ATI RN
Adult Health Nursing Answer Key Questions
Question 1 of 9
As Nurse Pedrito prepares for the day's visits, which of the following patients should be seen FIRST? A client with ________.
Correct Answer: C
Rationale: The patient with a history of congestive heart failure and dyspnea should be seen FIRST by Nurse Pedrito. Congestive heart failure is a serious condition that can lead to acute exacerbations and requires prompt assessment and management. Dyspnea (shortness of breath) is a common symptom of heart failure and can indicate worsening cardiac function or fluid overload, which requires immediate attention to prevent further complications. Timely assessment and intervention for heart failure exacerbations can help prevent hospital admissions and improve patient outcomes. Therefore, prioritizing this patient for assessment and intervention is crucial to ensure their safety and well-being.
Question 2 of 9
When can the patient tell all information to the nurse?
Correct Answer: B
Rationale: The patient can tell all information to the nurse once the feeling of security is established in the nurse-patient relationship. Open communication and sharing of information are essential components of nursing care. Patients are more likely to disclose personal information, concerns, and feelings when they trust their nurse and feel secure in the relationship. Building trust and creating a safe and supportive environment are crucial for effective therapeutic communication and holistic patient care. It is important for the nurse to establish a trusting relationship with the patient to encourage open communication and provide patient-centered care.
Question 3 of 9
The professional development of a nurse can be achieved through various ways, such as __________.
Correct Answer: D
Rationale: Continuing Professional Development (CPD) programs are essential for the professional growth and development of nurses. CPD programs provide opportunities for nurses to enhance their knowledge, skills, and competencies, keeping them up-to-date with the latest advancements in healthcare. These programs may include workshops, conferences, seminars, online courses, and certifications that contribute to a nurse's professional development. By engaging in CPD programs, nurses can improve their clinical practice, critical thinking skills, and patient care, ultimately benefiting both the nurse and the patients they serve.
Question 4 of 9
The nurse did an admission procedure. The best position to be assumed by Roy is _____.
Correct Answer: B
Rationale: The best position for a patient to assume during an admission procedure, particularly for respiratory assessment, is the semi-fowler position at least 30 degrees. In the semi-fowler position, the patient's head and upper body are elevated to a 30-degree angle. This position helps improve lung expansion and oxygenation by reducing pressure on the diaphragm and enhancing chest expansion. It also facilitates breathing and allows for better assessment of respiratory status. Additionally, the semi-fowler position helps prevent aspiration and promotes comfort and relaxation for the patient during the admission procedure.
Question 5 of 9
A patient is prescribed a proton pump inhibitor (PPI) for the treatment of peptic ulcer disease. Which adverse effect should the nurse monitor closely in the patient?
Correct Answer: B
Rationale: Proton pump inhibitors (PPIs) are commonly prescribed for conditions involving excessive stomach acid production, such as peptic ulcer disease. One of the potential adverse effects of PPIs, such as omeprazole or pantoprazole, is the risk of hypokalemia. Hypokalemia is a condition characterized by low levels of potassium in the bloodstream. Prolonged use of PPIs can inhibit the absorption of potassium in the intestines, leading to a decrease in potassium levels in the body. Hypokalemia can present with symptoms such as muscle weakness, fatigue, irregular heartbeat, and in severe cases, it can result in life-threatening complications like cardiac arrhythmias. Therefore, it is essential for the nurse to closely monitor the patient for signs and symptoms of hypokalemia while on PPI therapy, especially if the patient is at risk for developing electrolyte imbalances.
Question 6 of 9
A few days later, the patient comes into the emergency department via ambulance stretcher and reveals a work-up of blood sugar level at 800mg/dl, ketones are absent in the urine, she is dehydrated, and has an altered mental status. Based on the data, t he patient is most likely suferring from what specifi medical condition?
Correct Answer: A
Rationale: The patient's presentation with a blood sugar level of 800mg/dL, absence of ketones in the urine, dehydration, and altered mental status points towards Hyperosmolar nonketotic coma (HNKC). HNKC typically occurs in patients with Type 2 diabetes and is characterized by extremely high blood glucose levels (hyperglycemia) without significant ketosis. The absence of ketones in the urine distinguishes HNKC from Diabetic ketoacidosis (DKA). Patients with HNKC often present with severe dehydration, altered mental status, and hyperosmolarity. It is crucial to address the underlying cause of the hyperglycemia, correct dehydration, and normalize blood glucose levels promptly in the management of HNKC.
Question 7 of 9
Which of the following statements accurately describes the role of major histocompatibility complex (MHC) molecules in antigen presentation?
Correct Answer: B
Rationale: Major histocompatibility complex (MHC) class I molecules are responsible for presenting endogenous antigens, such as viral or intracellular proteins, to CD8+ T cells. These antigens are derived from within the cell, either synthesized within the cell itself or taken up from the cytoplasm. CD8+ T cells, also known as cytotoxic T cells, recognize antigens presented by MHC class I molecules and play a key role in cell-mediated immunity by destroying infected or abnormal cells.
Question 8 of 9
A patient presents with a sudden onset of severe vertigo, nausea, vomiting, and nystagmus. The patient reports a recent upper respiratory tract infection. Which of the following conditions is most likely responsible for this presentation?
Correct Answer: A
Rationale: The patient's sudden onset of severe vertigo, nausea, vomiting, and nystagmus following a recent upper respiratory tract infection is consistent with vestibular neuritis. Vestibular neuritis is characterized by acute onset vertigo, often severe, which is typically associated with nausea, vomiting, and nystagmus. The condition is thought to be caused by inflammation of the vestibular nerve, often viral in nature, which can occur following an upper respiratory tract infection. This inflammation leads to dysfunction of the vestibular system in the inner ear, resulting in the symptoms described. Benign paroxysmal positional vertigo (BPPV), characterized by brief episodes of vertigo triggered by specific head movements, is less likely in this case given the sudden onset of symptoms not triggered by head movements. Meniere's disease is characterized by recurrent episodes of vertigo accompanied by hearing loss, tinnitus, and a feeling of fullness
Question 9 of 9
A client is admitted with acute gouty arthritis. Which medication does the nurse anticipate the health care provider may prescribe to prevent and treat an acute attack of gout?
Correct Answer: C
Rationale: Colchicine is a medication commonly prescribed to prevent and treat acute attacks of gout. It works by reducing inflammation caused by the buildup of uric acid crystals in the joints. Colchicine is effective in relieving pain and reducing swelling during gout attacks. It is important to follow the prescribed dosage due to potential side effects such as gastrointestinal upset. Ibuprofen is a nonsteroidal anti-inflammatory drug that can be used for pain relief but is not specific for gout treatment. Probenecid is used for chronic gout by helping the kidneys remove uric acid, not for acute gout attacks. Hydrocortisone is a steroid that may be used in some cases but is not a first-line treatment for acute gouty arthritis.