ATI RN
foundation of nursing questions and answers Questions
Question 1 of 9
A patient who was diagnosed with Parkinsons disease several months ago recently began treatment with levodopa-carbidopa. The patient and his family are excited that he has experienced significant symptom relief. The nurse should be aware of what implication of the patients medication regimen?
Correct Answer: A
Rationale: The correct answer is A. The patient is in a honeymoon period when adverse effects of levodopa-carbidopa are not yet evident. This is because the initial response to levodopa-carbidopa in Parkinson's disease can be very positive, leading to significant symptom relief. However, over time, as the disease progresses and the body adjusts to the medication, adverse effects such as dyskinesias may become more prominent. Choice B is incorrect because the benefits of levodopa-carbidopa can be seen relatively soon after initiation of treatment and do not necessarily take 6 to 9 months to peak. Choice C is incorrect as the temporary improvement is likely related to the medication, given the significant symptom relief experienced. Choice D is incorrect because while benefits may diminish over time, it is not necessarily after 1 or 2 years of treatment, and some patients may continue to benefit from the medication long-term.
Question 2 of 9
The nurse is caring for a patient who is to begin receiving external radiation for a malignant tumor of the neck. While providing patient education, what potential adverse effects should the nurse discuss with the patient?
Correct Answer: A
Rationale: The correct answer is A: Impaired nutritional status. Radiation therapy to the neck can lead to mucositis, dysphagia, and taste changes, which can impair the patient's ability to eat and maintain adequate nutrition. This can lead to weight loss, weakness, and delayed wound healing. Discussing this potential adverse effect with the patient is crucial for proactive management. Choice B: Cognitive changes, and Choice C: Diarrhea are less likely to be direct adverse effects of radiation therapy to the neck. Cognitive changes are more commonly associated with brain radiation, while diarrhea is a more common side effect of abdominal radiation. Choice D: Alopecia is a side effect of chemotherapy, not radiation therapy. Radiation therapy does not typically cause hair loss unless it is in the treatment field. Therefore, discussing alopecia with the patient receiving radiation for a malignant neck tumor is not a priority.
Question 3 of 9
A patient is receiving opioids for pain. Which bowel assessment is a priority?
Correct Answer: B
Rationale: The correct answer is B: Constipation. When a patient is receiving opioids, constipation is a common side effect due to decreased gut motility. It is a priority assessment because untreated constipation can lead to serious complications such as bowel obstruction. Monitoring for constipation allows for early intervention with stool softeners or laxatives to prevent complications. Incorrect choices: A: Clostridium difficile - While important to consider in patients on antibiotics, it is not directly related to opioid use. C: Hemorrhoids - Although opioids can contribute to constipation which may exacerbate hemorrhoids, it is not the priority assessment. D: Diarrhea - Opioids typically cause constipation, so diarrhea is less likely to be a priority concern in this scenario.
Question 4 of 9
A nurse is inserting a catheter into a female patient. When the nurse inserts the catheter, no urine is obtained. The nurse suspects the catheter is not in the urethra. What should the nurse do?
Correct Answer: C
Rationale: The correct choice is C because if no urine is obtained, it indicates that the catheter is not in the urethra. The nurse should remove the catheter, wipe with alcohol to maintain cleanliness, and reinsert after lubrication to ensure proper placement in the urethra. This step-by-step approach allows for a more accurate catheter insertion and prevents potential complications. Choice A is incorrect as discarding the catheter and starting over without addressing the issue does not solve the problem. Choice B is incorrect as filling the balloon with sterile water is not relevant to the situation of catheter misplacement. Choice D is incorrect as leaving the catheter in the vagina can lead to infection and is not a recommended practice.
Question 5 of 9
A nurse is assessing the patient’s meaning ofillness. Which area of focus by the nurse ispriority?
Correct Answer: A
Rationale: The correct answer is A because understanding how a patient perceives and reacts to their illness is crucial for providing holistic care. By focusing on the patient's perspective, the nurse can address their emotional, mental, and social needs. Choice B is incorrect as it only considers biological aspects. Choice C is incorrect as it only focuses on psychological processes. Choice D is incorrect as it does not directly address the patient's perspective on illness. A holistic approach that considers the patient's meaning of illness is essential for providing patient-centered care.
Question 6 of 9
Following a recent history of dyspareunia and lower abdominal pain, a patient has received a diagnosis of pelvic inflammatory disease (PID). When providing health education related to self-care, the nurse should address which of the following topics? Select all that apply.
Correct Answer: A
Rationale: The correct answer is A: Use of condoms to prevent infecting others. This is important because PID is a sexually transmitted infection and using condoms can help prevent transmission to sexual partners. It is crucial to address this topic to ensure the patient understands the importance of safe sex practices. The other choices are incorrect: B: Appropriate use of antibiotics - While antibiotics are used to treat PID, this choice does not address self-care education for prevention. C: Taking measures to prevent pregnancy - While important for overall health, preventing pregnancy is not directly related to self-care for PID. D: The need for a Pap smear every 3 months - Pap smears are not directly related to PID management or prevention. E: The importance of weight loss in preventing symptoms - Weight loss is not a direct self-care measure for managing or preventing PID.
Question 7 of 9
A nurse is pouching an ostomy on a patient withan ileostomy. Which action by the nurse ismostappropriate?
Correct Answer: B
Rationale: The correct answer is B, emptying the pouch if it is more than one-third to one-half full. This action is appropriate to prevent leakage and skin irritation. When the pouch becomes too full, it can put pressure on the seal, leading to potential leaks. Emptying the pouch at one-third to one-half fullness helps maintain a secure seal and prevents skin breakdown. Choice A is incorrect because changing the skin barrier portion of the ostomy pouch daily is unnecessary and can lead to skin irritation and breakdown. Choice C is incorrect because cleansing the skin around the stoma with soap and water excessively can strip the skin of its natural oils and cause irritation. Choice D is incorrect because leaving a 1/2-inch space around the stoma when measuring for the barrier device may result in an improper fit, leading to leakage and skin issues.
Question 8 of 9
A nurse is creating a plan of care for an oncology patient and one of the identified nursing diagnoses is risk for infection related to myelosuppression. What intervention addresses the leading cause of infection- related death in oncology patients?
Correct Answer: D
Rationale: The correct answer is D: Assess the integrity of the patients oral mucosa regularly. Myelosuppression leads to decreased white blood cells, increasing infection risk. The oral mucosa can be a common site for infections. Regular assessment helps in early detection and intervention. A: Encouraging small meals does not directly address infection risk in myelosuppressed patients. B: Providing skin care is important for overall patient care but does not directly address the leading cause of infection-related death. C: Assisting with hygiene is important but does not specifically target the leading cause of infection-related death in oncology patients.
Question 9 of 9
A patient has returned to the floor after undergoing a transurethral resection of the prostate (TURP). The patient has a continuous bladder irrigation system in place. The patient tells you he is experiencing bladder spasms and asks what you can do to relieve his discomfort. What is the most appropriate nursing action to relieve the discomfort of the patient?
Correct Answer: D
Rationale: Rationale: Administering a smooth-muscle relaxant is the most appropriate nursing action to relieve bladder spasms post-TURP. The smooth-muscle relaxant helps relax the bladder muscles, reducing spasms and discomfort. Applying a cold compress (choice A) may provide temporary relief but won't address the underlying cause. Notifying the urologist (choice B) is important but not the immediate action for relieving spasms. Irrigating the catheter with normal saline (choice C) may not effectively address the spasms. Administering a smooth-muscle relaxant is the best choice for prompt relief.