ATI RN
Multi Dimensional Care | Exam | Rasmusson
1. A client on bed rest complains of pain and burning in the right calf area. What is the nurse's action?
- A. Deeply palpate the area for rebound tenderness
- B. Medicate the client for pain and reassess in 60 minutes
- C. Percuss over the area for a change in tone
- D. Compare the circumference to the left calf
Correct answer: D
Rationale:
2. Which among the following is NOT the cause of pressure ulcers?
- A. Immobility
- B. Poor nutrition
- C. Moisture
- D. Adequate perfusion
Correct answer: D
Rationale:
3. What is a negative effect of immobility on the cardiovascular system?
- A. Increased high density lipoprotein
- B. Increased circulation
- C. Increased pumping action of the heart
- D. Venous stasis
Correct answer: D
Rationale: Venous stasis is a negative effect of immobility on the cardiovascular system as it can lead to blood clots.
4. The client had surgery one day ago. What assessment is most likely related to pain?
- A. Blood pressure of 175/90 mm Hg
- B. Respirations of 10 breaths per minute
- C. Heart rate 60 beats/minute
- D. Oxygen saturation of 97%
Correct answer: A
Rationale:
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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