the client is diagnosed with pericarditis when assessing the client the nurse is unable to auscultate a friction rub which action should the nurse imp
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Nursing Elites

ATI RN

ATI RN Custom Exams Set 1

1. The client is diagnosed with pericarditis. When assessing the client, the nurse is unable to auscultate a friction rub. Which action should the nurse implement?

Correct answer: C

Rationale: The correct action for the nurse to take when unable to auscultate a pericardial friction rub in a client diagnosed with pericarditis is to ask the client to lean forward and listen again. This position brings the heart closer to the chest wall, making it easier to detect a friction rub if present. Notifying the healthcare provider is not necessary at this point as it may just be a matter of positioning for better auscultation. Documenting that the pericarditis has resolved is premature without proper assessment. Preparing to insert a unilateral chest tube is not indicated based on the absence of a friction rub.

2. The Army Medical Department has four major functions. Three are prevention, treatment, and evacuation. What is the fourth?

Correct answer: C

Rationale: The correct answer is C, 'Mobilization.' Mobilization is the fourth major function of the Army Medical Department. This involves preparing and organizing medical resources and personnel for deployment during military operations. Choices A, B, and D are incorrect because while they are important aspects in military healthcare, they do not represent the fourth major function of the Army Medical Department as specifically requested in the question.

3. In patients with heart failure, which type of diet is most recommended?

Correct answer: B

Rationale: In patients with heart failure, a low-sodium diet is most recommended. This type of diet helps manage fluid retention by reducing the amount of sodium in the body. Excess sodium can lead to fluid accumulation, putting additional strain on the heart. High-sodium diets can exacerbate symptoms of heart failure by causing fluid retention and increasing blood pressure. High-fat and low-carbohydrate diets are not specifically recommended for heart failure patients and may not address the underlying issues related to fluid balance and heart function.

4. The client is diagnosed with hereditary spherocytosis. Which treatment/procedure would the nurse prepare the client to receive?

Correct answer: B

Rationale: The correct answer is B: Splenectomy. Splenectomy is the treatment of choice for hereditary spherocytosis as it helps prevent hemolysis and improve anemia. Removing the spleen reduces the destruction of the abnormal red blood cells. Choice A, Bone marrow transplant, is not a standard treatment for hereditary spherocytosis. Choice C, Frequent blood transfusions, may be used to manage anemia in some cases but is not the primary treatment for hereditary spherocytosis. Choice D, Liver biopsy, is not a treatment for hereditary spherocytosis; it is a procedure used to diagnose liver conditions, not related to this hematologic disorder.

5. In supply and equipment management, what is the FIRST step in the procurement process?

Correct answer: B

Rationale: In the procurement process, the FIRST step is to establish requirements. This step involves identifying and defining the needs for supplies and equipment before moving forward with the procurement process. Keeping hand receipts up to date (Choice A) is a task related to tracking and managing inventory but comes after the requirements have been established. Requisitioning supplies and equipment (Choice C) and receiving, inspecting, and storing items (Choice D) are subsequent steps in the procurement process that follow after the requirements have been determined.

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