ATI RN
Foundations and Adult Health Nursing Study Guide Answers Questions
Question 1 of 5
A patient with terminal cancer experiences dyspnea and anxiety. Which intervention should the palliative nurse prioritize to address the patient's symptoms?
Correct Answer: C
Rationale: When a patient with terminal cancer experiences dyspnea (difficulty breathing) and anxiety, opioid medications are often prioritized by palliative care providers for symptom management. Opioids are effective in relieving dyspnea by acting as respiratory depressants and reducing the feeling of air hunger. Additionally, opioids have sedative effects that can help alleviate anxiety and promote relaxation. Therefore, in this situation, prescribing opioid medications would be the most appropriate intervention to address both the dyspnea and anxiety symptoms simultaneously. Oxygen therapy, relaxation techniques, and breathing exercises may also be useful adjunctive interventions, but opioid medications are typically prioritized for immediate symptom relief in this context.
Question 2 of 5
A patient presents with fever, chills, headache, and myalgia after returning from a camping trip. Laboratory tests reveal thrombocytopenia and leukopenia. Which of the following is the most likely causative agent?
Correct Answer: A
Rationale: The most likely causative agent in this scenario is Plasmodium falciparum, which is the parasite that causes malaria. The symptoms of fever, chills, headache, and myalgia following a camping trip are highly suggestive of malaria, especially if the patient has thrombocytopenia and leukopenia. Plasmodium falciparum is known to cause severe malaria with complications such as thrombocytopenia and leukopenia. The other options, Trypanosoma cruzi, Borrelia burgdorferi, and Leishmania donovani, do not typically present with all of the symptoms described and are not associated with the laboratory findings of thrombocytopenia and leukopenia.
Question 3 of 5
A woman in active labor is diagnosed with uterine rupture. What is the priority nursing action?
Correct Answer: A
Rationale: The priority nursing action for a woman diagnosed with uterine rupture during labor is to prepare for immediate cesarean section. Uterine rupture is a serious obstetric emergency that can lead to severe maternal and fetal complications, including hemorrhage, fetal distress, and injury to both mother and baby. A cesarean section is necessary to deliver the baby promptly and address any potential complications, such as controlling bleeding and ensuring the safety of both the mother and the baby. Time is critical in these situations, and prompt surgical intervention is essential to optimize outcomes. Administering intravenous oxytocin or assisting the mother into a hands-and-knees position would not address the immediate risks associated with uterine rupture. Initiating cardiopulmonary resuscitation (CPR) is only necessary if the mother's condition deteriorates to the point of cardiac or respiratory arrest, which may occur as a result of significant hemorrhage or other complications associated with uterine
Question 4 of 5
Mr. C is an older patient with a known history of peripheral vascular disease. The nurse places a heating pad directly on the patient's lower leg to relieve muscle spasms. The heating pad causes a burn, the area becomes infected, and the patient eventually must have a skin graft. This is an example of which of the following?
Correct Answer: D
Rationale: Negligence refers to the failure to take proper care in doing something. In this scenario, the nurse failed to exercise the standard of care expected in placing a heating pad directly on Mr. C's lower leg, knowing his history of peripheral vascular disease. This failure led to a burn and subsequent infection that required a skin graft for treatment. The actions of the nurse were negligent as they did not meet the expected standard of care, resulting in harm to the patient. This situation does not fit the definition of assault, malpractice, or vicarious liability, making negligence the most appropriate choice.
Question 5 of 5
A 24-year-old woman presents with cyclic pelvic pain, dysmenorrhea, and dyspareunia. On pelvic examination, tender nodules are palpated along the uterosacral ligaments. Which of the following conditions is most likely to be responsible for these findings?
Correct Answer: B
Rationale: The symptoms of cyclic pelvic pain, dysmenorrhea (painful menstruation), dyspareunia (painful intercourse), and tender nodules along the uterosacral ligaments are classic findings associated with endometriosis. In endometriosis, tissue similar to the lining of the uterus (endometrium) grows outside the uterus, commonly on the ovaries, fallopian tubes, and pelvic peritoneum. The presence of tender nodules along the uterosacral ligaments is known as "nodularity" and is a characteristic feature of advanced endometriosis. It occurs due to the formation of endometrial implants that respond to hormonal changes during the menstrual cycle, resulting in inflammation, scarring, and pain in affected areas.
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