ATI RN
ATI Nursing Specialty
1. A nurse is preparing for the hospital admission of a client who is suspected to have active tuberculosis (TB). Which of the following precautions should the nurse plan to implement to safely care for this client?
- A. Staff and visitors should wear gowns, masks, and gloves while in the client's room.
- B. The client should be placed in a private room with a special ventilation system.
- C. The client may be placed in a room with other clients who require droplet isolation precautions.
- D. The protocol for donning and removing personal protective equipment before entering or leaving the room of a client with TB is different than for clients who are in other types of isolation.
Correct answer: B
Rationale: When caring for a client suspected of having active tuberculosis (TB), it is essential to place the client in a private room with a special ventilation system to prevent the spread of TB bacteria to others. Choice A is incorrect because staff and visitors should wear respiratory protection, not just gowns, masks, and gloves. Choice C is incorrect as clients with TB should not be placed in a room with other clients, as they need to be isolated to prevent transmission. Choice D is incorrect because the protocol for donning and removing personal protective equipment for clients with TB is similar to other types of isolation, focusing on proper infection control measures.
2. A client who is HIV-positive, has pneumonia and is not responding to antibiotic therapy may have active pulmonary tuberculosis (TB) due to exposure history and symptoms of night sweats and hemoptysis. Which test is the most reliable to confirm the diagnosis of active pulmonary TB?
- A. Chest x-ray
- B. Presence of bronchophony
- C. Mantoux test
- D. Sputum culture for acid-fast bacillus
Correct answer: D
Rationale: The correct answer is D: Sputum culture for acid-fast bacillus. The most reliable test to confirm the diagnosis of active pulmonary TB is the sputum culture for acid-fast bacillus. This test helps identify the presence of Mycobacterium tuberculosis, the causative agent of TB, in the sputum. Chest x-rays can show characteristic findings of TB but are not as reliable as sputum cultures for confirmation. Bronchophony is a test for assessing vocal resonance and is not specific for TB diagnosis. The Mantoux test is a screening test for TB exposure but cannot confirm active disease.
3. During a home visit, a nurse sees a client with COPD receiving oxygen at 2 L/min through a nasal cannula. The client reports difficulty breathing. What is the priority nursing action at this time?
- A. Increase the oxygen flow to 3 L/min.
- B. Evaluate the client's respiratory status.
- C. Call emergency services for the client.
- D. Instruct the client to cough and clear secretions.
Correct answer: B
Rationale: The priority nursing action in this situation is to evaluate the client's respiratory status. When a client with COPD on oxygen therapy experiences difficulty breathing, the nurse should first assess the client's respiratory status to determine the severity of the situation. Increasing the oxygen flow without proper assessment can be harmful if not clinically indicated. While calling emergency services may eventually be necessary, it should not be the immediate action without assessing the client first. Instructing the client to cough and clear secretions is not appropriate as the nurse needs to evaluate the respiratory status before proceeding with interventions.
4. A nurse is assessing a client who has COPD. The nurse should expect the client's chest to be which of the following shapes?
- A. Pigeon
- B. Funnel
- C. Kyphotic
- D. Barrel
Correct answer: D
Rationale: When assessing a client with COPD, the nurse should expect the client's chest to be barrel-shaped. This shape is a classic characteristic of COPD due to hyperinflation of the lungs. A 'Pigeon' chest shape is associated with pectus carinatum, a deformity of the chest wall. A 'Funnel' chest shape is seen in conditions like pectus excavatum. 'Kyphotic' refers to an exaggerated outward curvature of the thoracic spine. Therefore, the correct answer is 'Barrel' as it is the expected chest shape in clients with COPD.
5. A client with peripheral arterial disease (PAD) is experiencing muscle pain or cramping during physical activity that resolves with rest. Which of the following symptoms is typically the initial reason clients with PAD seek medical attention?
- A. Intermittent claudication
- B. Dependent rubor
- C. Rest pain
- D. Foot ulcers
Correct answer: A
Rationale: The correct answer is Intermittent claudication. Intermittent claudication, which manifests as muscle pain or cramping during physical activity that improves with rest, is typically the initial reason clients with PAD seek medical attention. Dependent rubor, rest pain, and foot ulcers are more advanced symptoms of PAD and are not usually the initial reasons for seeking medical care.
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