ATI RN
ATI RN Custom Exams Set 4
1. The client is four hours post-operative abdominal aortic aneurysm repair. Which nursing intervention should be implemented for this client?
- A. Assist the client in ambulating
- B. Assess the client’s bilateral pedal pulses
- C. Maintain a continuous IV heparin drip
- D. Provide clear liquids to the client
Correct answer: B
Rationale: Assessing the client’s bilateral pedal pulses is crucial at this point to monitor the perfusion to the lower extremities after abdominal aortic aneurysm repair surgery. Ambulation (Choice A) may be appropriate but should be guided by the assessment findings. Maintaining a continuous IV heparin drip (Choice C) is not typically indicated post-operatively for this type of surgery. Providing clear liquids (Choice D) may not be suitable immediately after the surgery, as the client needs time to recover before resuming oral intake.
2. Who is at higher risk for drug-nutrient interactions?
- A. Infants
- B. People with diabetes
- C. Women of childbearing age
- D. Older men and women
Correct answer: D
Rationale: Older men and women are at higher risk for drug-nutrient interactions due to factors such as polypharmacy and physiological changes. Polypharmacy, common in older adults, increases the likelihood of interactions between drugs and nutrients. Physiological changes that occur with aging can affect how drugs and nutrients are absorbed, distributed, metabolized, and excreted in the body. Infants, people with diabetes, and women of childbearing age are not typically considered high-risk groups for drug-nutrient interactions compared to older adults.
3. Short-bowel syndrome usually occurs when:
- A. The longitudinal muscles of the intestine contract
- B. More than 50% of the small intestine is surgically removed
- C. More than 50% of the large intestine is surgically removed
- D. Transit time is decreased due to infection or drugs
Correct answer: B
Rationale: Short-bowel syndrome usually occurs when more than 50% of the small intestine is surgically removed. This condition results in malabsorption of nutrients and fluids due to the reduced length of the small intestine. Choice A is incorrect because the contraction of longitudinal muscles does not lead to short-bowel syndrome. Choice C is incorrect as short-bowel syndrome is primarily related to the small intestine, not the large intestine. Choice D is incorrect since decreased transit time due to infection or drugs is not a direct cause of short-bowel syndrome.
4. The nurse is preparing to assist in examining a Hispanic child who was brought to the clinic by the mother. During the assessment of the child, the nurse should take which action(s)?
- A. Admiring the child
- B. Taking the child’s temperature
- C. A, D
- D. Obtaining an interpreter if necessary
Correct answer: C
Rationale: In a multicultural healthcare setting, it's essential for the nurse to build rapport with the child and family. Admiring the child can help establish trust and comfort. Additionally, since the child's mother brought them to the clinic, it's crucial to ensure effective communication. Obtaining an interpreter, if necessary, is vital for clear and accurate information exchange. Taking the child's temperature, while important in a physical assessment, is not specifically highlighted in this scenario. Therefore, choices A and B alone are not sufficient, making the correct answer C, which includes both building rapport by admiring the child and ensuring clear communication by obtaining an interpreter if needed.
5. Determining whether the care provided is appropriate and effective in relation to the patient's current physiological and psychological status is a part of which of the following steps for determining and fulfilling the nursing care needs of the patient?
- A. Evaluation
- B. Planning
- C. Implementation
- D. Assessment
Correct answer: A
Rationale: The correct answer is A: Evaluation. Evaluation involves assessing the appropriateness and effectiveness of care provided to the patient. It helps determine if the care aligns with the patient's current physiological and psychological status. Choice B, Planning, refers to developing a plan of care based on assessment data. Choice C, Implementation, involves carrying out the planned interventions. Choice D, Assessment, is the initial step that involves collecting data about the patient's condition.
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