ATI RN
ATI RN Custom Exams Set 2
1. Determining nursing care priorities is a part of which of the following steps in determining and fulfilling the nursing care needs of the patient?
- A. Evaluation
- B. Planning
- C. Implementation
- D. Assessment
Correct answer: B
Rationale: Corrected Rationale: Planning in nursing involves setting priorities based on the patient's needs, resources, and desired outcomes. It includes organizing and coordinating care activities to achieve the identified goals. Therefore, determining nursing care priorities is a key aspect of the planning phase.\n Incorrect Rationales:\n- Evaluation (Choice A) comes after implementing the care plan to assess the effectiveness of interventions and make necessary adjustments.\n- Implementation (Choice C) is the phase where the care plan is put into action, involving carrying out the nursing interventions designed during the planning phase.\n- Assessment (Choice D) is the initial step in the nursing process where data about the patient's health status is collected and analyzed to identify needs and formulate a care plan. It precedes planning and determining care priorities.
2. The nurse is teaching a community class to people with Type 2 diabetes mellitus. Which explanation would explain the development of Type 2 diabetes?
- A. The islet cells in the pancreas stop producing insulin
- B. The client eats too many foods that are high in sugar
- C. The pituitary gland does not produce vasopressin
- D. The cells become resistant to the circulating insulin
Correct answer: D
Rationale: In Type 2 diabetes, the primary issue is insulin resistance, where cells do not respond effectively to insulin. Choice A is incorrect as in Type 1 diabetes the islet cells in the pancreas stop producing insulin. Choice B is incorrect as while excessive sugar intake can contribute to the development of Type 2 diabetes, it is not the primary cause. Choice C is incorrect as the pituitary gland's function is unrelated to the development of Type 2 diabetes.
3. Identifying the strengths and weaknesses in the nursing care plan is part of which of the following steps in determining and fulfilling the patient's nursing care needs?
- A. Evaluation
- B. Planning
- C. Implementation
- D. Assessment
Correct answer: A
Rationale: Correct. Evaluation involves assessing the effectiveness of the nursing care plan by identifying its strengths and weaknesses. This step helps in determining if the plan is meeting the patient's needs. Choice B (Planning) is incorrect because planning involves developing the nursing care plan based on the assessment of the patient's needs. Choice C (Implementation) is incorrect as it refers to putting the nursing care plan into action. Choice D (Assessment) is incorrect as assessment is the initial step in the nursing process, involving data collection and analysis to identify the patient's needs.
4. In which situation(s) can personal health information be disclosed?
- A. Compliance with legal proceedings
- B. For research purposes in limited circumstances
- C. To a family member or significant other in an emergency
- D. All of the above
Correct answer: D
Rationale: Personal health information can be disclosed in various situations. Compliance with legal proceedings allows for disclosure under specific legal requirements. Disclosure for research purposes is permitted in limited circumstances with appropriate approvals. In emergencies, information can be shared with family members or significant others. Therefore, all of the choices are correct as they represent valid scenarios for disclosing personal health information.
5. The nurse is caring for the client recovering from intestinal surgery. Which assessment finding would require immediate intervention?
- A. Presence of thin pink drainage in the Jackson Pratt
- B. Guarding when the nurse touches the abdomen
- C. Tenderness around the surgical site during palpation
- D. Complaints of chills and feeling feverish
Correct answer: D
Rationale: Complaints of chills and feeling feverish may indicate infection, which requires immediate intervention. This finding suggests a systemic response to infection, which can be life-threatening if not promptly addressed. Options A, B, and C are common postoperative findings and may not necessarily require immediate intervention unless accompanied by other concerning signs or symptoms.
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