ATI RN
Multi Dimensional Care | Rasmusson
1. What is the best intervention to reduce the risk of falling in the hospital room for a blind client being cared for?
- A. Tell the client’s family that they will be expected to stay overnight
- B. Apply restraints to the client
- C. Shout to the client
- D. Orient the client to the location of objects in the room
Correct answer: D
Rationale: The best intervention to reduce the risk of falling in the hospital room for a blind client is to orient the client to the location of objects in the room. This helps the client navigate safely and independently. Choices A, B, and C are incorrect because telling the client's family to stay overnight, applying restraints, and shouting are not appropriate interventions for preventing falls in a blind client; in fact, they could potentially lead to increased anxiety and risk of falls.
2. A client with lupus experience Raynaud's phenomenon. What should the nurse include when providing client education about this?
- A. In order to avoid flare-ups of Raynaud's, ensure you wear gloves in winter.'
- B. In order to avoid flare-ups of Raynaud's, ensure you brush your teeth for 2 minutes.'
- C. In order to avoid flare-ups of Raynaud's, ensure to keep cool.'
- D. In order to avoid flare-ups of Raynaud's, ensure you wear sunscreen.'
Correct answer: A
Rationale:
3. What medication class can decrease tissue in inflammation but delays bone healing?
- A. Opioids
- B. Anticoagulants
- C. Narcotics
- D. Nonsteroidal anti-inflammatory drugs (NSAIDS)
Correct answer: D
Rationale:
4. What does CREST stand for?
- A. Calcinosis, Raynaud's, Esophageal dysmotility, Sclerodactyly and Telecines
- B. Calcinosis, Reverse isolation, Esophageal dysmotility, Sclerodactyly and Telangiectasia
- C. Calcinosis, Raynaud's, Everted colon, Sclerodactyly and Telangiectasia
- D. Calcinosis, Raynaud's Esophageal dysmotility, Sclerodactyly and telangiectasia
Correct answer: D
Rationale:
5. What should be done immediately after an ankle injury?
- A. Immobilize, heat, compress, and elevate the ankle
- B. Rest, ice, compress, and lower the ankle
- C. Rest, ice, compress, and elevate the ankle
- D. Rest, incubate, confine, and lower the ankle
Correct answer: C
Rationale: The correct answer is C: Rest, ice, compress, and elevate the ankle. After an ankle injury, it is essential to follow the RICE method (Rest, Ice, Compression, Elevation) for immediate treatment. Resting the injured ankle helps prevent further damage, applying ice reduces swelling and pain, compression with a bandage provides support and helps control swelling, and elevating the ankle above heart level reduces swelling by allowing fluid to drain away from the injury site. Choices A, B, and D are incorrect because heating, incubating, or confining the ankle can worsen the injury by increasing swelling and inflammation instead of reducing them.
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