ATI RN
Introduction to Professional Nursing Questions
Question 1 of 5
The nurse is performing a breast assessment to a client. Which of the following findings is a deviation from normal?
Correct Answer: C
Rationale: The correct answer is C: Retraction or dimpling. This finding is a deviation from normal as it can indicate possible breast cancer or other abnormalities. Retraction or dimpling can be a sign of tissue distortion or fibrosis, which should be further evaluated. Presence of striae (A) is common and not a cause for concern. Breasts that are rounded (B) and slightly unequal in size are considered normal variations. Simply being round (D) does not necessarily indicate a deviation from normal.
Question 2 of 5
Which of these children at the site of a disaster at a child day care center would the triage nurse put in the treat last" category?"
Correct Answer: B
Rationale: The correct answer is B because the toddler with severe deep abrasions over 98% of the body would be categorized as "treat last" in triage. This decision is based on the principle of prioritizing care based on the severity of injuries. Severe deep abrasions over a large body surface area indicate a critical condition that requires immediate medical attention to prevent complications like infection or shock. The other choices do not present as immediate life-threatening conditions as the severe abrasions, hence they would not be categorized as "treat last." The infant with bulging anterior fontanel may have a concerning sign, but it does not indicate an immediate life-threatening condition. The preschooler with leg fractures and school-age child with singed hair also do not present as critical as the toddler with severe abrasions.
Question 3 of 5
If all of the following nursing measures are possible, which helps most when planning to obtain a sputum specimen?
Correct Answer: A
Rationale: The correct answer is A: Provide the client with generous fluid intake. Adequate fluid intake helps in thinning respiratory secretions, making it easier to obtain a sputum specimen. This measure promotes hydration, which can facilitate coughing and sputum production. Regular position changes (B) may help prevent complications like pressure ulcers but are not directly related to obtaining a sputum specimen. A high-protein diet (C) and sufficient rest periods (D) are important for overall client well-being but do not specifically aid in obtaining a sputum specimen.
Question 4 of 5
To prepare a patient for a thoracentesis, the nurse should:
Correct Answer: B
Rationale: The correct answer is B: Ask the patient to sign a consent form for the procedure. This step is crucial to ensure that the patient understands the risks and benefits of the thoracentesis procedure and gives informed consent. Signing a consent form also protects both the patient and the healthcare provider legally. A: Reminding the patient to eat or drink nothing for six hours before the procedure is not necessary for a thoracentesis, as it is not typically a procedure that requires fasting. C: Positioning the patient on the side of the bed leaning over the bedside table is not correct for a thoracentesis procedure. The patient should be sitting upright or slightly leaning forward to facilitate the procedure. D: Pulling the privacy curtain and dimming the lights of the room are not essential steps for preparing a patient for a thoracentesis. These actions are more related to creating a comfortable and private environment but are not directly related to the procedure itself.
Question 5 of 5
The physician orders ampicillin (Omnipen), 500 mg by mouth every 6 hours. This medication order is an example of:
Correct Answer: A
Rationale: The correct answer is A: A standard written order. This is because a standard written order specifies the medication, dose, route, frequency, and duration of administration. In this case, the order for ampicillin 500 mg by mouth every 6 hours is clearly outlined and does not specify any special circumstances like a one-time dose or immediate administration (stat order). Additionally, it is not an as-needed order which would only be given based on the patient's symptoms or condition. It also does not qualify as a single order as it is intended to be administered multiple times at specified intervals.