is crucial in assessing the cardiac function of a patient with a history of myocardial infarction. Monitoring blood pressure and heart rate helps in evaluating cardiovascular status and detecting any potential complications. Abnormal values in these parameters can indicate inadequate perfusion to the heart or other organs, which can be life-threatening. Other choices are incorrect because: B: Temperature and respiratory rate are important assessments but not the priority for a patient with a history of myocardial infarction. C: Bowel sounds and abdominal girth are more relevant for gastrointestinal issues and not a priority in this scenario. D: Urine output and skin integrity are important assessments for overall health but do not directly relate to the cardiovascular status in a patient with a history of myocardial infarction.
Question 3 of 9
A nurse is caring for a patient with a history of chronic obstructive pulmonary disease (COPD). Which of the following interventions should the nurse prioritize?
Correct Answer: B
Rationale: The correct answer is B: Providing supplemental oxygen. In COPD, patients often have difficulty breathing due to impaired lung function. Supplemental oxygen helps improve oxygenation and relieves respiratory distress. Prioritizing this intervention is crucial for managing COPD exacerbations and preventing complications. Administering diuretics (A) may be indicated for comorbid conditions like heart failure but is not a priority in managing COPD. Increasing fluid intake (C) may not directly address the patient's respiratory distress. Encouraging bed rest (D) may lead to deconditioning and worsen respiratory function in COPD patients.
Question 4 of 9
A nurse is teaching a patient with asthma about managing triggers. Which of the following statements by the patient indicates the need for further education?
Correct Answer: C
Rationale: The correct answer is C: "I should smoke to relieve stress and manage symptoms." This statement indicates a need for further education because smoking can worsen asthma symptoms. Here's the rationale: 1. Smoking is a common trigger for asthma exacerbations due to irritants in tobacco smoke. 2. Smoking can lead to airway inflammation and constriction, making asthma symptoms more severe. 3. Asthma management involves avoiding smoking and secondhand smoke exposure. 4. Choices A, B, and D are correct as they align with asthma management guidelines to avoid triggers and use inhalers as prescribed.
Question 5 of 9
A patient drifts off to sleep when there is no stimulation. The nurse can arouse her easily by calling her name, but she remains drowsy during the conversation. The best description of this patient's level of consciousness would be:
Correct Answer: A
Rationale: The correct answer is A: Lethargic. Lethargic is defined as a state of drowsiness or diminished alertness where the patient can be easily aroused by simple stimuli like calling their name, but they remain drowsy and may drift back to sleep. This patient's ability to be aroused by verbal stimuli and their drowsiness during conversation fits the description of lethargic. Explanation for other choices: B: Obtunded - Obtunded refers to a more severe level of decreased consciousness where the patient is difficult to fully arouse and may have limited interactions with the nurse. C: Stuporous - Stuporous indicates an even deeper state of unconsciousness where the patient requires significant stimulation to be aroused and has minimal responsiveness. D: Semialert - Semialert would describe a patient who is more responsive than lethargic, showing better awareness of their surroundings and able to maintain a conversation more effectively.
Question 6 of 9
What question would you initially ask a patient who has a positive tuberculin test?
Correct Answer: C
Rationale: The correct initial question to ask a patient with a positive tuberculin test is whether they have received bacille Calmette-Guérin (BCG) vaccine. This is because BCG vaccination can cause a false positive result on the tuberculin test due to cross-reactivity with the purified protein derivative (PPD) used in the test. Asking about recent hospitalization (A), homelessness (B), or recent travel out of the country (D) would not provide relevant information regarding the interpretation of the positive tuberculin test.
Question 7 of 9
A nurse is assessing a patient with chronic kidney disease. The nurse should prioritize which of the following lab values?
Correct Answer: A
Rationale: The correct answer is A: Serum creatinine levels. In patients with chronic kidney disease, monitoring serum creatinine levels is crucial because it reflects kidney function. An increase in creatinine levels indicates worsening kidney function. Hemoglobin levels (B) are important in assessing anemia, common in CKD, but not the priority. White blood cell count (C) and platelet count (D) may indicate infection or bleeding, respectively, but are not specific to kidney function in this context.
Question 8 of 9
The interview portion of data collection obtains:
Correct Answer: D
Rationale: The correct answer is D: Subjective data. During the interview portion of data collection, subjective data is obtained as it involves personal opinions, feelings, and experiences shared by the interviewee. This data is based on individual perspectives and cannot be measured objectively. Physical data (A) refers to tangible measurements, historical data (B) relates to past events or records, and objective data (C) is based on observable and measurable facts. In contrast, subjective data (D) captures the interviewee's viewpoints and interpretations, making it the most appropriate choice for the given scenario.
Question 9 of 9
A patient with diabetes is experiencing a hypoglycemic episode. Which of the following is the nurse's first priority in this situation?
Correct Answer: B
Rationale: The correct answer is B: Providing a source of fast-acting carbohydrate. In a hypoglycemic episode, the priority is to raise the blood sugar quickly to prevent further complications. Fast-acting carbohydrates such as glucose tablets or orange juice can rapidly increase blood sugar levels. Administering insulin (choice A) can further lower blood sugar, checking blood glucose levels (choice C) may delay treatment, and contacting the healthcare provider (choice D) is not necessary in the immediate management of hypoglycemia.