ATI RN
Foundations and Adult Health Nursing Study Guide Answers Questions
Question 1 of 9
What is the M0ST APPROPRIATE nursing diagnosis for this patient?
Correct Answer: A
Rationale: The most appropriate nursing diagnosis for this patient would be "Self-care deficit related to neuromuscular impairment." This diagnosis is supported by the information provided, which indicates that the patient is experiencing neuromuscular impairment that is likely affecting their ability to perform self-care activities. A self-care deficit diagnosis is relevant when a patient is unable to perform activities of daily living independently due to physical or cognitive limitations. In this case, the neuromuscular impairment is likely impacting the patient's ability to engage in self-care tasks, such as feeding, grooming, bathing, and dressing. By identifying and addressing this self-care deficit, the healthcare team can help the patient maintain optimal functioning and independence despite their neuromuscular impairment.
Question 2 of 9
Which of the following dental conditions is characterized by the irreversible demineralization of the enamel and dentin, leading to cavitation and destruction of tooth structure?
Correct Answer: B
Rationale: Dental caries, commonly known as tooth decay, is characterized by the irreversible demineralization of the enamel and dentin due to acids produced by bacterial activity. This process leads to cavitation and destruction of the tooth structure, ultimately resulting in the formation of a cavity. Gingivitis is inflammation of the gums, periodontitis is inflammation and infection of the supporting structures of the teeth (gums, bone, and ligaments), and a dental abscess is a collection of pus in the tissues surrounding the tooth, none of which are specifically related to the irreversible demineralization of enamel and dentin seen in dental caries.
Question 3 of 9
A nurse is preparing to assist with a magnetic resonance imaging (MRI) procedure for a patient. What action should the nurse prioritize to ensure procedural safety?
Correct Answer: A
Rationale: The nurse should prioritize screening the patient for contraindications to MRI, such as metal implants or claustrophobia, to ensure procedural safety. Metallic objects can be hazardous in an MRI environment as they can be attracted to the magnet, potentially causing harm to the patient or staff. Claustrophobia can also be a significant issue for patients undergoing an MRI scan, and identifying this beforehand allows for appropriate measures to be taken to address the patient's anxiety or discomfort. Prioritizing this screening step helps ensure the safety and well-being of the patient during the MRI procedure.
Question 4 of 9
Nurse Nora monitors the patient, knowing that which finding indicates an adequate contraction pattern?
Correct Answer: A
Rationale: An adequate contraction pattern during labor is characterized by regular contractions occurring at a frequency of three to 5 contractions in a 10-minute period, with resultant cervical dilatation. This pattern indicates efficient uterine activity that is helping to progress labor by dilating the cervix. In option A, the contractions are occurring at an appropriate frequency and are resulting in cervical dilatation, making it the correct choice for indicating an adequate contraction pattern.
Question 5 of 9
Mr. C is an older patient with a known history of peripheral vascular disease. The nurse places a heating pad directly on the patient's lower leg to relieve muscle spasms. The heating pad causes a burn, the area becomes infected, and the patient eventually must have a skin graft. This is an example of which of the following?
Correct Answer: D
Rationale: Negligence refers to the failure to take proper care in doing something. In this scenario, the nurse failed to exercise the standard of care expected in placing a heating pad directly on Mr. C's lower leg, knowing his history of peripheral vascular disease. This failure led to a burn and subsequent infection that required a skin graft for treatment. The actions of the nurse were negligent as they did not meet the expected standard of care, resulting in harm to the patient. This situation does not fit the definition of assault, malpractice, or vicarious liability, making negligence the most appropriate choice.
Question 6 of 9
Which of the following diagnostic tests is most appropriate for evaluating a woman with suspected cervical dysplasia?
Correct Answer: C
Rationale: Colposcopy with biopsy is the most appropriate diagnostic test for evaluating a woman with suspected cervical dysplasia. Colposcopy is a procedure in which a special magnifying instrument called a colposcope is used to examine the cervix for any abnormal areas. If abnormal tissue is identified during colposcopy, a biopsy will be taken to confirm the presence of cervical dysplasia and determine the severity. This allows for a more accurate diagnosis and appropriate management of the condition. Pap smear, although a screening test for cervical dysplasia, may not provide a definitive diagnosis and may require further evaluation with colposcopy and biopsy. Endometrial biopsy and transvaginal ultrasound are not indicated for evaluating cervical dysplasia specifically.
Question 7 of 9
Nurse Selma conducts her INITIAL assessment on Catherine. patient keeps on crying and constantly pulls her right ear. What is her MOST APPROPRIATE action?
Correct Answer: D
Rationale: When a patient is crying and continuously pulling at a specific body part, such as Catherine pulling her right ear, it indicates discomfort or pain in that area. Nurse Selma's most appropriate action would be to further assess the description and frequency of the pain. This will help her identify the possible cause of the pain, whether it is due to an ear infection, injury, or any other underlying issue. Understanding the nature and intensity of the pain will guide Nurse Selma in providing appropriate care and intervention for Catherine. It is crucial to address the patient's pain promptly to ensure their comfort and well-being. Referring to the attending physician may be necessary after this initial assessment but assessing the pain should be the immediate priority.
Question 8 of 9
A patient presents with a palpable thyroid nodule and signs of hyperthyroidism. Fine-needle aspiration biopsy reveals follicular cells with nuclear features suggestive of malignancy. Which endocrine disorder is most likely responsible for these symptoms?
Correct Answer: D
Rationale: Follicular thyroid carcinoma is a type of thyroid cancer that arises from the follicular cells of the thyroid gland. Patients with follicular thyroid carcinoma may present with a palpable thyroid nodule, which in this case is causing signs of hyperthyroidism due to the overproduction of thyroid hormones by the malignant cells. Fine-needle aspiration biopsy revealing follicular cells with nuclear features suggestive of malignancy further supports the diagnosis of follicular thyroid carcinoma in this scenario.
Question 9 of 9
Nurse Mary had observedthat most patients with hypertension stop taking their medications and heard them saying "I feel good already" Which is the APPROPRIATE nursing diagnosis?
Correct Answer: D
Rationale: The appropriate nursing diagnosis for this situation is "Ineffective coping" because the patients with hypertension who stop taking their medications despite feeling good may be using this behavior as a maladaptive coping mechanism. It suggests that they might not fully understand the importance of medication adherence or are struggling to accept their diagnosis. By not adhering to their prescribed treatment, they are putting themselves at risk for complications associated with uncontrolled hypertension. Therefore, the nursing diagnosis of "Ineffective coping" addresses the patients' inability to deal with their condition in a healthy manner, leading to noncompliance with their treatment regimen.