ATI RN
Multi Dimensional Care | Final Exam
1. A nurse is caring for an immobile client. What is the priority assessment of this client?
- A. Palpate for edema
- B. Auscultate for bowel sounds
- C. Inspect the skin for injury
- D. Auscultation of lung sounds
Correct answer: C
Rationale: Inspecting the skin for injury is crucial to prevent pressure ulcers and other complications in immobile clients.
2. A client is bedridden and appears to be frail and malnourished. Which nursing interventions will increase the risk of pressure injury?
- A. Applying moisturizer to dry areas of the skin
- B. Massaging the client's reddened shoulders and heels
- C. Cleansing the skin routinely after soiling occurs
- D. Using a Hoyer lift for all transfers
Correct answer: B
Rationale:
3. What are nonsurgical treatment options for carpal tunnel syndrome? (Select all that apply)
- A. Using a splint
- B. Ultrasound therapy
- C. Endoscopic carpal tunnel release
- D. All of the above
Correct answer: D
Rationale: The correct answer is D, 'All of the above.' Non-surgical treatments for carpal tunnel syndrome include using a splint, ultrasound therapy, corticosteroid injections, and NSAIDs. Choice A is correct as using a splint helps to keep the wrist in a neutral position, reducing pressure on the median nerve. Choice B is correct as ultrasound therapy can help reduce inflammation and alleviate symptoms. Choice C, 'Endoscopic carpal tunnel release,' is incorrect as it is a surgical procedure, not a nonsurgical treatment option for carpal tunnel syndrome.
4. A client just received a diagnosis of cancer. Which statement by the nurse demonstrates empathy?
- A. "This must be hard news to hear. Tell me more about it."?
- B. "I believe you can overcome this because I have seen how strong you are."?
- C. "Tomorrow will be better."
- D. "What is your biggest fear about this diagnosis?"?
Correct answer: A
Rationale:
5. What is the priority nursing diagnosis for a client with metastatic bone disease?
- A. Chronic pain
- B. Impaired mobility
- C. Risk for falls
- D. Risk for infection
Correct answer: C
Rationale: The correct answer is 'Risk for falls.' In clients with metastatic bone disease, weakened bones can lead to an increased risk of falls, making it a priority nursing diagnosis. Chronic pain (choice A) may be present but addressing the risk for falls is more critical in this situation. While impaired mobility (choice B) can be a consequence of metastatic bone disease, preventing falls takes precedence. Risk for infection (choice D) is not the priority in this case, as falls pose a more immediate threat to the client's safety.
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