ATI RN
test bank foundations of nursing Questions
Question 1 of 9
The nurse is caring for a patient withClostridiumdifficile. Which nursing actions will have thegreatest impact in preventing the spread of the bacteria?
Correct Answer: D
Rationale: Correct Answer: D - Proper hand hygiene techniques Rationale: 1. Clostridium difficile is mainly spread through contact with contaminated surfaces. 2. Proper hand hygiene is the most effective way to prevent the spread of bacteria. 3. Hand hygiene removes bacteria from hands, reducing the risk of transmission. 4. Appropriate disposal (A) is important but doesn't directly prevent spread. Monthly in-services (B) and mandatory cultures (C) are not as effective as hand hygiene in preventing transmission.
Question 2 of 9
A nurse is caring for a patient with a postsurgical wound. When planning care, which goal will be the priority?
Correct Answer: C
Rationale: The correct answer is C: Promote positive nitrogen balance. In a postsurgical patient, promoting positive nitrogen balance is crucial for wound healing and tissue repair. This goal helps prevent muscle wasting and promotes overall recovery. A: Reduce dependent nitrogen balance is incorrect as it does not address the need for positive nitrogen balance in wound healing. B: Maintain negative nitrogen balance is incorrect because negative nitrogen balance indicates a loss of protein stores, which is detrimental for healing. D: Facilitate neutral nitrogen balance is incorrect as it does not actively support the increased protein needs for wound repair.
Question 3 of 9
A patient with an inoperable brain tumor has been told that he has a short life expectancy. On what aspects of assessment and care should the home health nurse focus? Select all that apply.
Correct Answer: A
Rationale: The correct answer is A: Pain control. This is the main focus because the patient's quality of life should be prioritized, and managing pain is crucial for comfort and well-being in end-of-life care. Pain can significantly impact the patient's physical and emotional state. The other choices are incorrect because managing treatment complications (B) and administering treatments (E) may not be relevant if the tumor is inoperable and the patient has a short life expectancy. Interpretation of diagnostic tests (C) may not be necessary at this stage, and assistance with self-care (D) may not be the main priority compared to pain control.
Question 4 of 9
The nurse is teaching a patient to care for her new ocular prosthesis. What should the nurse emphasize during the patients health education?
Correct Answer: C
Rationale: The correct answer is C: The need to perform thorough hand hygiene before handling the prosthesis. This is crucial to prevent infection. By washing hands thoroughly, the patient reduces the risk of introducing harmful bacteria or pathogens to the prosthesis, which could lead to infections or other complications. Incorrect Choices: A: The need to limit exposure to bright light - This is not directly related to caring for an ocular prosthesis. B: The need to maintain a low Fowlers position when removing the prosthesis - Positioning is not typically a concern when caring for an ocular prosthesis. D: The need to apply antiviral ointment to the prosthesis daily - Antiviral ointment is not a standard part of ocular prosthesis care unless specifically prescribed by a healthcare provider for a particular reason.
Question 5 of 9
A nurse is using the explanatory model to determinethe etiology of an illness. Which questions should the nurse ask? (Select all that apply.)
Correct Answer: B
Rationale: The correct answer is B: What do you call your problem? In the explanatory model, this question helps the nurse understand the patient's perspective and cultural beliefs about their illness. By asking how the patient labels their illness, the nurse gains insight into the patient's understanding of the illness, which can influence their treatment adherence and outcomes. The other options are incorrect because: A: How should your sickness be treated? - This question focuses on treatment preferences rather than understanding the patient's beliefs. C: How does this illness work inside your body? - This question is more aligned with the biomedical model, seeking physiological explanations rather than patient perspectives. D: What do you fear most about your sickness? - While important for assessing emotional aspects, this question does not directly address the patient's explanatory model.
Question 6 of 9
A patient with HIV will be receiving care in the home setting. What aspect of self-care should the nurse emphasize during discharge education?
Correct Answer: B
Rationale: The correct answer is B: Importance of personal hygiene. Maintaining good personal hygiene is crucial for patients with HIV to prevent infections. This includes regular handwashing, oral care, and bathing. By emphasizing personal hygiene, the nurse can help the patient reduce the risk of opportunistic infections. Prophylactic antibiotics (choice A) are important but should be prescribed by the healthcare provider. Signs and symptoms of wasting syndrome (choice C) are significant, but focusing on prevention through hygiene is more practical. Adjusting antiretroviral dosages (choice D) is the responsibility of the healthcare provider, not the patient.
Question 7 of 9
A nurse is planning discharge education for a patient who underwent a cervical diskectomy. What strategies would the nurse assess that would aid in planning discharge teaching?
Correct Answer: A
Rationale: Correct Answer: A - Care of the cervical collar Rationale: 1. Care of the cervical collar is essential post-cervical diskectomy to ensure proper immobilization and support. 2. Proper care prevents complications and promotes healing. 3. It is a crucial aspect of discharge education to prevent injury and promote recovery. Summary of other choices: B: Technique for performing neck ROM exercises - Important for rehabilitation but not directly related to discharge education post-cervical diskectomy. C: Home assessment of ABGs - Irrelevant to post-cervical diskectomy discharge education. D: Techniques for restoring nerve function - Important for recovery but not a primary focus of discharge education.
Question 8 of 9
A gerontologic nurse is advocating for diagnostic testing of an 81-year-old patient who is experiencing personality changes. The nurse is aware of what factor that is known to affect the diagnosis and treatment of brain tumors in older adults?
Correct Answer: A
Rationale: The correct answer is A because the cognitive effects of aging can mimic symptoms of brain tumors in older adults, leading to misdiagnosis or delayed diagnosis. Aging can also affect the presentation, progression, and treatment outcomes of brain tumors. Option B is incorrect as brain tumors in older adults can indeed produce focal effects. Option C is incorrect as not all older adults have numerous benign brain tumors, and this is not a factor affecting the diagnosis and treatment of brain tumors in this case. Option D is incorrect as age alone does not preclude treatment for brain tumors.
Question 9 of 9
The nurse is providing health education to a patient newly diagnosed with glaucoma. The nurse teaches the patient that this disease has a familial tendency. The nurse should encourage the patients immediate family members to undergo clinical examinations how often?
Correct Answer: B
Rationale: The correct answer is B: At least once every 2 years. Glaucoma has a familial tendency, meaning it can run in families. Regular eye exams are crucial for early detection and treatment. Having family members undergo clinical examinations every 2 years allows for timely identification of any potential signs of glaucoma. Monthly exams (A) would be too frequent and unnecessary. Exams every 5 years (C) or 10 years (D) are too infrequent and may miss early signs of the disease. Regular biennial exams strike a balance between early detection and practicality.