ATI RN
jarvis health assessment test bank Questions
Question 1 of 5
What is the priority nursing intervention for a client experiencing chest pain and a history of heart disease?
Correct Answer: A
Rationale: The correct answer is A: Administer nitroglycerin. This is the priority intervention because nitroglycerin helps dilate blood vessels, reducing chest pain in clients with heart disease. It improves blood flow to the heart, relieving ischemia. Morphine (B) can mask symptoms and should be used if pain persists after nitroglycerin. Beta blockers (C) are beneficial in chronic management but not for immediate relief. Aspirin (D) helps prevent clot formation but is not the priority in acute chest pain.
Question 2 of 5
What is the most important nursing intervention for a client with an open fracture?
Correct Answer: A
Rationale: The correct answer is A: Apply a sterile dressing. This is the most important intervention to prevent infection and protect the wound. Applying a sterile dressing helps maintain a clean environment, reduces the risk of contamination, and promotes wound healing. Administering fluids (B) may be necessary but is not the top priority. Administering IV antibiotics (C) may be required but is secondary to wound care. Monitoring for bleeding (D) is important but addressing the wound with a sterile dressing takes precedence to prevent infection.
Question 3 of 5
A 5-year-old boy is being admitted to the hospital to have his tonsils removeWhich of the following information should be collected before this procedure?
Correct Answer: D
Rationale: The correct answer is D: Reactions to previous hospitalizations. Before any medical procedure, it is crucial to gather information about the child's previous reactions to hospitalizations to ensure the safety and well-being of the child during the tonsil removal. This information helps healthcare providers anticipate and prevent potential complications based on past experiences. A: The child's birth weight is irrelevant to the tonsil removal procedure and does not impact the current situation. B: The age at which he started to crawl is not relevant to the tonsil removal procedure and does not provide any useful information for the medical staff. C: Whether he has had the measles is not directly related to the tonsil removal procedure and does not influence the immediate care needed for the child.
Question 4 of 5
When using the mnemonic PQRSTU to help remember all the points of a patient's perception of his or her problem, what does the "S" signify?
Correct Answer: C
Rationale: The correct answer is C: Severity. In the PQRSTU mnemonic, "S" stands for Severity, which refers to the intensity or seriousness of the symptoms experienced by the patient. This is crucial in assessing the impact of the problem on the patient's health and well-being. Incorrect choices: A: Swelling - Swelling is a physical symptom and does not encompass all aspects of the patient's perception. B: Subjectivity - While the patient's subjective experience is important, it does not specifically refer to severity. D: Symptoms - While symptoms are part of the patient's perception, the "S" in PQRSTU specifically focuses on the severity of those symptoms.
Question 5 of 5
What is the priority action when a client with a history of seizures experiences one?
Correct Answer: B
Rationale: The correct answer is B: Place in a safe environment. This is the priority action because it ensures the client's safety by preventing injury during the seizure. Placing the client in a safe environment involves removing any objects that could harm them, such as sharp objects or furniture. Positioning on their side (choice A) is important after the seizure to prevent aspiration. Applying warm compresses (choice C) is not indicated during a seizure. Inserting an oral airway (choice D) is not recommended as it can be dangerous during a seizure and should only be done if the client is not breathing after the seizure.
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