ATI RN
ATI RN Custom Exams Set 1
1. When measuring the leg circumference of a client with bipedal edema, what position is best to ensure accurate measurements?
- A. Dorsal recumbent
- B. Sitting
- C. Standing
- D. Supine
Correct answer: A
Rationale: When measuring the leg circumference of a client with bipedal edema, the best position to ensure accurate and consistent measurements is the dorsal recumbent position. This position allows the legs to be positioned comfortably, and the individual is lying on their back with legs extended, facilitating accurate measurement of the circumference without the influence of gravity. Sitting, standing, and supine positions may not provide optimal conditions for accurate leg circumference measurements, particularly in clients with bipedal edema where positioning and consistency are crucial. Sitting and standing positions may not allow for consistent leg positioning and could introduce errors due to the effects of gravity on the fluid distribution. The supine position, while similar to dorsal recumbent, may not be as comfortable for the client and could still be influenced by gravity when measuring leg circumference.
2. Participating in the development of long-term and preventive health goals with the patient and their family 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: B
Rationale: The correct answer is B: Planning. In the nursing process, planning involves developing long-term and preventive health goals in collaboration with the patient and their family. This step focuses on outlining the strategies and interventions needed to achieve the desired outcomes. Choice A, Evaluation, occurs after interventions are implemented to assess the effectiveness of the care provided. Choice C, Implementation, involves carrying out the planned interventions. Choice D, Assessment, is the initial step in the nursing process that involves collecting data to identify the patient's needs and health status.
3. The nurse instructs a client 5 days after a lumbar laminectomy with spinal fusion about how to move from a supine position to standing at the left side of the bed with a walker. Which of the following directions by the nurse is BEST?
- A. Raise the head of the bed so you are sitting straight up, bend your knees, and swing your legs to the side and then to the floor
- B. Rock your body from side to side, going further each time until you build up enough momentum to be lying on your right side, and then raise your trunk toward your toes
- C. Reach over to the left side rail with your right hand, pull your body onto its side, bend your upper leg so the foot is on the bed, and push down to elevate your trunk
- D. Focus on using your arms, the left elbow as a pivot with the left hand grasping the mattress edge and the right hand pushing on the mattress above the elbow, then slide your legs over the side of the mattress
Correct answer: C
Rationale: Choice C is the best direction provided by the nurse. This method involves reaching over to the left side rail with the right hand, pulling the body onto its side, bending the upper leg so the foot is on the bed, and pushing down to elevate the trunk. This approach helps maintain spinal alignment while moving from a lying to a standing position, reducing strain on the back. Choices A, B, and D involve movements that are not suitable for a client recovering from a lumbar laminectomy with spinal fusion and could potentially cause harm or discomfort.
4. A patient with a history of peptic ulcer disease should avoid which medication?
- A. Acetaminophen
- B. Antacids
- C. Nonsteroidal anti-inflammatory drugs
- D. Antihistamines
Correct answer: C
Rationale: Patients with a history of peptic ulcer disease should avoid nonsteroidal anti-inflammatory drugs (NSAIDs) because they can worsen peptic ulcers. NSAIDs inhibit the production of prostaglandins, which help protect the stomach lining. Acetaminophen (Choice A) is a safer alternative for pain relief in patients with peptic ulcers. Antacids (Choice B) can actually help in symptom relief by neutralizing stomach acid. Antihistamines (Choice D) are not known to worsen peptic ulcers and are generally safe for use in patients with this condition.
5. The nurse is caring for a client in a sickle cell crisis. Which is the pain regimen of choice to relieve the pain?
- A. Frequent aspirin (acetylsalicylic acid) and a non-narcotic analgesic
- B. Motrin (ibuprofen), an NSAID, PRN
- C. Demerol (meperidine), a narcotic analgesic, every four (4) hours
- D. Morphine, a narcotic analgesic, every two (2) to three (3) hours PRN
Correct answer: D
Rationale: In a sickle cell crisis, morphine is the preferred analgesic due to its potency and effectiveness in managing severe pain. Choice A is incorrect because aspirin is contraindicated in sickle cell disease due to its potential to cause a further decrease in blood flow. Choice B, Motrin (ibuprofen), is also not the ideal choice as NSAIDs can exacerbate renal complications in sickle cell patients. Choice C, Demerol (meperidine), is not recommended for sickle cell pain management due to its toxic metabolite accumulation which can cause seizures and other complications.
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