ATI RN
foundations of nursing test bank Questions
Question 1 of 9
Which maternal condition always necessitates delivery by cesarean birth?
Correct Answer: B
Rationale: The correct answer is B: Total placenta previa. In this condition, the placenta completely covers the cervix, posing a risk of severe bleeding during vaginal delivery. Cesarean birth is necessary to avoid potential life-threatening complications for both the mother and the baby. Partial abruptio placentae (choice A) involves premature separation of the placenta, but it doesn't always require a cesarean birth. Ectopic pregnancy (choice C) occurs when the fertilized egg implants outside the uterus, typically requiring surgical intervention but not always a cesarean birth. Eclampsia (choice D) is a serious condition characterized by high blood pressure and seizures, but it doesn't always necessitate cesarean birth unless there are other complications that require it.
Question 2 of 9
A patient with mastoiditis is admitted to the post-surgical unit after undergoing a radical mastoidectomy. The nurse should identify what priority of postoperative care?
Correct Answer: A
Rationale: The correct answer is A: Assessing for mouth droop and decreased lateral eye gaze. After a radical mastoidectomy, the nurse should prioritize assessing for signs of facial nerve damage, such as mouth droop and decreased lateral eye gaze, which can indicate injury to the facial nerve during surgery. This is crucial as immediate intervention may be needed to prevent long-term complications. Choices B, C, and D are incorrect: B: Assessing for increased middle ear pressure and perforated ear drum is not the priority postoperative care for a radical mastoidectomy patient. C: Assessing for gradual onset of conductive hearing loss and nystagmus is not the priority as these are not immediate concerns postoperatively. D: Assessing for scar tissue and cerumen obstructing the auditory canal is not the priority as these are not immediate postoperative complications that require urgent attention.
Question 3 of 9
A nurse is charting on a patient’s record. Whichaction will the nurse take that is accurate legally?
Correct Answer: A
Rationale: The correct answer is A: Charts legibly. This is accurate legally because clear and legible documentation is crucial for accurately conveying patient information, ensuring continuity of care, and meeting legal standards. Illegible handwriting can lead to errors in patient care and legal issues. Choice B is incorrect as labeling a patient as "belligerent" without evidence can be perceived as unprofessional and potentially harmful to the patient. Choice C is incorrect as writing an entry for another nurse can lead to inaccurate documentation and legal consequences. Choice D is incorrect because using correction fluid can raise suspicion of tampering with records and compromise the integrity of the documentation.
Question 4 of 9
A nurse is using the RESPECT mnemonic to establishrapport, the “R” in RESPECT. Which actions should the nurse take? (Select all that apply.)
Correct Answer: A
Rationale: The correct answer is A: Connect on a social level. In the RESPECT mnemonic, "R" stands for "Rapport," which is crucial in building a therapeutic relationship with the patient. Connecting on a social level helps establish trust, empathy, and understanding between the nurse and the patient. This connection can lead to better communication, collaboration, and ultimately improved patient outcomes. Summary: - Choice B: Helping the patient overcome barriers is important but not specifically related to establishing rapport in the RESPECT mnemonic. - Choice C: Suspending judgment is important for effective communication but does not directly address building rapport. - Choice D: Stressing collaboration is valuable but does not specifically focus on connecting on a social level to build rapport.
Question 5 of 9
A child has been diagnosed with a severe walnut allergy after suffering an anaphylactic reaction. What is a priority for health education?
Correct Answer: B
Rationale: The correct answer is B: The need for the parents to carry an epinephrine pen. This is the priority for health education because in case of another anaphylactic reaction to walnuts, immediate administration of epinephrine can be life-saving. Immunotherapy (choice A) is not the primary focus in an emergency situation. Maintaining immunization status (choice C) is important but not as critical as having an epinephrine pen. Avoiding high potential allergens (choice D) is important but having an epinephrine pen takes precedence in managing severe allergic reactions.
Question 6 of 9
A nurse completes a nursing history form when a patient is admitted to a nursing unit, not when the patient is discharged. SOAP notes are not given to patients who are being discharged. SOAP notes are a type of documentation style. A home health nurse is preparing for an initialhome visit. Which information should be included in the patient’s home care medical record?
Correct Answer: D
Rationale: The correct answer is D: Reports to third-party payers. In home health care, it is essential to document and report patient care to third-party payers for reimbursement purposes. This includes detailed reports on the services provided, patient progress, and any changes in the care plan. This information is crucial for ensuring that the patient receives appropriate reimbursement for the care received. Incorrect choices: A: Nursing process form - While a nursing process form is important for documenting patient care, it is not specifically related to reporting to third-party payers. B: Step-by-step skills manual - While a skills manual may be helpful for guiding care provision, it is not typically included in the patient's medical record. C: A list of possible procedures - While a list of procedures may be useful for reference, it is not a formal part of the patient's medical record for home care documentation.
Question 7 of 9
A nurse is working at a health fair screening people for liver cancer. Which population group should the nurse monitor mostclosely for liver cancer?
Correct Answer: B
Rationale: The correct answer is B: Asian Americans. Asian Americans have a higher incidence of liver cancer compared to other population groups due to factors such as chronic hepatitis B infection and dietary aflatoxin exposure. Monitoring this group closely is essential for early detection and intervention. Incorrect choices: A: Hispanic - While Hispanics have a higher prevalence of fatty liver disease, the highest risk of liver cancer is not among this group. C: Non-Hispanic Caucasians - Caucasians have a lower incidence of liver cancer compared to Asian Americans. D: Non-Hispanic African-Americans - African-Americans have a lower risk of liver cancer compared to Asian Americans due to differences in risk factors and prevalence of hepatitis B.
Question 8 of 9
An older adult with a recent history of mixed hearing loss has been diagnosed with a cholesteatoma. What should this patient be taught about this diagnosis? Select all that apply
Correct Answer: C
Rationale: The correct answer is C. Cholesteatomas are often the result of chronic otitis media. Chronic otitis media can lead to the formation of cholesteatomas, which are noncancerous but can cause complications if left untreated. Cholesteatomas do not resolve spontaneously (A), are not the result of metastasis (B), do not typically cause intractable neuropathic pain (D), and usually require surgical removal to prevent complications (E). Therefore, educating the patient about the association between chronic otitis media and cholesteatoma is essential for understanding the diagnosis and potential treatment options.
Question 9 of 9
A public health nurse is teaching a health promotion workshop that focuses on vision and eye health. What should this nurse cite as the most common causes of blindness and visual impairment among adults over the age of 40? Select all that apply.
Correct Answer: A
Rationale: The correct answer is A: Diabetic retinopathy. This is because diabetic retinopathy is a leading cause of blindness in adults over 40, resulting from diabetes affecting blood vessels in the retina. Trauma (B) is a common cause of visual impairment but not as prevalent as diabetic retinopathy in this age group. Macular degeneration (C) primarily affects older individuals, typically over 50, rather than those over 40. Cytomegalovirus (D) is a cause of blindness in immunocompromised individuals, not specific to the age group mentioned. Glaucoma (E) is a leading cause of blindness worldwide but is more common in older adults and not specifically over 40.