ATI RN
Nursing Process Final Exam Questions Questions
Question 1 of 9
At a public health fair, a nurse discusses the dangers of sun exposure. Prolonged sun exposure has been blamed for which form of cancer?
Correct Answer: D
Rationale: The correct answer is D, "All of the above." Malignant melanoma, basal cell epithelioma, and squamous cell carcinoma are all types of skin cancer associated with prolonged sun exposure. Melanoma is the most dangerous form, while basal cell and squamous cell carcinomas are more common but less aggressive. Sun exposure can lead to DNA damage in skin cells, increasing the risk of developing these types of cancers. Therefore, all three choices are correct as they are all linked to sun exposure. The other choices are incorrect because each type of skin cancer mentioned can be caused by prolonged sun exposure, so selecting any one of them individually would not fully capture the scope of the risks associated with sun exposure.
Question 2 of 9
A nurse is getting ready to discharge a patient who has a problem with physical mobility. What does the nurse need to do before discontinuing the patient’s plan of care?
Correct Answer: B
Rationale: The correct answer is B because before discontinuing a patient's plan of care related to physical mobility, the nurse needs to evaluate whether the patient goals and outcomes have been met. This step ensures that the patient has achieved the desired level of physical mobility improvement and is ready to safely continue their care at home. A: Determining whether the patient has transportation to get home is important but not directly related to the patient's physical mobility goals and outcomes. C: Establishing a follow-up appointment is important but does not directly address the evaluation of the patient's physical mobility improvement. D: Ensuring that the patient's prescriptions are filled is crucial for medication management but does not specifically evaluate the patient's physical mobility progress.
Question 3 of 9
Inhalation of carbogen for short period is recommended:
Correct Answer: D
Rationale: The correct answer is D. Carbogen is a gas mixture of carbon dioxide and oxygen. Inhaling carbogen can stimulate respiration due to increased oxygen levels and carbon dioxide acting as a respiratory stimulant. It can also dilate blood vessels, enhancing oxygen delivery to tissues. Additionally, carbogen can help dislodge blood clots by improving blood flow and oxygenation. Therefore, all the choices (A, B, and C) are correct as inhaling carbogen can have multiple beneficial effects on respiration, blood vessels, and blood clot dislodging.
Question 4 of 9
A client was brought to the school clinic wuth severe, constant, localized abdominal pain. Abdominal muscles are rigid, and rebound tenderness is present. Peritonitis is suspected. The client is hypotensive and tachycardic. The nursing diagnosis most appropriate to the client’s signs/symptoms is:
Correct Answer: A
Rationale: The correct answer is A: fluid volume deficit related to depletion of intravascular volume. Peritonitis causes inflammation of the peritoneum, leading to fluid shifting into the peritoneal cavity, causing hypovolemia. Hypotension and tachycardia are signs of decreased intravascular volume. Rigid abdominal muscles and rebound tenderness indicate peritoneal irritation. Choice B is incorrect because elevated ammonia levels are not associated with the client's symptoms. Choice C is incorrect because increased peristalsis does not explain the client's hypotension and tachycardia. Choice D is incorrect because malabsorption does not align with the client's acute presentation of severe abdominal pain and peritonitis.
Question 5 of 9
A patient asks the nurse what side effects to expect from a muscle relaxant medication that has been prescribed. Which of the ff. side effects should the nurse relate?
Correct Answer: B
Rationale: The correct answer is B: Drowsiness. Muscle relaxants can cause drowsiness as a common side effect due to their sedative properties. This can impair alertness and coordination, so it's crucial for the patient to be aware of this potential effect. Choice A, hypoglycemia, is not typically associated with muscle relaxants. Choice C, hypotension, is more commonly linked to medications like antihypertensives. Choice D, dyspnea, which is difficulty breathing, is not a common side effect of muscle relaxants. Therefore, the nurse should primarily focus on educating the patient about the potential side effect of drowsiness.
Question 6 of 9
Which of the ff is an important nursing intervention for HIV positive clients?
Correct Answer: D
Rationale: Step 1: Providing referral to support groups and resources for information is essential for HIV positive clients as it offers emotional support, education, and access to resources for managing the condition. Step 2: Support groups provide a safe space for clients to share experiences, seek advice, and reduce feelings of isolation. Step 3: Resources for information help clients stay informed about their condition, treatment options, and lifestyle modifications. Step 4: Referral to support groups and resources promotes holistic care and enhances the client's overall well-being. Summary: Choices A, B, and C are incorrect as they do not address the specific needs of HIV positive clients and may even pose risks to their health. Option D is the most appropriate intervention as it focuses on comprehensive support and empowerment for clients.
Question 7 of 9
A client seeks medical evaluation for fatigue, night sweats, and a 20-lb weight loss in 6 weeks. To confirm that the client has been infected with the human immunodeficiency virus (HIV), the nurse expects the physician to order:
Correct Answer: D
Rationale: The correct answer is D, the Western blot test with ELISA. First, ELISA is used as a screening test for HIV antibodies. If positive, a confirmatory test like Western blot is needed to detect specific antibodies. Western blot is highly specific and confirms the presence of HIV antibodies. E-rosette immunofluorescence is not typically used for HIV diagnosis. Quantification of T-lymphocytes is used to monitor disease progression in HIV but does not confirm HIV infection. ELISA alone is not confirmatory; it needs to be followed by a more specific test like Western blot.
Question 8 of 9
Which of the ff finding would confirm that a female client has mastitis? Choose all that apply
Correct Answer: C
Rationale: The correct answer is C because mastitis typically presents with swollen, firm, and hard breasts due to inflammation and infection of the breast tissue. This occurs as a result of milk stasis and bacterial infection. Option A is incorrect because a crack in the nipple or areola can be indicative of nipple trauma or infection, not necessarily mastitis. Option B is incorrect because multiple lumps within the breast tissue may suggest fibrocystic changes or breast cancer, but not specifically mastitis. Option D is incorrect because enlargement of the axillary lymph nodes is more commonly seen in breast cancer, not mastitis.
Question 9 of 9
Three days after admission Ms. CC continued to have frequent stools. Her oral intake of both fluids and solids are poor. Her physician ordered parenteral hyperalimentation. Hyperalimentation solutions are:
Correct Answer: D
Rationale: The correct answer is D: Hyperosmolar solutions used primarily to reverse negative nitrogen balance. Rationale: 1. Hyperalimentation solutions are designed to provide essential nutrients intravenously. 2. Hyperosmolar solutions have a higher osmolarity compared to body fluids, providing concentrated nutrition. 3. Negative nitrogen balance occurs when the body breaks down more protein than it synthesizes, requiring additional protein intake. 4. Hyperosmolar solutions can provide adequate protein and nutrients to reverse negative nitrogen balance. Summary: A: Hypotonic solutions do not increase osmotic pressure, but rather decrease it. B: Hypertonic solutions are not primarily used for hydration in this context. C: Alkalizing solutions are not the primary purpose of hyperalimentation and do not directly address cellular sweating.