A patient with chronic kidney disease presents with fatigue, dyspnea on exertion, peripheral edema, and hypertension. Laboratory findings reveal elevated serum creatinine and urea levels, metabolic acidosis, and hyperkalemia. What is the most appropriate initial management for this patient?

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Question 1 of 9

A patient with chronic kidney disease presents with fatigue, dyspnea on exertion, peripheral edema, and hypertension. Laboratory findings reveal elevated serum creatinine and urea levels, metabolic acidosis, and hyperkalemia. What is the most appropriate initial management for this patient?

Correct Answer: B

Rationale: The most appropriate initial management for the patient described is hemodialysis. Hemodialysis is essential for managing chronic kidney disease with severe symptoms and electrolyte imbalances like hyperkalemia and metabolic acidosis. Hemodialysis helps to remove urea and creatinine from the blood, correct electrolyte abnormalities, and improve symptoms such as fatigue, dyspnea, and peripheral edema. Initiation of ACE inhibitor therapy (Choice A) is contraindicated in severe kidney disease due to the risk of worsening renal function. Intravenous administration of calcium gluconate (Choice C) is used for acute hyperkalemia with cardiac toxicity, not for initial management. Sodium bicarbonate administration (Choice D) may help correct metabolic acidosis, but it does not address the underlying cause or the need for urgent renal replacement therapy.

Question 2 of 9

The physician inserted a chest tube drainage to Mr. Alda in order to help re-expand the lungs. Which of the following should you prepare FIRST as a nurse in case of emergency when the tube is accidentally disconnected?

Correct Answer: A

Rationale: Correct Answer: A - sterile clamps Rationale: 1. **Immediate action**: Sterile clamps are essential to clamp the chest tube to prevent air from entering the pleural space. 2. **Prevent lung collapse**: Clamping the tube will prevent lung collapse and maintain positive pressure in the pleural space. 3. **Buy time**: By clamping the tube, you buy time to properly reattach the tube or secure it with a new connection. 4. **Safety**: Sterile clamps are a quick and effective solution to prevent a potentially life-threatening situation. Summary of other choices: B: Sterile dressing - Not the first priority as the immediate concern is preventing air from entering the pleural space. C: Another chest tube - Not necessary initially as clamping can buy time to reattach the disconnected tube. D: A bottle of sterile water - Not needed for emergency management of a disconnected chest tube.

Question 3 of 9

A surgeon accidentally cuts his patient's bladder while attempting to remove his appendix. The surgeon could be guilty of _________

Correct Answer: C

Rationale: The correct answer is C: Malpractice. Malpractice refers to professional negligence or failure to perform duties according to accepted standards of practice. In this scenario, the surgeon's act of cutting the patient's bladder during an appendectomy could be considered a breach of duty and failure to provide the expected standard of care, which falls under malpractice. Battery (A) involves intentional harmful or offensive contact without consent. Negligence (B) is the failure to exercise reasonable care, but in this case, it was more than just a lack of care. Tort (D) refers to a civil wrong that causes harm, but malpractice is a specific type of tort related to professional negligence.

Question 4 of 9

When patient record reach the Medical Records, the assigned staff will _____.

Correct Answer: C

Rationale: The correct answer is C because checking the completeness of the charting by doctors and nurses ensures that all necessary information is accurately documented, facilitating proper patient care and treatment. This step helps identify any missing or incorrect information that may impact patient safety. A: Storing the charts in respective shelves is a routine task that does not involve verifying the accuracy or completeness of the information. B: Separating medico-legal charts is important but does not directly address the completeness of charting by doctors and nurses. D: Binding the charts immediately is not necessary before ensuring the completeness and accuracy of the information documented.

Question 5 of 9

Which of the indicators BEST describes an effective outcome of school nursing programs and initiatives.

Correct Answer: A

Rationale: The correct answer is A because zero absenteeism and tardiness of pupils indicate that the school nursing programs are effectively promoting student health and well-being. This outcome shows that students are healthy, engaged, and present in school, which is a key goal of school nursing initiatives. Choice B is incorrect as teachers being observers does not directly measure the effectiveness of the nursing programs. Choice C is incorrect as limited information hinders the success and impact of school health initiatives. Choice D is incorrect as constant visits and phone calls from parents may not necessarily reflect the success of the nursing programs.

Question 6 of 9

A patient that had a stroke is experiencing memory loss and impaired learning capacity. In which lobe does the nurse determine that brain damage has MOST likely occurred?

Correct Answer: D

Rationale: The correct answer is D: Temporal lobe. Memory and learning are primarily associated with the temporal lobe, specifically the hippocampus. Damage to this area due to stroke can lead to memory loss and impaired learning capacity. Frontal lobe (A) is involved in decision-making and problem-solving. Parietal lobe (B) is responsible for sensory processing. Occipital lobe (C) is related to visual processing. Therefore, the temporal lobe is the most likely site of brain damage in this scenario based on the symptoms presented.

Question 7 of 9

Which diagnostic procedure is commonly used to establish the diagnosis of lung cancer which provides a detailed description of the tracheobronchial tree and allows for biopsies of suspicious areas?

Correct Answer: B

Rationale: The correct answer is B: Bronchoscopy. This procedure involves inserting a thin, flexible tube with a camera through the mouth or nose to examine the tracheobronchial tree. It allows direct visualization of the airways, collection of tissue samples for biopsy, and detection of abnormalities like tumors. A: CT scan provides detailed images of the lungs but does not allow for direct tissue sampling. C: Sputum cytology involves examining sputum for cancer cells but may not provide accurate results. D: PET scan is used to detect metabolic activity in tissues, including tumors, but does not provide detailed visualization of the airways or allow for biopsies.

Question 8 of 9

Nurse Merry 's application to Canada has finally been approved and she was advised to depart in three months But, she is also enrolled in the graduate school and ambivalent to go because of this engagement plus the fact that her mother has just been discharged from the hospital. Which of the following actions is BEST?

Correct Answer: C

Rationale: The correct answer is C. Nurse Merry should tell the recruiter to give her more time to settle her personal affairs before departing to Canada. This is the best action because it shows responsibility and consideration for her current commitments and family situation. By requesting more time, she can prioritize her mother's recovery and complete her graduate studies, demonstrating good decision-making skills and care for her loved ones. Option A is incorrect because it dismisses the importance of family and personal obligations. Option B is incorrect as it shows a lack of planning and responsibility. Option D is incorrect as it suggests running away from problems instead of addressing them responsibly.

Question 9 of 9

When a person vaccinated with a Covid-19 vaccine produces antibodies to the disease, the immunity is termed:

Correct Answer: A

Rationale: The correct answer is A: Active artificial immunity. This is because the person's immune system is actively stimulated by the vaccine to produce antibodies against Covid-19. It is considered artificial because it is acquired through vaccination rather than natural exposure to the disease. B: Active natural immunity is incorrect because it refers to immunity acquired through natural exposure to the disease. C: Passive natural immunity is incorrect because it refers to temporary immunity passed from mother to baby through breast milk or placenta. D: Passive artificial immunity is incorrect because it refers to receiving pre-formed antibodies, such as through an injection of antibodies rather than the body producing them itself.

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