ATI RN
Pharmacology and the Nursing Process Test Bank Questions
Question 1 of 9
The following data collection findings could indicate to the nurse that the patient has a hearing loss, EXCEPT:
Correct Answer: A
Rationale: Rationale: A relaxed face during conversation typically does not indicate a hearing loss, as the patient is likely able to hear and understand. B, speaking loudly, is a common sign of hearing loss. C, turning towards the speaker, suggests an effort to hear better. D, being withdrawn, could indicate difficulty in communication due to hearing loss. Therefore, A is the correct answer as it does not align with typical signs of hearing loss.
Question 2 of 9
A new nurse writes the following nursing diagnoses on a patient’s care plan. Which nursing diagnosis will cause the nurse manager to intervene?
Correct Answer: B
Rationale: The correct answer is B: Hemorrhage. The nurse manager would intervene because hemorrhage is a life-threatening condition requiring immediate attention. Wandering (A), urinary retention (C), and impaired swallowing (D) are important assessments but do not pose the same level of immediate risk as hemorrhage. The nurse manager would prioritize addressing the hemorrhage to ensure the patient's safety and well-being.
Question 3 of 9
Which of the following patients should the nurse monitors because of increased risk for surgical complications?
Correct Answer: B
Rationale: The correct answer is B because the patient's Body Mass Index (BMI) indicates obesity, putting them at higher risk for surgical complications. Obesity is associated with increased risks of infections, delayed wound healing, respiratory issues, and cardiovascular problems post-surgery. Monitoring this patient closely is crucial. Choice A is less likely to have increased surgical complications due to age and condition. Choice C, a 12-year-old, is less likely to have significant surgical complications compared to adults. Choice D, a 17-year-old with gallstones, may have risks but the BMI of the patient in choice B indicates a higher risk.
Question 4 of 9
A client is admitted for postoperative assessment and recovery after surgery for a kidney tumor. The nurse needs to assess for signs of urinary tract infection. Which of the ff measures can be used to help detect UTI?
Correct Answer: B
Rationale: The correct answer is B: Monitor temperature every 4hrs. This is crucial in detecting signs of urinary tract infection as fever is a common symptom. Monitoring temperature regularly allows for early detection and appropriate intervention. A: Encouraging the client to breathe deeply and cough every 2hrs is a measure to prevent respiratory complications postoperatively, not related to UTI detection. C: Splinting the incision when repositioning the client is important for wound care, not for detecting UTI. D: Irrigating tubes as ordered is a specific intervention for tube care, not for monitoring UTI symptoms.
Question 5 of 9
The nurse understands that which of the ff. best describes the action of enalapril maleate (Vasotec)?
Correct Answer: A
Rationale: Step-by-step rationale for why choice A is correct: 1. Enalapril maleate is an angiotensin-converting enzyme (ACE) inhibitor. 2. ACE inhibitors like enalapril maleate block the conversion of angiotensin I to angiotensin II. 3. By inhibiting the formation of angiotensin II, enalapril maleate decreases the levels of angiotensin II. 4. Angiotensin II is a potent vasoconstrictor, so decreasing its levels leads to vasodilation and decreased blood pressure. Summary of why other choices are incorrect: - Choice B: Enalapril maleate primarily dilates arterioles by decreasing angiotensin II levels, not veins. - Choice C: Enalapril maleate does not directly adjust extracellular volume; it primarily affects the renin-angiotensin-aldosterone system. - Choice D: Enalapril maleate
Question 6 of 9
A nurse has been examining the vital signs of the client for the past 2 days. On a particular day, she observe a sudden change in the vital signs of the client. Which of the ff steps should the nurse take immediately?
Correct Answer: A
Rationale: The correct answer is A: Inform the physician. This is essential because a sudden change in vital signs may indicate a critical condition that requires immediate medical attention. The physician needs to be informed promptly to assess the situation and provide appropriate interventions. Summary: - B: Changing environmental settings is not a priority when dealing with sudden changes in vital signs. - C: Altering diet intake is not an immediate response to sudden changes in vital signs. - D: Decreasing physical activity may not address the underlying cause of the sudden change in vital signs.
Question 7 of 9
Which of the ff. would the nurse explain to the patient is the triad of symptoms associated with Meniere’s disease?
Correct Answer: A
Rationale: The correct answer is A: Hearing loss, vertigo, and tinnitus. Meniere's disease is characterized by a triad of symptoms: recurrent episodes of vertigo, sensorineural hearing loss, and tinnitus. Vertigo is a spinning sensation, hearing loss affects the inner ear, and tinnitus is ringing in the ear. Nausea, vomiting, pain, nystagmus, or headache are not typically part of the classic triad of Meniere's disease symptoms. Therefore, option A is the most appropriate choice based on the specific symptomatology associated with Meniere's disease.
Question 8 of 9
A man‘s blood type is AB and he requires a blood transfusion. To prevent complications of blood incompatibilities, which blood type may the client receive?
Correct Answer: D
Rationale: The correct answer is D because individuals with AB blood type are considered universal recipients, meaning they can receive blood from any blood type without risking complications due to incompatibility. This is because their blood cells have both A and B antigens and do not produce antibodies against either type. Therefore, the client can safely receive blood from types A, B, AB, or O without adverse reactions. Choices A, B, and C are incorrect because they limit the options for blood transfusion based on the client's AB blood type, which is not necessary given the unique nature of AB blood as universal recipients.
Question 9 of 9
While bathing an 82 y.o. man hospitalized with pneumonia, a nurse notes an ulcerated area on his penis. What action should the nurse take first?
Correct Answer: A
Rationale: The correct action is to report the ulcer to the admitting care provider first. This is essential because the ulcer could be a sign of an underlying infection or condition that needs immediate attention, especially in a hospitalized patient with pneumonia. Reporting the ulcer ensures prompt evaluation and appropriate treatment. The other options are incorrect because teaching about STD prevention and asking about syphilis assume the cause of the ulcer is related to a sexually transmitted infection, which may not be the case in this scenario. Additionally, cleaning the ulcer without proper assessment and diagnosis by a healthcare provider can lead to complications or delay in appropriate treatment.