ATI RN
foundations of nursing practice questions Questions
Question 1 of 9
A patient who had premature rupture of the membranes (PROM) earlier in the pregnancy at 28 weeks returns to the labor unit 1 week later complaining that she is now in labor. The labor and birth nurse performs the NfollRowiIng aGssesBsm.eCntsM. The vaginal exam is deferred until the U S N T O physician is in attendance. The patient is placed on electronic fetal monitoring (EFM) and a baseline FHR of 130 bpm is noted. No contraction pattern is observed. The patient is then transferred to the antepartum unit for continued observation. Several hours later, the patient complains that she does not feel the baby move. Examination of the abdomen reveals a fundal height of 34 cm. Muscle tone is no different from earlier in the hospital admission. The patient is placed on the EFM and no fetal heart tones are observed. What does the nurse suspect is occurring?
Correct Answer: D
Rationale: The correct answer is D: Hidden placental abruption. In this scenario, the patient had PROM and is now presenting with decreased fetal movement and absence of fetal heart tones after a fundal height increase. These signs suggest a hidden placental abruption, where the placenta has partially detached, leading to fetal distress and potential fetal demise. The absence of contractions rules out active labor (B) as the cause. Placental previa (A) would typically present with painless vaginal bleeding, which is not described in the scenario. Placental abruption (C) usually presents with painful vaginal bleeding, which is also not mentioned. Therefore, the most likely explanation for the symptoms described is a hidden placental abruption.
Question 2 of 9
A nurse is developing a plan to reduce data entryerrors and maintain confidentiality. Which guidelines should the nurse include? (Select all that apply.)
Correct Answer: B
Rationale: The correct answer is B: Implement an automatic sign-off. This guideline helps reduce data entry errors by ensuring that all entries are completed and saved before exiting the system, thus maintaining confidentiality. Bypassing the firewall (A) would compromise data security. Creating a password with just letters (C) may not be secure enough. Using a programmed speed-dial key when faxing (D) is unrelated to reducing data entry errors or maintaining confidentiality.
Question 3 of 9
After contributing to the care of several patients who died in the hospital, the nurse has identified some lapses in the care that many of these patients received toward the end of their lives. What have research studies identified as a potential deficiency in the care of the dying in hospital settings?
Correct Answer: A
Rationale: The correct answer is A. Research studies have consistently shown that families' needs for information and support often go unmet in hospital settings when caring for dying patients. This is a crucial deficiency as effective communication and support for families can greatly impact the quality of care provided to the dying patient. When families are not adequately informed and supported, it can lead to increased stress, confusion, and dissatisfaction with the care provided. Choices B, C, and D are incorrect because they do not address the specific deficiency identified in research studies. While pain control, communication, and attention from caregivers are important aspects of end-of-life care, the primary focus in this scenario is on the unmet needs of families for information and support. Ignoring families' needs can have significant negative consequences on the overall care provided to the dying patient.
Question 4 of 9
An older adult has encouraged her husband to visit their primary care provider, stating that she is concerned that he may have Parkinsons disease. Which of the wifes descriptions of her husbands health and function is most suggestive of Parkinsons disease?
Correct Answer: A
Rationale: The correct answer is A because one of the hallmark symptoms of Parkinson's disease is bradykinesia, which is characterized by slowness of movement. This symptom commonly presents as a person moving far more slowly than usual. Option B is more indicative of arthritis or another musculoskeletal condition. Option C suggests possible cognitive decline or dementia, not specific to Parkinson's disease. Option D could indicate a different medical condition causing weight loss despite a good appetite. Therefore, A is the most suggestive of Parkinson's disease based on the symptom of bradykinesia.
Question 5 of 9
The nurse is assessing a patient for nutritional status. Which action will the nurse take?
Correct Answer: D
Rationale: The correct answer is D, combining multiple objective measures with subjective measures. This approach provides a comprehensive assessment of the patient's nutritional status by incorporating both quantitative data (objective measures) such as weight, BMI, and laboratory values, as well as qualitative information (subjective measures) like dietary history and appetite changes. By combining these measures, the nurse can obtain a more holistic view of the patient's nutritional status, allowing for better identification of nutritional deficiencies or excesses. This method enhances the accuracy and reliability of the assessment compared to relying solely on one type of measure. Choice A is incorrect because nutritional assessment is crucial even in the presence of chronic disease to address potential malnutrition risks. Choice B is incorrect as the Mini Nutritional Assessment is not intended for pediatric patients but for adults. Choice C is incorrect as using a single tool may not capture the full complexity of the patient's nutritional status.
Question 6 of 9
The nurse is using different toileting schedules.Which principles will the nurse keep in mind when planning care? (Select all that apply.)
Correct Answer: A
Rationale: The correct answer is A because habit training involves keeping a bladder diary to identify patterns and develop a toileting schedule. This helps in promoting regular voiding habits. B is incorrect because timed voiding isn't solely based on the patient's urge to void, but rather on a predetermined schedule. C is incorrect as prompted voiding involves reminding patients to use the restroom at regular intervals, not just asking if they are wet or dry. D is incorrect because elevating feet in patients with edema may help reduce swelling but has no direct impact on nighttime voiding.
Question 7 of 9
The patient has just started on enteral feedings, and the patient is reporting abdominal cramping. Which action will the nurse takenext?
Correct Answer: A
Rationale: Correct Answer: A Rationale: Abdominal cramping in a patient on enteral feedings could indicate feeding intolerance. The nurse's initial action should be to slow down the rate of the tube feeding to allow the patient's gastrointestinal tract to adjust gradually. This helps reduce the risk of further complications and allows for better tolerance. Slowing the rate is a safe and effective intervention that can help alleviate the abdominal cramping without causing additional stress on the patient's digestive system. Summary of Incorrect Choices: B: Instilling cold formula is not a recommended practice and can potentially cause harm or discomfort to the patient. C: Changing to a high-fat formula may exacerbate the abdominal cramping as it can be harder to digest for some patients. D: Consulting with the healthcare provider about prokinetic medication should come after trying less invasive interventions such as slowing the rate of tube feeding.
Question 8 of 9
A patient with a family history of allergies has suffered an allergic response based on a genetic predisposition. This atopic response is usually mediated by what immunoglobulin?
Correct Answer: D
Rationale: The correct answer is D: Immunoglobulin E. The atopic response in allergies is mainly mediated by IgE antibodies. IgE binds to allergens and triggers the release of histamine and other chemicals that cause allergic symptoms. IgA is mainly found in mucosal areas, IgM is involved in early immune responses, and IgG is important for long-term immunity. IgE is specifically associated with allergic reactions due to its role in sensitizing mast cells and basophils to allergens.
Question 9 of 9
Which finding in the exam of a patient with a diagnosis of threatened abortion would change the diagnosis to inevitable abortion?
Correct Answer: C
Rationale: The correct answer is C: Clear fluid from vagina. In threatened abortion, there is vaginal bleeding but the cervix is closed, indicating the possibility of the pregnancy continuing. If clear fluid is present, it suggests rupture of the amniotic sac, leading to inevitable abortion. Backache (A) and pelvic pressure (D) can be common symptoms in both threatened and inevitable abortion. A rise in hCG level (B) alone does not indicate a change from threatened to inevitable abortion.