ATI RN
Adult Health Nursing Answer Key Questions
Question 1 of 5
One morning during rounds, Nurse Myra noticed that Marlene was unduly sad. The nurse 's BEST way of communicating her concern is _______.
Correct Answer: D
Rationale: Placing her hand over Marlene's shoulder and asking why the sad face is the best way for Nurse Myra to communicate her concern. This approach shows empathy and creates a safe space for Marlene to open up about her feelings. By using physical touch and showing genuine interest in Marlene's well-being, Nurse Myra can effectively address the situation and provide appropriate support or guidance as needed. Simply dismissing Marlene's feelings (option B and C) or resorting to religious advice (option A) may not effectively address the underlying cause of Marlene's sadness. It is important in situations like this to show empathy, compassion, and a willingness to listen in order to provide the best support for the individual in distress.
Question 2 of 5
A patient admitted to the ICU develops delirium characterized by acute onset confusion and agitation. What intervention should the healthcare team prioritize to manage the patient's delirium?
Correct Answer: B
Rationale: The healthcare team should prioritize implementing environmental modifications to promote orientation in a patient with delirium. Delirium is a state of acute confusion and agitation that can be triggered by various factors such as medications, infections, or metabolic disturbances. Environmental modifications involve creating a calm, quiet, and well-lit environment for the patient. Promoting proper orientation through the use of clocks, calendars, and familiar objects can help reduce confusion and improve the patient's understanding of their surroundings. These interventions are non-pharmacological and aim to address the underlying causes of delirium while minimizing the need for additional medications that may have potential side effects. Antipsychotic medications and benzodiazepines should be used judiciously and under close supervision due to the risk of adverse effects in older adults and critically ill patients. Referring the patient to a psychiatrist may be considered if the delirium is complex or if there are underlying psychiatric issues contributing to the presentation.
Question 3 of 5
In order not to frighten small children, it is best to examine things that are uncomfortable or frightening to them last so as not to lose their cooperation. This means the LAST thing to do in a child is, which of the following, EXCEPT________.
Correct Answer: C
Rationale: When examining a child, especially one who may already be feeling scared or uncomfortable, it is important to prioritize the order of procedures to help maintain their cooperation and reduce their anxiety. Undressing the child is typically done first to ensure a thorough examination can be performed, and it is a less invasive procedure compared to others. Inspection of the throat with a throat stick and inspection of the ears with an otoscope are common procedures that may cause mild discomfort but are often tolerated well by children. Auscultation of the heart is usually done after these initial steps and is not typically as uncomfortable or frightening for children compared to other procedures. Therefore, auscultation of the heart should not be the last thing to do when examining a child to avoid frightening them.
Question 4 of 5
When an accurate documentation whether done manually or by electronic by the health care professionals in their Work setting is a component of what quality standards in a health care delivery system?
Correct Answer: C
Rationale: Accurate documentation, whether done manually or electronically by health care professionals, is a critical component of information management in a health care delivery system. Information management involves the collection, storage, processing, and sharing of data to support decision-making and ensure quality care for patients. Properly documented records enable health care providers to have access to relevant information about a patient's medical history, treatment plans, and progress. This helps in delivering effective and coordinated care, reducing medical errors, and improving overall patient outcomes. Moreover, well-kept records are essential for legal and regulatory compliance, billing, quality assessment, and research purposes. Therefore, accurate documentation plays a key role in information management within the healthcare setting.
Question 5 of 5
While preparing the operating room (OR) for a surgical procedure, the nurse notices a malfunctioning anesthesia machine. What is the nurse's priority action?
Correct Answer: C
Rationale: The nurse's priority action when noticing a malfunctioning anesthesia machine in the operating room should be to inform the anesthesia provider immediately. Anesthesia providers are responsible for administering anesthesia safely during surgical procedures, and they need to be made aware of any equipment issues promptly to ensure patient safety. Continuing with the surgical procedure using a malfunctioning anesthesia machine can pose serious risks to the patient's well-being. Using an alternative anesthesia machine may be an option, but informing the anesthesia provider first ensures that the appropriate action is taken to address the issue effectively. Documenting the malfunction in the equipment log is important for record-keeping purposes, but it should not take precedence over informing the anesthesia provider and taking immediate action to address the problem.
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