ATI RN
ATI RN Custom Exams Set 4
1. The nurse is teaching the client with peripheral vascular disease. Which intervention should the nurse discuss with the client?
- A. Keep the area between the toes dry.
- B. Wear comfortable, well-fitting shoes.
- C. Cut toenails straight across.
- D. A,B
Correct answer: D
Rationale: The correct interventions for a client with peripheral vascular disease include keeping the area between the toes dry to prevent moisture-related skin issues and wearing comfortable, well-fitting shoes to prevent injury and promote circulation. Cutting toenails straight across is important to prevent ingrown toenails, but in this case, an arch cut can lead to injury. Therefore, choices A and B are correct, making option D the most appropriate answer. Choice C is incorrect in this context.
2. Patients with gallbladder disease should reduce their intake of:
- A. Protein
- B. Sodium
- C. Cholesterol
- D. Fat
Correct answer: D
Rationale: Patients with gallbladder disease are advised to reduce their fat intake because fats can trigger gallbladder symptoms such as pain and bloating. While protein, sodium, and cholesterol may also impact overall health, reducing fat intake specifically helps manage gallbladder-related symptoms effectively. Protein is important for tissue repair, sodium can affect blood pressure, and cholesterol levels impact heart health, but in the context of gallbladder disease, fat reduction is the most beneficial.
3. Which nutrient deficiency is most likely to be seen in patients with chronic alcoholism?
- A. Vitamin C
- B. Vitamin D
- C. Vitamin B12
- D. Vitamin B1
Correct answer: D
Rationale: In patients with chronic alcoholism, the most likely nutrient deficiency is Vitamin B1 (thiamine), not Vitamin B12. Chronic alcoholism often leads to Vitamin B1 deficiency, causing conditions like Wernicke's encephalopathy. While other vitamin deficiencies can also occur in chronic alcoholism, such as Vitamin C and Vitamin D, Vitamin B1 deficiency is more commonly associated with alcoholism.
4. The client diagnosed with acute pancreatitis has developed a pseudocyst that ruptures. Which procedure should the nurse anticipate the HCP ordering?
- A. Paracentesis
- B. Chest tube insertion
- C. Lumbar puncture
- D. Biopsy of the pancreas
Correct answer: B
Rationale: The correct answer is B: Chest tube insertion. In the context of a pancreatic pseudocyst rupturing, a chest tube may be needed if the pseudocyst extends into the pleural space, leading to a pleural effusion. Choice A, paracentesis, involves the removal of fluid from the abdominal cavity, not the pleural space. Choice C, lumbar puncture, is a procedure performed to collect cerebrospinal fluid from the spinal canal, not relevant in this scenario. Choice D, biopsy of the pancreas, is not indicated in the immediate management of a ruptured pseudocyst.
5. The nurse is caring for a client who goes into ventricular tachycardia. Which intervention should the nurse implement first?
- A. Call a code immediately
- B. Assess the client for a pulse
- C. Begin chest compressions
- D. Continue to monitor the client
Correct answer: B
Rationale: The correct answer is to assess the client for a pulse. In ventricular tachycardia, the priority is to determine if the client has a pulse. If there is no pulse, immediate initiation of CPR with chest compressions is required. Calling a code or continuing to monitor the client can delay life-saving interventions. Therefore, assessing for a pulse is the most crucial step in managing ventricular tachycardia.
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