ATI RN
Adult Health Nursing Test Banks Questions
Question 1 of 9
The PRIORITY nursing action of the nurse for Jose due for oxygen therapy is _____.
Correct Answer: C
Rationale: The PRIORITY nursing action of the nurse for Jose due for oxygen therapy is to turn on the oxygen. Ensuring that the oxygen is turned on is the necessary first step before any other actions can be effective in delivering oxygen to the patient. Without oxygen being turned on, all other steps such as attaching the humidifier, connecting tubing, or adjusting the flow rate would be ineffective in providing the necessary oxygen therapy to the patient. Therefore, turning on the oxygen is the most crucial initial step to take in this situation to ensure that the patient receives the needed oxygen promptly and safely.
Question 2 of 9
Because Mr. Steve cannot pay for his medical bills, he is referred to the social worker. which of the following rights is applicable in this case the right to_______.
Correct Answer: A
Rationale: The right to considerate and respectful care irrespective of socio-economic status is applicable in this case because Mr. Steve is facing financial difficulties in paying for his medical bills. This right ensures that all patients receive proper treatment and care regardless of their ability to pay. It emphasizes that every individual deserves to be treated with dignity and respect, regardless of their financial situation. In Mr. Steve's case, being referred to a social worker due to inability to pay should not impact the quality of care and respect he receives from healthcare providers.
Question 3 of 9
In the community setting which is ESSENTIAL record about the patient?
Correct Answer: B
Rationale: In the community setting, the essential record about the patient is the patient's chart. This chart contains all important information about the patient, including medical history, treatment plans, medications, progress notes, and any other pertinent information related to the patient's care. It serves as a crucial document for healthcare providers to track and monitor the patient's health status, facilitate communication among team members, ensure continuity of care, and make informed clinical decisions. The patient's chart is a comprehensive and centralized source of information that guides the delivery of quality care in the community setting.
Question 4 of 9
The PRIORITY nursing action of the nurse for Jose due for oxygen therapy is _____.
Correct Answer: C
Rationale: The PRIORITY nursing action of the nurse for Jose due for oxygen therapy is to turn on the oxygen. Ensuring that the oxygen is turned on is the necessary first step before any other actions can be effective in delivering oxygen to the patient. Without oxygen being turned on, all other steps such as attaching the humidifier, connecting tubing, or adjusting the flow rate would be ineffective in providing the necessary oxygen therapy to the patient. Therefore, turning on the oxygen is the most crucial initial step to take in this situation to ensure that the patient receives the needed oxygen promptly and safely.
Question 5 of 9
A patient presents with a sensation of a foreign body stuck in the throat, difficulty swallowing, and odynophagia. Flexible laryngoscopy reveals a submucosal mass arising from the posterior pharyngeal wall. Which of the following conditions is most likely responsible for this presentation?
Correct Answer: A
Rationale: Zenker's diverticulum is a condition in which there is a pouch or sac that forms at the posterior pharyngeal wall above the upper esophageal sphincter. It can present with symptoms such as sensation of a foreign body stuck in the throat, difficulty swallowing (dysphagia), and odynophagia (painful swallowing). Flexible laryngoscopy can reveal a submucosal mass arising from the posterior pharyngeal wall, which is characteristic of Zenker's diverticulum.
Question 6 of 9
During the active phase of labor, the nurse observes that the cervix is dilated to 6 cm and the contractions are regular, lasting 60 seconds each, occurring every 3 minutes. What action should the nurse take?
Correct Answer: D
Rationale: During the active phase of labor, a cervical dilation of 6 cm and regular contractions lasting 60 seconds each, occurring every 3 minutes indicate good progress in labor. The nurse should continue to monitor the progress closely by assessing the mother's vital signs, fetal heart rate, and the pattern of contractions. It is important to provide support and encouragement to the mother, continue with comfort measures, and be prepared to assist with the delivery when the cervix is fully dilated. This stage of labor is focused on active dilation and effacement of the cervix, and it is not yet time for the mother to push or for the nurse to administer oxytocin to augment labor.
Question 7 of 9
A patient with a history of chronic obstructive pulmonary disease (COPD) presents with increased dyspnea and cough productive of purulent sputum. On auscultation, coarse crackles are heard bilaterally. Which complication of COPD is the patient most likely experiencing?
Correct Answer: A
Rationale: The patient with a history of COPD presenting with increased dyspnea, cough productive of purulent sputum, and coarse crackles on auscultation is most likely experiencing an acute exacerbation of COPD. Acute exacerbations in COPD are defined as sustained worsening of the patient's respiratory symptoms beyond normal day-to-day variations, leading to a change in medication. Common triggers for exacerbations include respiratory infections, air pollution, and non-compliance with medications.
Question 8 of 9
A postpartum client who delivered a macrosomic infant expresses concerns about breastfeeding difficulties due to the baby's size. What nursing intervention should be prioritized to support successful breastfeeding in this situation?
Correct Answer: A
Rationale: Providing education on techniques to improve latch and milk transfer should be prioritized to support successful breastfeeding in this situation. Newborns who are macrosomic (large for gestational age) may have difficulties latching due to their size and may require additional support to effectively breastfeed. By educating the postpartum client on proper latch techniques and milk transfer, the nurse can help optimize the breastfeeding experience for both the mother and baby. This intervention focuses on addressing the specific concerns related to the infant's size and aims to promote successful breastfeeding despite potential challenges. As such, recommending supplemental formula feedings, encouraging the client to avoid breastfeeding, or immediately referring to a lactation consultant may not directly address the immediate need for support in improving breastfeeding in this situation.
Question 9 of 9
A patient in the ICU develops catheter-related bloodstream infection (CRBSI) associated with a central venous catheter. What intervention should the healthcare team prioritize to manage the patient's infection?
Correct Answer: A
Rationale: The primary intervention that should be prioritized for managing a catheter-related bloodstream infection (CRBSI) associated with a central venous catheter is to remove the central venous catheter. CRBSI is a serious complication that can lead to severe infections and sepsis. The removal of the catheter is crucial to eliminate the source of the infection and prevent further dissemination of the pathogens into the bloodstream. Once the catheter is removed, the healthcare team can consider other interventions such as administering targeted antibiotics based on culture results, performing blood cultures to identify the causative organism, and implementing sterile dressing changes and catheter care protocols. However, immediate removal of the catheter takes precedence in managing CRBSI to prevent worsening of the infection and improve patient outcomes.