ATI RN
Nursing Process Questions Questions
Question 1 of 5
The nurse is gathering data on a patient. Which data will the nurse report as objective data?
Correct Answer: C
Rationale: Objective data are measurable and observable facts obtained through physical examination or diagnostic tests. In this case, "Respirations 16" is a quantifiable and observable measurement, making it objective data. It is not influenced by personal interpretation or feelings. The other choices, such as "States 'doesn't feel good'", "Reports a headache", and "Nauseated" are subjective data because they are based on the patient's feelings or experiences, which can vary depending on individual perception and interpretation, making them less reliable for making clinical decisions. By focusing on objective data like "Respirations 16", the nurse can provide a more accurate assessment of the patient's condition.
Question 2 of 5
Which information indicates a nurse has a good understanding of a goal? It is a statement describing the patient’s accomplishments without a time
Correct Answer: D
Rationale: Step 1: A goal should be measurable to track progress effectively. Step 2: The statement "a measurable change in a patient's physical state" indicates a specific and quantifiable outcome. Step 3: This aligns with the SMART criteria for goal setting - Specific, Measurable, Achievable, Relevant, Time-bound. Step 4: Other choices lack the specificity and measurability required for a clear goal. Step 5: Choice A talks about restriction, which is not directly related to understanding a goal. Step 6: Choice B focuses on negative responses, which is not necessarily indicative of understanding the goal. Step 7: Choice C is vague and lacks the specificity of a measurable outcome.
Question 3 of 5
A client is being prepared for cardiac catheterization. The nurse performs an initial assessment and records the vital signs. Which of the following data collected can be classified as subjective data?
Correct Answer: B
Rationale: Subjective data refers to information provided by the client based on their feelings, perceptions, or beliefs. Nausea is a symptom that the client experiences and reports subjectively. The client feels nauseous, which is not something directly measurable like blood pressure, heart rate, or respiratory rate. Therefore, nausea is the correct choice for subjective data. Blood pressure, heart rate, and respiratory rate are all objective data that can be measured and observed. Blood pressure, heart rate, and respiratory rate are all objective data that can be measured and observed.
Question 4 of 5
Which of the ff. nursing interventions will help prevent complications in the patient with Bell’s Palsy?
Correct Answer: D
Rationale: Correct Answer: D - Lubricating eye drops Rationale: Lubricating eye drops help prevent complications such as corneal abrasions in patients with Bell's Palsy by keeping the eye moist and preventing dryness. Bell's Palsy can cause difficulty in closing the eye properly, leading to dryness and potential damage to the cornea. Using lubricating eye drops helps maintain eye health. Summary of Incorrect Choices: A: Megavitamin therapy - Not directly related to preventing complications in Bell's Palsy. B: Application of ice to the affected area - Ice may not address eye dryness or prevent corneal abrasions. C: Elastic bandages - Not relevant to preventing complications associated with Bell's Palsy.
Question 5 of 5
In a 28-year-old female client who is being successfully treated for Cushing syndrome, the nurse would expect a decline in:
Correct Answer: D
Rationale: The correct answer is D: menstrual flow. In a 28-year-old female with Cushing syndrome, excess cortisol levels can disrupt the menstrual cycle, leading to irregular or absent periods. Successful treatment for Cushing syndrome aims to restore normal cortisol levels, which should result in the resumption of regular menstrual flow. This indicates that the hormonal balance is improving. Now, let's analyze the other choices: A: Serum glucose level - While Cushing syndrome can lead to hyperglycemia, successful treatment would aim to normalize glucose levels, not cause a decline. B: Bone mineralization - Cushing syndrome can cause osteoporosis due to loss of bone density, but successful treatment would help prevent further bone loss rather than decline. C: Hair loss - Cushing syndrome can cause hair loss, but successful treatment would not necessarily lead to a decline in hair loss as it may take time for hair to regrow. Therefore, the correct answer is D as it directly relates to the restoration of hormonal
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