ATI RN
ATI Fundamentals
1. A healthcare provider is caring for a client following a thoracentesis. Which of the following manifestations should the healthcare provider NOT recognize as risks for complications?
- A. Dyspnea
- B. Localized bloody drainage on the dressing
- C. Fever
- D. Hypotension
Correct answer: B
Rationale: After a thoracentesis, some expected complications include dyspnea, fever, and hypotension. Localized bloody drainage on the dressing is a common and expected finding post-thoracentesis due to the procedure's nature of puncturing the chest wall. Therefore, the healthcare provider should not consider this finding as a risk for complications.
2. Which of the following principles of primary nursing has proven the most satisfying to the patient and nurse?
- A. Administer oxygen by Venturi mask at 24% as needed
- B. Allow a 1-hour rest period between activities
- C. Patients and nurses both respond well to primary nursing care units
- D. Studies have shown that patients and nurses both respond well to primary nursing care units
Correct answer: C
Rationale: Primary nursing care units have been proven to be highly satisfying for both patients and nurses. This model promotes a consistent and continuous relationship between a patient and a primary nurse, leading to improved communication, personalized care, and overall satisfaction for both parties involved.
3. A patient presents with an exacerbation of chronic obstructive pulmonary disease (COPD) characterized by shortness of breath, orthopnea, thick, tenacious secretions, and a dry hacking cough. An appropriate nursing diagnosis would be:
- A. Ineffective airway clearance related to thick, tenacious secretions.
- B. Ineffective airway clearance related to dry, hacking cough.
- C. Ineffective individual coping with COPD.
- D. Pain related to immobilization of affected leg.
Correct answer: A
Rationale: The patient's symptoms of shortness of breath, orthopnea, thick, tenacious secretions, and a dry hacking cough all point towards a potential airway clearance issue. This makes option A, 'Ineffective airway clearance related to thick, tenacious secretions,' the most appropriate nursing diagnosis. It directly addresses the thick secretions and suggests a potential cause of the breathing difficulty the patient is experiencing.
4. If a patient asks the nurse for her opinion about a particular physician and the nurse replies that the physician is incompetent, the nurse could be held liable for:
- A. Slander
- B. Libel
- C. Assault
- D. Respondent superior
Correct answer: A
Rationale: In this scenario, if the nurse makes a false verbal statement about the physician being incompetent, it is considered slander. Slander is the act of making defamatory spoken statements or gestures. Libel, on the other hand, refers to defamatory statements that are written or published. Assault involves the threat of physical harm, and respondent superior is a legal doctrine holding an employer responsible for the actions of an employee in the course of employment.
5. During a client's first hospitalization, which of the following actions ensures the safety of the client?
- A. Keep unnecessary furniture out of the way
- B. Keep the lights on at all times
- C. Keep side rails up at all times
- D. Keep all equipment out of view
Correct answer: A
Rationale: During a client's first hospitalization, it is essential to keep unnecessary furniture out of the way to prevent obstacles and ensure a safe environment. This action helps reduce the risk of accidents or falls, promoting the client's safety and well-being. Keeping the lights on at all times may not be necessary and can disrupt the client's rest. Keeping side rails up at all times can restrict the client's movement and independence unnecessarily. Keeping all equipment out of view may hinder the healthcare team's ability to monitor and access necessary tools for providing care.
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