ATI RN
foundations of nursing practice questions Questions
Question 1 of 9
The nurse is providing care for a patient who has experienced a type I hypersensitivity reaction. What condition is an example of such a reaction?
Correct Answer: A
Rationale: The correct answer is A: Anaphylactic reaction after a bee sting. Type I hypersensitivity reactions involve an immediate response triggered by exposure to an allergen, leading to the release of histamine and other inflammatory mediators. In this case, a bee sting would introduce an allergen, causing a rapid and severe systemic reaction, known as anaphylaxis. B: Skin reaction resulting from adhesive tape is an example of a Type IV hypersensitivity reaction, mediated by T cells, not IgE antibodies as in Type I reactions. C: Myasthenia gravis is an autoimmune disorder involving antibodies attacking acetylcholine receptors, not a Type I hypersensitivity reaction. D: Rheumatoid arthritis is an autoimmune disorder involving immune complexes and inflammatory responses, not a Type I hypersensitivity reaction.
Question 2 of 9
A nurse is watching a nursing assistive personnel(NAP) perform a postvoid bladder scan on a female with a previous hysterectomy. Which action will require the nurse to follow up?
Correct Answer: D
Rationale: The correct answer is D because setting the scanner to female is incorrect for a patient who has had a hysterectomy as they do not have a uterus. This could lead to inaccurate results. Palpating the symphysis pubis (A) ensures proper positioning, wiping the scanner head with alcohol (B) maintains infection control, and applying gel (C) facilitates sound wave transmission.
Question 3 of 9
A patient is brought to the emergency department (ED) in a state of anaphylaxis. What is the ED nurses priority for care?
Correct Answer: B
Rationale: The correct answer is B: Protect the patient's airway. In anaphylaxis, airway compromise can lead to respiratory distress and even respiratory arrest. The priority is to ensure the patient has a patent airway to maintain oxygenation. This can be achieved through interventions such as positioning, oxygen therapy, and potentially intubation if needed. Monitoring the patient's level of consciousness (A) is important but secondary to ensuring airway patency. Providing psychosocial support (C) is not the immediate priority in anaphylaxis. Administering medications (D) is also important but only after ensuring the airway is protected.
Question 4 of 9
Which action indicates the nurse is meeting aprimary goal of cultural competent care for patients?
Correct Answer: C
Rationale: The correct answer is C because providing individualized care is a fundamental aspect of cultural competence. This means tailoring care to meet the unique cultural, social, and personal needs of each patient. It involves understanding and respecting a patient's beliefs, values, and practices. Explanation: A. Providing care to transgender patients is important, but it is not the primary goal of cultural competence. B. Restoring relationships is beneficial but may not directly address cultural competence. D. Providing care to surgical patients is a common nursing duty but does not specifically relate to cultural competence.
Question 5 of 9
A patient is exploring treatment options after being diagnosed with age-related cataracts that affect her vision. What treatment is most likely to be used in this patients care?
Correct Answer: D
Rationale: The correct answer is D: Surgical intervention. Cataracts are a clouding of the lens in the eye, which can lead to vision impairment. Surgery is the most common and effective treatment for cataracts, involving the removal of the cloudy lens and replacement with an artificial one. Antioxidant supplements (Choice A) may help prevent cataracts but are not a treatment for existing ones. Eyeglasses or magnifying lenses (Choice B) can help with vision correction but do not address the cataracts themselves. Corticosteroid eye drops (Choice C) are used for treating inflammation in the eye, not cataracts. Therefore, surgical intervention is the most appropriate treatment option for age-related cataracts.
Question 6 of 9
A patient has just returned to the unit from the PACU after surgery for a tumor within the spine. The patient complains of pain. When positioning the patient for comfort and to reduce injury to the surgical site, the nurse will position to patient in what position?
Correct Answer: B
Rationale: The correct answer is B: In a flat side-lying position. Rationale: 1. A flat side-lying position helps reduce pressure on the surgical site, promoting comfort and preventing injury. 2. This position minimizes strain on the spine and supports proper alignment. 3. High Fowlers position may increase pressure on the surgical area due to increased intra-abdominal pressure. 4. Trendelenberg position and reverse Trendelenberg position are not appropriate for spine surgery patients as they can cause increased blood flow to the surgical site, leading to potential complications.
Question 7 of 9
A patient is experiencing oliguria. Which actionshould the nurse performfirst?
Correct Answer: A
Rationale: The correct answer is A: Assess for bladder distention. Oliguria indicates decreased urine output, which could be due to urinary retention. Assessing for bladder distention helps identify the underlying cause. Requesting diuretics (B) without assessing first is premature. Increasing IV fluid rate (C) may worsen the situation if there is urinary retention. Encouraging caffeinated beverages (D) is not appropriate as they can worsen dehydration.
Question 8 of 9
A nurse needs to know how to find, evaluate, and use information effectively.
Correct Answer: C
Rationale: The correct answer is C: Clinical decision support system. A clinical decision support system is a type of system or design that helps healthcare professionals, including nurses, in making clinical decisions by providing them with relevant information and knowledge. This system assists in analyzing data to generate patient-specific recommendations or alerts to improve patient care. In the given scenario, the nurse's need to find, evaluate, and use information effectively aligns with the purpose of a clinical decision support system. This system enables the nurse to access evidence-based information, guidelines, and recommendations to enhance their decision-making process and improve patient outcomes. Summary of why other choices are incorrect: A: Computer competency does not equate to informatics competency. While computer skills are important, informatics involves a deeper understanding of using information effectively in practice. B: This choice provides a detailed explanation of informatics but does not directly address the type of system or design the nurse would be using to find, evaluate, and use information effectively. D: Nursing process
Question 9 of 9
A nurse is using SOLER to facilitate active listening.Which technique should the nurse use for R?
Correct Answer: A
Rationale: The correct answer is A: Relax. In the SOLER technique for active listening, "R" stands for Relax. This technique involves the nurse maintaining a relaxed and open body posture to show attentiveness and create a comfortable environment for the speaker. This helps to build trust and encourages the speaker to express themselves freely. Choice B: Respect is incorrect as it refers to showing respect towards the speaker, which is important in communication but not specifically related to the relaxation aspect of active listening. Choice C: Reminisce is incorrect as it means to recall past experiences or memories, which is not part of the SOLER technique for active listening. Choice D: Reassure is incorrect as it involves providing comfort or support to the speaker, which is different from the relaxation required for active listening.