ATI RN
Foundations and Adult Health Nursing Study Guide Answers Questions
Question 1 of 9
Which of the following salivary glands is located superior and anterior to the ear and produces mainly serous saliva?
Correct Answer: A
Rationale: The parotid gland is the salivary gland that is located superior and anterior to the ear. It mainly produces serous saliva, which is a thin, watery fluid rich in enzymes. The other salivary glands mentioned are the sublingual gland, submandibular gland, and submaxillary gland, all of which have different locations and produce different types of saliva.
Question 2 of 9
Which of the following is NOT TRUE of type 2 diabetes Mellitus?
Correct Answer: C
Rationale: Type 2 diabetes mellitus is characterized by insulin resistance in the peripheral tissues and defective beta cell secretion with loss of insulin. In type 2 diabetes, there is typically not destruction of beta cells from an autoimmune mechanism that leads to lack of insulin and hyperglycemia as seen in type 1 diabetes mellitus. Instead, in type 2 diabetes, the pancreas initially produces insulin, but the body's cells become resistant to its effects. This results in hyperglycemia due to the inability of the body to properly regulate blood sugar levels. Therefore, choice C is not true for type 2 diabetes mellitus.
Question 3 of 9
A pregnant woman presents with painless, bright red vaginal bleeding at 34 weeks gestation. On examination, the cervix is found to be closed. Which of the following conditions is the most likely cause of these symptoms?
Correct Answer: C
Rationale: Placenta previa is a condition where the placenta partially or completely covers the cervix, leading to painless vaginal bleeding during pregnancy. In the scenario described, the painless, bright red vaginal bleeding at 34 weeks gestation with a closed cervix is classic for placenta previa. This condition is more common in the third trimester and can be diagnosed through ultrasound. It is important to manage placenta previa carefully to prevent complications such as severe bleeding, preterm birth, and maternal/fetal distress.
Question 4 of 9
Primary care nursing is organized so that the patient is at the center of the structure. How many nurses have 24-hour responsibility for care planning and coordination?
Correct Answer: A
Rationale: In primary care nursing, typically, one nurse is designated to have 24-hour responsibility for care planning and coordination for each patient. This helps ensure continuity of care and accountability. By having one nurse overseeing all aspects of the patient's care, it allows for a more personalized and coordinated approach that puts the patient at the center of the care structure. Having one primary care nurse also promotes better communication, efficiency, and consistency in managing the patient's health and well-being.
Question 5 of 9
Nurse Noli should include in his teachings the following EXCEPT:
Correct Answer: D
Rationale: Nurse Noli should include in his teachings less saturated fat, maintaining weight within normal limits, and exercising regularly as these are all components of a healthy lifestyle. However, including "more fats in the diet" goes against the principles of healthy eating and weight management. Consuming excessive amounts of fats, especially unhealthy saturated fats, can contribute to various health issues such as obesity, cardiovascular diseases, and other medical conditions. Therefore, it is crucial for Nurse Noli to emphasize reducing saturated fat intake rather than promoting more fats in the diet for overall health and wellness.
Question 6 of 9
After the successful vaginal1 delivery, medication was ordered to be given immediately. The supervisor reassured the newly hired nurse that everything will be fine because the medication will
Correct Answer: B
Rationale: The medication given after a successful vaginal delivery that helps to hasten uterine contractility and control bleeding is typically an oxytocic agent, such as oxytocin. Oxytocin helps the uterus to contract effectively, which is important for preventing excessive bleeding after delivery. This medication is commonly used in the postpartum period to help the uterus return to its normal size and position. The supervisor reassured the newly hired nurse that everything will be fine because this medication will help promote uterine contractions and control bleeding, which are crucial steps in the postpartum management.
Question 7 of 9
A postpartum client who delivered via cesarean section expresses concerns about abdominal incision care and the prevention of wound complications. What nursing intervention should be prioritized to promote optimal incision healing?
Correct Answer: A
Rationale: Nursing intervention should prioritize providing education on proper incisional wound care techniques to promote optimal healing of the abdominal incision. This may include instructions on how to clean the incision site, signs and symptoms of infection, and when to seek medical attention. Proper wound care can help prevent complications such as infection and dehiscence, leading to better outcomes for the client. Administering prophylactic antibiotics, encouraging the use of abdominal binders, and instructing the client on activity restrictions are also important interventions, but educating the client on wound care techniques is crucial for their active participation in their recovery process.
Question 8 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.
Question 9 of 9
A woman in active labor is experiencing prolonged rupture of membranes (>24 hours). What complication should the nurse assess for in the mother and fetus?
Correct Answer: A
Rationale: Prolonged rupture of membranes (>24 hours) increases the risk of intrauterine infection for both the mother and the fetus. When the amniotic sac has been ruptured for an extended period, there is a higher likelihood of bacteria entering the uterus, leading to chorioamnionitis (inflammation of the fetal membranes due to infection). Intrauterine infection can be dangerous for both the mother and fetus, potentially causing sepsis, preterm labor, and other complications. Therefore, it is crucial for the nurse to assess for signs and symptoms of infection in both the mother and fetus when managing a woman in active labor with prolonged rupture of membranes.