ATI RN
Proctored Nutrition ATI
1. Muscle weakness due to wasting would most likely be evaluated by which test?
- A. recall of food intake
- B. skinfold thickness
- C. handgrip strength
- D. red blood cell levels
Correct answer: C
Rationale: Handgrip strength is a reliable test to assess muscle function and detect muscle weakness due to wasting. It is often used to identify conditions like sarcopenia in clinical settings. Options A, B, and D are not suitable for evaluating muscle weakness. Food intake recall does not directly measure muscle function, skinfold thickness assesses body fat but not muscle strength, and red blood cell levels are unrelated to muscle wasting.
2. A client is recovering from an ileostomy that was performed to treat inflammatory bowel disease. During discharge teaching for this client, the nurse should stress:
- A. increasing fluid intake to prevent dehydration.
- B. wearing an appliance pouch at all times.
- C. consuming a low-protein, high-fiber diet.
- D. avoiding enteric-coated medications.
Correct answer: A
Rationale: The correct answer is A: increasing fluid intake to prevent dehydration. An ileostomy typically drains liquid waste, so the client is at risk of fluid loss. By increasing fluid intake, the client can prevent dehydration. It's essential for the client to wear a collection appliance at all times because ileostomy drainage is incontinent. Consuming a low-protein, high-fiber diet is not recommended as high-fiber foods can cause intestinal irritation. Enteric-coated medications should be avoided because they may not be absorbed properly after an ileostomy.
3. When planning care for a client with severe acute respiratory distress syndrome (SARS), which of the following actions should not be included in the care plan?
- A. Administer antibiotics
- B. Provide supplemental oxygen
- C. Administer antiviral medications
- D. Administer bronchodilators
Correct answer: Administer antibiotics
Rationale: Severe acute respiratory distress syndrome (SARS) is caused by a virus, not bacteria, and antibiotics are ineffective against viral infections. Therefore, administering antibiotics would not be appropriate in the care plan for a client with SARS. The priority interventions for SARS include providing supplemental oxygen to improve oxygenation, administering antiviral medications to target the viral infection, and using bronchodilators to help with bronchospasm or airway constriction. Antibiotics are not indicated unless there is a secondary bacterial infection present.
4. Before administering an MMR (measles, mumps, and rubella) vaccine to a 15-month-old, which question should the nurse ask the mother of the child?
- A. “Has your child had any sore throats?”
- B. “Has your child been eating properly?”
- C. “Is your child allergic to any antibiotics?”
- D. “Has your child been exposed to any infections?”
Correct answer: C
Rationale: The correct question the nurse should ask the mother before administering an MMR vaccine to a 15-month-old is whether the child is allergic to any antibiotics. This is crucial because vaccines like MMR contain components that the child could be allergic to, such as neomycin. Checking for antibiotic allergies is essential to prevent adverse reactions to the vaccine. The other options are less relevant in this context. Asking about sore throats, eating habits, or exposure to infections does not directly impact the administration of the MMR vaccine.
5. After undergoing mastectomy, a patient demonstrates understanding of the nurse's instructions by doing which of the following?
- A. Dangle arms at the bedside
- B. Lie down on the affected chest
- C. Drink plenty of fluids immediately after surgery
- D. Elevate the affected arm
Correct answer: D
Rationale: The correct answer is to elevate the affected arm. Elevating the affected arm helps prevent lymphedema after a mastectomy. Choices A, B, and C are incorrect. 'Dangling arms at the bedside' does not provide any benefit after a mastectomy. 'Lying down on the affected chest' can cause discomfort and possible complications. 'Drinking plenty of fluids immediately after surgery' is not related to preventing lymphedema post-mastectomy.