ATI RN
Introduction to Community Health Nursing Questions
Question 1 of 5
Independent nursing interventions commonly used for clients with pressure ulcers include which of the following?
Correct Answer: A
Rationale: Rationale for Correct Answer (A): Changing the client's position regularly helps to minimize pressure on the ulcer site, promoting circulation and preventing further tissue damage. This intervention is essential for preventing pressure ulcers and promoting healing. Other Choices Incorrect: B: Applying a drying agent like antacid can be harmful as it may further dry out the tissue and impede healing. C: Debriding the ulcer is not an independent nursing intervention and should be performed by a healthcare provider to remove necrotic tissue safely. D: This choice does not provide a specific nursing intervention for pressure ulcers but rather states a general concept that necrotic tissue can impede healing.
Question 2 of 5
The nurse assesses a patient who had a total abdominal hysterectomy 2 days ago. Which information about the patient is most important to communicate to the health care provider?
Correct Answer: B
Rationale: The correct answer is B because a swollen and warm calf could indicate deep vein thrombosis (DVT), a serious postoperative complication. DVT can lead to pulmonary embolism, which is life-threatening. Communicating this finding promptly allows for prompt evaluation and treatment. A: Elevated temperature is common postoperatively and may indicate infection, but DVT is more urgent. C: Abdominal pain when ambulating is expected post-hysterectomy and usually resolves with rest. D: Fluid intake greater than output may indicate a fluid imbalance, but DVT is a more concerning issue.
Question 3 of 5
A patient arrives in the emergency department with a swollen ankle after a soccer injury. Which action by the nurse is appropriate?
Correct Answer: A
Rationale: The correct answer is A: Elevate the ankle above heart level. This action helps reduce swelling by promoting venous return and decreasing edema. Elevating the ankle aids in reducing inflammation and pain. Applying a warm moist pack (option B) may increase swelling and should be avoided initially. Asking the patient to bear weight (option C) could worsen the injury. Assessing passive ROM (option D) is important but should be done after elevating the ankle to address swelling first.
Question 4 of 5
An experienced nurse orients a new nurse to the postanesthesia care unit (PACU). Which action by the new nurse, if observed by the experienced nurse, indicates that the orientation was successful?
Correct Answer: C
Rationale: The correct answer is C because positioning an unconscious patient on the side in the PACU helps prevent aspiration and ensures proper airway management. This position also promotes optimal ventilation and prevents airway obstruction. Choice A is incorrect because assisting a nauseated patient to a supine position can increase the risk of aspiration. Choice B is incorrect because placing a sleeping patient supine with the head elevated does not address airway protection for an unconscious patient. Choice D is incorrect as placing a patient in Trendelenburg position for low blood pressure is not recommended without a specific indication and can increase intracranial pressure in some cases.
Question 5 of 5
A patient who has been anticoagulated with warfarin (Coumadin) has been admitted for gastrointestinal bleeding. The history and physical examination indicates that the patient may have taken too much warfarin. The nurse anticipates that the patient will receive which antidote?
Correct Answer: B
Rationale: The correct antidote for a patient who has taken too much warfarin is Vitamin K. Warfarin inhibits Vitamin K-dependent clotting factors, leading to bleeding. Vitamin K helps restore these clotting factors. Vitamin E does not reverse warfarin's effects. Protamine sulfate is an antidote for heparin, not warfarin. Potassium chloride is used for treating low potassium levels, not warfarin toxicity. In summary, Vitamin K is the correct antidote for warfarin toxicity due to its role in restoring Vitamin K-dependent clotting factors, while the other choices are not indicated for this specific situation.