ATI RN
Multi Dimensional Care | Exam | Rasmusson
1. A client is immobile and requires mechanical ventilation with a tracheostomy. She has a pressure injury on her coccyx measuring 5 cm by 3 cm. the nurse observes bone and tendon at the base of the wound. How would the nurse document this wound?
- A. Stage III pressure injury
- B. A stage II pressure injury
- C. A non-staging pressure injury
- D. Stage IV pressure injury
Correct answer: D
Rationale:
2. Antibodies are passed from mother to fetus through the placenta. What is this type of immunity called?
- A. Artificial passive
- B. Natural passive
- C. Natural active
- D. Artificial active
Correct answer: B
Rationale:
3. By providing measures to reduce skin breakdown, how does the nurse break the chain of infection?
- A. Sterilizing the area to reduce the reservoir risk
- B. Maintaining the integrity of a portal of entry
- C. Creating a reservoir to decrease the risk of infection
- D. Creating a susceptible host
Correct answer: B
Rationale:
4. What are some of the expected outcomes when medications are given for rheumatoid arthritis?
- A. Increased quality of life
- B. Increased range of motion
- C. Decreased pain
- D. Cure the disease
Correct answer: C
Rationale:
5. A client is in the emergency room in critical condition and hypotensive. Her spouse is distraught. What is the priority nursing action?
- A. Maintain the client's blood pressure
- B. Call a chaplain
- C. Provide the spouse a chair
- D. Ask the client's spouse to explain what happened
Correct answer: A
Rationale:
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