ATI RN
Multi Dimensional Care | Final Exam
1. What is an example of proper body mechanics when lifting?
- A. Lifting the object with your back
- B. Standing with a narrow stance
- C. Lifting excessive weight to strengthen the muscles
- D. Holding the object close to the body
Correct answer: D
Rationale: Proper body mechanics include holding objects close to the body to prevent injury.
2. What is the priority nursing diagnosis for a client with immobility?
- A. Constipation related to immobility
- B. Ineffective breathing pattern related to inability to breathe deeply in a supine position
- C. Risk for impaired skin integrity as evidenced by pressure over bony prominences
- D. Risk for disuse syndrome as evidenced by immobility
Correct answer: C
Rationale: The correct priority nursing diagnosis for a client with immobility is 'Risk for impaired skin integrity as evidenced by pressure over bony prominences.' Immobility predisposes the client to the development of pressure ulcers due to prolonged pressure on bony areas. Monitoring and preventing impaired skin integrity is crucial to prevent complications. Choices A, B, and D are not the priority in this case. Constipation, ineffective breathing pattern, and disuse syndrome are important but secondary to the immediate risk of skin breakdown associated with immobility.
3. Which of the following clients are at an increased risk for deep vein thrombosis following a reduction and internal fixation of the hip? (Select all that apply)
- A. A client on birth control pills
- B. A client who is immobile
- C. A client on an anticoagulant
- D. A client with dementia who has been wandering
Correct answer: a
Rationale: Clients on birth control pills, immobile, and smokers are at increased risk of DVT after hip surgery.
4. What statement by the client with plantar fasciitis indicates a need for further teaching?
- A. I will use warm packs on my feet.
- B. I will use nonsteroidal anti-inflammatory drugs (NSAIDS) for comfort.
- C. I will rest and stretch my feet.
- D. I will wear supportive shoes.
Correct answer: A
Rationale: The correct answer is A. Using warm packs can exacerbate inflammation in plantar fasciitis. Choices B, C, and D are all appropriate interventions for managing plantar fasciitis. Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation. Resting and stretching the feet can promote healing and reduce symptoms. Wearing supportive shoes can provide stability and reduce strain on the plantar fascia. Therefore, the client's statement about using warm packs indicates a need for further teaching as it can worsen the condition.
5. A client with chronic osteomyelitis is being discharged from the hospital. What is the nurse’s priority discharge intervention?
- A. Teaching adherence to an exercise program
- B. Teaching about a healthy dietary intake
- C. Teaching adherence to the antibiotic regimen
- D. Scheduling daily dressing changes
Correct answer: C
Rationale: The correct answer is C: Teaching adherence to the antibiotic regimen. In chronic osteomyelitis, the priority is to ensure proper treatment of the infection, which heavily relies on consistent adherence to the prescribed antibiotic regimen. This helps in eradicating the infectious organisms and preventing recurrence. Choices A, B, and D are important aspects of care but teaching adherence to the antibiotic regimen takes precedence as it directly impacts the successful management of chronic osteomyelitis.
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