ATI RN
Multidimensional Basis of Health Protective Behaviors Questions
Question 1 of 5
Ricardo is scheduled for a prostatectomy, and the anesthesiologist plans to use a spinal (subarachnoid) block during surgery. In the operating room, the nurse positions the client according to the anesthesiologist's instructions. Why does the client require special positioning for this type of anesthesia?
Correct Answer: C
Rationale: The correct answer is C: To prevent cerebrospinal fluid (CSF) leakage. During a spinal block, the needle is inserted into the subarachnoid space where the cerebrospinal fluid is located. Proper positioning ensures that the needle puncture site is correctly aligned, minimizing the risk of CSF leakage. Preventing CSF leakage is crucial to maintain the effectiveness of the anesthesia and prevent complications such as post-dural puncture headache. Incorrect choices: A: To prevent confusion - Positioning is not related to preventing confusion during anesthesia. B: To prevent seizures - Seizures are not a common concern with spinal blocks and are not prevented by specific positioning. D: To prevent cardiac arrhythmias - Positioning in this case is not directly related to preventing cardiac arrhythmias during a prostatectomy with a spinal block.
Question 2 of 5
A female client is scheduled to receive a heart valve replacement with a porcine valve. Which of the following types of transplant is this?
Correct Answer: D
Rationale: The correct answer is D: Xenogeneic. A porcine valve is derived from pigs, making it a xenogeneic transplant. Allogeneic (A) refers to transplant between genetically different individuals of the same species. Autologous (B) involves using the patient's own tissue. Syngeneic (C) is transplant between genetically identical individuals, such as identical twins. In this case, since the heart valve is from a different species (pig), the correct term is xenogeneic.
Question 3 of 5
Cyrill with severe head trauma sustained in a car accident is admitted to the intensive care unit. Thirty-six hours later, the client's urine output suddenly rises above 200 ml/hour, leading the nurse to suspect diabetes insipidus. Which laboratory findings support the nurse's suspicion of diabetes insipidus?
Correct Answer: D
Rationale: The correct answer is D. Diabetes insipidus results from inadequate production or action of antidiuretic hormone, leading to excessive urine output and dilute urine. In this case, the sudden rise in urine output above 200 ml/hour indicates a large volume of dilute urine being excreted. Therefore, the urine osmolality will be low (below normal) due to its diluteness. On the other hand, the serum osmolality will be high (above normal) because the body is unable to retain water properly, leading to dehydration and concentration of solutes in the blood. This imbalance in osmolality levels between urine and serum supports the nurse's suspicion of diabetes insipidus. Incorrect choices: A: Above-normal urine and serum osmolality levels - This is incorrect because in diabetes insipidus, urine osmolality is low (dilute) and serum osmolality is high. B: Below-normal urine and serum os
Question 4 of 5
Nurse Sarah expects to note an elevated serum glucose level in a client with hyperosmolar hyperglycemic nonketotic syndrome (HHNS). Which other laboratory finding should the nurse anticipate?
Correct Answer: D
Rationale: The correct answer is D: Below-normal serum potassium level. In HHNS, there is severe hyperglycemia leading to osmotic diuresis and dehydration. As a result, potassium is lost in the urine, causing hypokalemia. This can lead to life-threatening cardiac arrhythmias. Elevated serum acetone level (A) and serum ketone bodies (B) are typically seen in diabetic ketoacidosis, not in HHNS. Serum alkalosis (C) is not commonly associated with HHNS.
Question 5 of 5
Hemoptysis may be present in the client with a pulmonary embolism because of which of the following reasons?
Correct Answer: A
Rationale: The correct answer is A, as hemoptysis in pulmonary embolism is often due to alveolar damage in the infarcted area caused by the blockage of blood flow to the lung tissue. This leads to inflammation and subsequent bleeding. Choice B is incorrect because major blood vessel involvement does not directly lead to hemoptysis. Choices C and D are incorrect as they are too general and do not specifically address the mechanism of hemoptysis in pulmonary embolism.