ATI RN
jarvis health assessment test bank Questions
Question 1 of 5
What should the nurse do when a client develops a fever after surgery?
Correct Answer: C
Rationale: The correct answer is C: Monitor the client's blood pressure. When a client develops a fever after surgery, it could indicate various causes, including infection or inflammatory response. Monitoring blood pressure is essential to assess circulatory status, as fever can lead to increased heart rate and decreased blood pressure. Administering antibiotics (choice A) should only be done if infection is confirmed. Monitoring temperature and assessing for infection (choice B) is important but not the immediate priority. Administering fluid resuscitation (choice D) may be necessary based on the client's overall condition but should be guided by monitoring blood pressure.
Question 2 of 5
What is the primary intervention for a client with an acute myocardial infarction?
Correct Answer: A
Rationale: The correct answer is A: Administer aspirin. Aspirin helps prevent further clot formation by inhibiting platelet aggregation, reducing the risk of additional heart damage. It is a standard treatment in acute myocardial infarction. Administering morphine (B) may be considered for pain relief but is not the primary intervention. Monitoring vital signs (C) is important, but not the primary intervention. Administering fibrinolytics (D) is indicated in certain cases but is not the primary intervention and requires specific criteria and caution.
Question 3 of 5
Which nursing intervention is most appropriate for a client with chronic pain?
Correct Answer: B
Rationale: Correct Answer: B (Administer nonsteroidal anti-inflammatory drugs - NSAIDs) Rationale: 1. NSAIDs are commonly used for chronic pain management due to their anti-inflammatory properties. 2. NSAIDs target the underlying inflammation that often contributes to chronic pain. 3. Opioids may be reserved for severe pain due to their potential for addiction and side effects. 4. Monitoring blood pressure is important but not the primary intervention for chronic pain. 5. Acetaminophen is a mild pain reliever and may not be as effective for chronic pain compared to NSAIDs.
Question 4 of 5
What is the most appropriate nursing intervention for a client with acute pain after surgery?
Correct Answer: B
Rationale: The correct answer is B: Encourage fluid intake. Adequate hydration helps in pain management by promoting circulation and reducing inflammation. Opioids (choice A) should only be used if non-pharmacological interventions fail. Administering oxygen (choice C) is not typically indicated for pain management. Monitoring electrolyte levels (choice D) is important but not the most immediate intervention for acute pain post-surgery.
Question 5 of 5
What is the most effective action when a client with acute respiratory distress syndrome (ARDS) develops hypoxemia?
Correct Answer: A
Rationale: The correct answer is A: Administer oxygen. In ARDS, the primary issue is hypoxemia due to impaired gas exchange in the lungs. Administering oxygen helps to increase the oxygen levels in the blood, improving oxygenation to vital organs. Corticosteroids (B) are not indicated as they have not shown consistent benefit in ARDS treatment. Bronchodilators (C) are not effective as ARDS is not primarily a bronchoconstrictive disorder. Applying an ice pack to the chest (D) is not relevant and will not address the underlying hypoxemia. Administering oxygen is the most effective and essential intervention to correct hypoxemia in ARDS.