anita is performing bse and she stands in front of the mirror the rationale for standing in front of the mirror is to check for
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Nursing Elites

ATI RN

ATI Nutrition Practice Test A 2019

1. Why does Anita stand in front of the mirror while performing a Breast Self-Examination (BSE)?

Correct answer: C

Rationale: When performing a Breast Self-Examination (BSE), one of the reasons for standing in front of a mirror is to observe the size and contour of the breast (Choice C). This helps in identifying any visible changes or abnormalities such as dimpling, puckering, or changes in the size and shape of the breasts. While unusual discharges (Choice A) and thickness or lumps (Choice D) can be part of the changes a person might notice during a BSE, these are typically identified by palpation or by squeezing the nipple for discharge, not by just looking in the mirror. Choice B, checking for obvious malignancy, is too vague and not specific enough as malignancy is often not visible to the naked eye.

2. Which mental health disorder can lead to the erosion of lingual enamel, enlarged parotid glands, palatal bruising, and dentinal hypersensitivity?

Correct answer: A

Rationale: The correct answer is A: Bulimia. Bulimia involves repeated episodes of binge eating followed by purging, which can lead to the erosion of lingual enamel, enlarged parotid glands, palatal bruising, and dentinal hypersensitivity. This behavior exposes the teeth to stomach acid during purging, causing damage to the enamel. Choices B, C, and D are incorrect because these conditions are not typically associated with the specific oral health issues mentioned in the question.

3. What nursing diagnosis would be most appropriate for a patient with heart failure?

Correct answer: B

Rationale: The most appropriate nursing diagnosis for a patient with heart failure is 'fluid volume excess.' In heart failure, the heart's reduced pumping ability leads to fluid retention, causing an excess of fluid in the body. This can result in symptoms such as edema, shortness of breath, and weight gain. 'Risk for infection,' 'impaired body temperature,' and 'ineffective airway clearance' are not the most appropriate nursing diagnoses for a patient with heart failure as they do not directly relate to the pathophysiology and common issues seen in heart failure patients.

4. A nurse is planning teaching for the parents of a toddler who follows a vegetarian diet. The nurse should plan to include which of the following foods as the best source of dietary protein for the child?

Correct answer: C

Rationale: Dried beans are the best source of dietary protein for a toddler following a vegetarian diet. They are rich in protein and other essential nutrients. Soy milk, while a good source of protein, may not provide as much protein density as dried beans. Peanut butter is a good source of protein but may not be as protein-dense as dried beans. Whole grains are not as high in protein content compared to dried beans, making them a less optimal choice for meeting the toddler's protein needs.

5. What is the primary function of a written nursing care plan?

Correct answer: D

Rationale: A written nursing care plan fundamentally serves to facilitate the development of a nursing diagnosis. This procedure involves analyzing patient data and identifying health problems that nurses can address independently. This analysis then aids in determining the most appropriate nursing interventions for the identified health issues. Although evaluating the achievement of nursing care goals is an important aspect, it is not the primary function of a nursing care plan. Similarly, while delivering quality nursing care is crucial, it is a broader concept that includes many other facets beyond just the initial nursing diagnosis and interventions.

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