ATI RN
ATI RN Custom Exams Set 5
1. The nurse supervises care of a client in Buck’s traction. The nurse determines that care is appropriate if which of the following is observed? (Select all that apply)
- A. The nurse removes the foam boot three times per day to inspect the skin
- B. The staff turn the client to the unaffected side
- C. The staff turn the client to the unaffected side and the nurse asks the client to dorsiflex the foot on the affected leg
- D. The nurse asks the client to dorsiflex the foot on the affected leg
Correct answer: C
Rationale: Correct care for a client in Buck’s traction includes turning the client to the unaffected side to prevent complications such as pressure ulcers. Additionally, asking the client to dorsiflex the foot on the affected leg helps prevent foot drop. Removing the foam boot three times per day to inspect the skin is unnecessary and could disrupt the traction, so it is not appropriate. Therefore, choices A and D are incorrect.
2. 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.
3. A client takes an antidepressant and oral contraceptives. Which herbal supplement should the nurse educate the client about as a potential drug-herb interaction?
- A. Iron supplement
- B. Garlic
- C. Green tea
- D. St. John’s Wort
Correct answer: D
Rationale: St. John’s Wort is the correct answer because it can interact with antidepressants and oral contraceptives, potentially affecting their efficacy. Iron supplement, garlic, and green tea do not typically interact with antidepressants or oral contraceptives to the same extent as St. John’s Wort.
4. Which of the following is the primary enlisted personnel performing nursing care duties at the various levels of health care?
- A. 68A30
- B. 68WM6
- C. Physician assistant
- D. 6.80E+21
Correct answer: B
Rationale: The correct answer is B: '68WM6'. The 68WM6 (Practical Nurse) is the primary enlisted personnel responsible for performing nursing care duties at various levels of health care. This choice is correct as it specifically identifies the enlisted personnel role related to nursing care. Choice A (68A30) is incorrect as it does not pertain to nursing care duties. Choice C (Physician assistant) is incorrect as physician assistants are not typically enlisted personnel. Choice D (6.80E+21) is incorrect as it is a numerical value and not a designation for enlisted personnel.
5. The nurse is caring for a client whose religious background is Seventh Day Adventist (Church of GOD). Which nursing action(s) are most appropriate in terms of providing for the dietary needs of this client? Select all that apply.
- A. Providing snacks between meals
- B. Excluding caffeine and pork from the client's diet
- C. Removing coffee from the breakfast tray
- D. Ensuring that there is no pork on the dinner tray
Correct answer: B
Rationale: The correct answer is B. Seventh Day Adventists typically avoid caffeine and pork due to religious dietary restrictions. Providing snacks between meals (choice A) is not specifically related to the dietary needs of this client. While removing coffee from the breakfast tray (choice C) aligns with the client's dietary restrictions, ensuring no pork on the dinner tray (choice D) is redundant as it is already covered in the correct answer. Therefore, choices C and D are not necessary to include as separate options.
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