ATI RN
test bank foundations of nursing Questions
Question 1 of 5
The patient is an 80-year-old male who is visiting the clinic today for a routine physical examination. The patient’s skin turgor is fair, but the patient reports fatigue and weakness. The skin is warm and dry, pulse rate is 116 beats/min, and urinary sodium level is slightly elevated. Which instruction should the nurse provide?
Correct Answer: A
Rationale: The correct answer is A: Drink more water to prevent further dehydration. Given the patient's fair skin turgor, fatigue, weakness, warm and dry skin, elevated pulse rate, and slightly elevated urinary sodium level, these are signs of dehydration. Increasing water intake would help improve the patient's hydration status. Other choices are incorrect because B (calorie-dense fluids) does not address the dehydration issue, C (milk and dairy products) does not directly address the symptoms presented, and D (grapefruit juice) is not essential for hydration in this case.
Question 2 of 5
A nurse is performing the admission assessment of a patient who has AIDS. What components should the nurse include in this comprehensive assessment? Select all that apply.
Correct Answer: A
Rationale: The correct answer is A: Current medication regimen. In the admission assessment of a patient with AIDS, it is crucial to assess the patient's current medication regimen to ensure proper management of the condition. This includes antiretroviral therapy, prophylactic medications, and any other medications the patient may be taking to manage comorbidities. Understanding the medications the patient is currently taking allows the nurse to assess for potential drug interactions, side effects, and adherence to the treatment plan. This information is essential for providing safe and effective care for the patient. Choice B: Identification of patients support system is important but not a specific component of the comprehensive assessment for a patient with AIDS. Choice C: Immune system function is a relevant aspect in a patient with AIDS, but it is not typically assessed in the admission assessment as it requires specialized testing. Choice D: Genetic risk factors for HIV are not typically assessed in the admission assessment of a patient with AIDS as the focus is on the current condition and management
Question 3 of 5
A nurse is caring for an immigrant with low income.Which information should the nurse consider when planning care for this patient?
Correct Answer: B
Rationale: The correct answer is B: There is an increased incidence of disease. Low-income immigrants often face barriers to healthcare access, leading to higher rates of undiagnosed and untreated health conditions. This information is crucial for the nurse to plan appropriate care interventions. Incorrect choices: A: Decreased frequency of morbidity is not accurate as low-income immigrants may experience higher rates of illness due to lack of resources. C: Increased level of health is unlikely in this population due to socioeconomic factors affecting health outcomes. D: Decreased mortality rate is not supported as low-income immigrants may have higher mortality rates due to limited access to healthcare.
Question 4 of 5
A patient with a diagnosis of gastric cancer has been unable to tolerate oral food and fluid intake and her tumor location precludes the use of enteral feeding. What intervention should the nurse identify as best meeting this patients nutritional needs?
Correct Answer: B
Rationale: The correct answer is B: TPN administered via a peripherally inserted central catheter. TPN provides comprehensive nutrition intravenously, bypassing the GI tract, which is important for patients unable to tolerate oral intake. A peripherally inserted central catheter allows for long-term TPN administration. A: Administration of parenteral feeds via a peripheral IV is not ideal for long-term nutrition as it may not provide complete nutrition. C: Insertion of an NG tube may not be feasible due to the tumor location and the patient's inability to tolerate oral intake. D: Maintaining NPO status and IV hydration alone may lead to malnutrition over time as it does not provide adequate nutrition.
Question 5 of 5
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.