ATI RN
Foundations and Adult Health Nursing Test Bank Questions
Question 1 of 9
A patient with renal failure presents with confusion, seizures, asterixis, and a sweet odor to the breath. Laboratory findings reveal severe metabolic acidosis, hyperkalemia, and elevated blood urea nitrogen (BUN) and creatinine levels. What is the most likely diagnosis?
Correct Answer: B
Rationale: The patient's presentation with renal failure, confusion, seizures, asterixis, and a sweet odor to the breath, along with laboratory findings of severe metabolic acidosis, hyperkalemia, and elevated BUN and creatinine levels, is consistent with uremic encephalopathy. Uremic encephalopathy is a neurological complication of acute or chronic renal failure resulting from the buildup of uremic toxins in the blood, leading to various neurological symptoms such as confusion and seizures. The sweet odor to the breath can be attributed to the presence of urea, a waste product that accumulates in renal failure. Other metabolic abnormalities like hyperkalemia and severe metabolic acidosis are also common in renal failure. It is crucial to promptly recognize and manage uremic encephalopathy to prevent further neurological complications.
Question 2 of 9
Despite the reaction of the patient, which of the ethical principle that the nurse is responsible of providing all patients with caring attention and information?
Correct Answer: D
Rationale: Advocacy is the ethical principle that the nurse is responsible for providing all patients with caring attention and information, despite the reaction of the patient. Advocacy involves supporting and speaking up for the patient's best interests, ensuring they receive the care and information they need to make informed decisions about their health and well-being. Providing caring attention and information is essential in advocating for the patient's autonomy and well-being, even if the patient may not initially appreciate or react positively to these efforts.
Question 3 of 9
What post operative teaching will the patient strictly follow?
Correct Answer: B
Rationale: The patient who had a left total hip replacement surgery due to osteoarthritis needs to strictly follow the postoperative teaching of being shown how to gently irrigate the external auditory canal because this instruction is unrelated to a hip replacement surgery. The other options are not relevant to the surgery and patient's condition. Option A about airplane travel, Option C about dizziness, and Option D about hair washing are not appropriate instructions for a patient who had a hip replacement. It is important for healthcare providers to give accurate and relevant postoperative instructions to help the patient recover successfully.
Question 4 of 9
Nurse Rica is in charge of the animal bite program of the health center, which of the following is the causative agent of rabies?
Correct Answer: C
Rationale: Rabies is a viral disease that affects the central nervous system. It is primarily transmitted through the bite of an infected animal, such as dogs, bats, raccoons, and foxes. The causative agent of rabies is the rabies virus, specifically from the genus Lyssavirus. Once the virus enters the body, it spreads through the nervous system to the brain, leading to severe neurological symptoms and, if left untreated, is almost always fatal. This is why prompt medical attention and vaccination following an animal bite are crucial in preventing the development of rabies in humans.
Question 5 of 9
Which of the following conditions is characterized by degenerative changes in the intervertebral discs, leading to narrowing of the disc space and osteophyte formation?
Correct Answer: B
Rationale: Spondylosis is a condition characterized by degenerative changes in the intervertebral discs, leading to narrowing of the disc space and the formation of osteophytes (bone spurs). This degenerative process commonly occurs with aging and can cause symptoms such as neck or back pain, stiffness, and reduced range of motion. Spondylosis is a common finding on imaging studies like X-rays and MRI scans in individuals over the age of 50 and is a natural part of the aging process of the spine.
Question 6 of 9
A patient presents with fatigue, weakness, hyperpigmentation of the skin, and salt craving. Laboratory tests reveal low serum sodium levels and elevated serum potassium levels. Which endocrine disorder is most likely responsible for these symptoms?
Correct Answer: D
Rationale: Addison's disease is a rare endocrine disorder characterized by adrenal insufficiency, leading to a deficiency in cortisol and aldosterone production. The symptoms of Addison's disease include fatigue, weakness, hyperpigmentation of the skin (due to elevated levels of ACTH stimulating melanocytes), and salt craving (due to aldosterone deficiency). Low serum sodium levels and elevated serum potassium levels are also common laboratory findings in Addison's disease, as aldosterone plays a key role in maintaining electrolyte balance. Patients with Addison's disease are at risk of developing an adrenal crisis, which can be life-threatening if not promptly recognized and treated with glucocorticoid and mineralocorticoid replacement therapy.
Question 7 of 9
A patient presents with gradual, painless visual field loss in both eyes, particularly in the peripheral vision. Tonometry reveals elevated intraocular pressure (IOP). Which of the following conditions is most likely responsible for this presentation?
Correct Answer: A
Rationale: The patient presents with gradual, painless visual field loss in both eyes, particularly in the peripheral vision, which is characteristic of glaucoma. The elevated intraocular pressure (IOP) on tonometry further supports a diagnosis of glaucoma. Open-angle glaucoma is the most common type of glaucoma and typically presents insidiously with a slow progression of vision loss. In open-angle glaucoma, the drainage angle of the eye remains open but becomes less efficient over time, leading to increased intraocular pressure and optic nerve damage. This results in peripheral visual field loss. Closed-angle glaucoma, on the other hand, presents more acutely with sudden eye pain, redness, and blurred vision due to a sudden increase in intraocular pressure from a blocked drainage angle. Age-related macular degeneration and diabetic retinopathy typically do not present with elevated IOP or peripheral visual field loss.
Question 8 of 9
The elderly should be affforded health protection by
Correct Answer: D
Rationale: Regular health check-ups play a crucial role in the prevention, early detection, and management of health issues, especially for the elderly. By ensuring that the elderly receive regular health check-ups, healthcare providers can monitor their health status, detect any potential health problems early on, and provide appropriate medical interventions. This proactive approach can help protect the elderly from developing serious health issues or complications. Additionally, regular health check-ups can also promote overall health and well-being, allowing healthcare professionals to address any existing health concerns and provide necessary treatments or recommendations to maintain the elderly's health and quality of life.
Question 9 of 9
Which assessment by the nurse would cause a concern for Meperidine Overdosed?
Correct Answer: C
Rationale: Meperidine (Demerol) is an opioid analgesic. Overdose of Meperidine can lead to respiratory depression, characterized by slow and shallow breathing. As a result of respiratory depression, hypercapnia, which is an increased level of carbon dioxide in the blood, can occur. This is a serious concern and requires immediate medical intervention to support respiratory function. Therefore, hypercapnia would be the assessment by the nurse that causes a concern for Meperidine overdose.