ATI RN
hesi health assessment test bank 2023 Questions
Question 1 of 5
The nurse is teaching parents of a newborn about feeding their infant. Which instruction should the nurse include?
Correct Answer: A
Rationale: Rationale for Correct Answer A: 1. Using the defrost setting on microwave ovens to warm bottles is safe because it ensures even heating without creating hot spots that could burn the baby's mouth. 2. This method helps to preserve the nutrients in the breast milk or formula. 3. It is important to warm the bottle to body temperature to mimic the natural feel of breast milk for the baby's comfort. Summary of Incorrect Choices: B: Feeding the baby partially used bottles after 24 hours can increase the risk of bacterial contamination and foodborne illness. C: Mixing two parts water and one part concentrate for formula concentrate is incorrect as it may dilute the formula, leading to inadequate nutrition for the baby. D: Adding new formula to partially used bottles can alter the balance of nutrients and increase the risk of contamination, affecting the baby's health.
Question 2 of 5
Which technique is most effective for assessing the patient's abdominal organ size?
Correct Answer: B
Rationale: The correct answer is B: Palpation. Palpation is the most effective technique for assessing the patient's abdominal organ size as it allows the healthcare provider to feel and evaluate the size, texture, and consistency of the abdominal organs through touch. This hands-on approach provides valuable information about any abnormalities or tenderness in the organs. Inspection (choice A) involves looking at the abdomen for any visible signs but does not provide information on organ size. Percussion (choice C) involves tapping on the abdomen to assess the density of underlying structures, not specifically organ size. Auscultation (choice D) involves listening to sounds within the abdomen and does not directly assess organ size. Palpation is the preferred method for accurately assessing abdominal organ size due to its tactile nature.
Question 3 of 5
What is the priority nursing action for a client who is experiencing severe chest pain?
Correct Answer: A
Rationale: The correct answer is A: Administer nitroglycerin. The priority nursing action for a client experiencing severe chest pain is to administer nitroglycerin to help dilate the blood vessels and improve blood flow to the heart, reducing chest pain. This action helps to address the immediate issue of chest pain and potential heart damage. Administering morphine (B) may be considered if chest pain persists despite nitroglycerin. Administering oxygen (C) can also be helpful but is not the initial priority. Monitoring blood pressure (D) is important but not the most urgent action in this scenario.
Question 4 of 5
A nurse is assessing a patient with a history of smoking. The patient reports a persistent cough that has worsened over the past few months. The nurse would be most concerned about the possibility of:
Correct Answer: B
Rationale: The correct answer is B: Chronic obstructive pulmonary disease (COPD). The patient's history of smoking, persistent cough, and worsening symptoms over months are indicative of COPD, a progressive lung disease commonly caused by smoking. Asthma (A) typically presents with intermittent symptoms, bronchitis (C) may cause cough but not necessarily worsening over time, and pulmonary embolism (D) is characterized by sudden onset symptoms and is less likely in this case. COPD is the most concerning due to the patient's smoking history and progressive symptoms.
Question 5 of 5
What is the most appropriate action when a client presents with acute abdominal pain?
Correct Answer: C
Rationale: The correct answer is C: Monitor blood pressure. When a client presents with acute abdominal pain, monitoring blood pressure is crucial as it can help assess for potential complications like hypovolemic shock or internal bleeding. Changes in blood pressure may indicate worsening condition and prompt the need for immediate intervention. Monitoring vital signs (A) is important but blood pressure takes precedence in this scenario. Assessing abdominal tenderness (B) is valuable but does not directly address potential life-threatening issues. Monitoring for dehydration (D) is also important but not the most immediate concern in the case of acute abdominal pain.
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