ATI RN
Multi Dimensional Care | Final Exam
1. What is the condition called when the client's pupils are different sizes and have been this way since childhood?
- A. Exophthalmos
- B. Anisocoria
- C. Strabismus
- D. Scleral edema
Correct answer: B
Rationale: Anisocoria is the correct answer. Anisocoria is the condition of having pupils of different sizes. Exophthalmos refers to abnormal protrusion of the eyeball, not pupil size difference. Strabismus is a condition where the eyes are not properly aligned with each other. Scleral edema is swelling of the sclera, the white part of the eye, and not related to differing pupil sizes.
2. A nurse is caring for a client who has acute osteomyelitis. Which of the following interventions is the nurse's priority?
- A. Administer antibiotics to the client
- B. Increase the client's protein intake
- C. Teach relaxation breathing to reduce the client's pain
- D. Provide the client with anti-pyretic therapy
Correct answer: A
Rationale:
3. The nurse uses proper body mechanics to move a client up in bed. What action by the nurse will increase their risk of a workplace injury?
- A. Place the bed in the lowest possible position
- B. Use the legs when lifting
- C. Keep feet apart to provide a wide base of support
- D. Face the direction of the movement
Correct answer: A
Rationale: Placing the bed in the lowest possible position increases the risk of injury because it does not support proper body mechanics. When lifting a client, it is important to have the bed at a comfortable height to avoid strain. Using the legs when lifting (choice B) is correct as it reduces the strain on the back. Keeping feet apart to provide a wide base of support (choice C) helps with stability and balance. Facing the direction of the movement (choice D) is essential for maintaining proper alignment and reducing the risk of injury.
4. The nurse is providing education to a client regarding the administration of eye drops. Which of the following actions indicates the need for further client education?
- A. The client instills the prescribed number of eye drops into the conjunctival sac
- B. The client sets the cap to the eye drop container down in a manner that does not contaminate it
- C. The client touches the administration dropper her to the eye
- D. The client washes her hands before instilling the eye drops
Correct answer: C
Rationale:
5. A client who had an elective below-the-knee amputation reports pain in the foot that was amputated. What is the best response by the nurse?
- A. The pain will go away after the swelling decreases.
- B. That is phantom limb pain.
- C. Your foot has been amputated, so you are not having pain in that foot.
- D. On a scale of 0-10, how would you rate your pain?
Correct answer: D
Rationale: The correct response is to assess the pain intensity by asking the client to rate their pain on a scale of 0-10. This helps the nurse to effectively manage the client's pain. Choice A is incorrect as it dismisses the client's pain without proper assessment. Choice B is incorrect as it assumes the pain is phantom limb pain without assessing the client's current condition. Choice C is incorrect as it invalidates the client's pain experience and does not address the issue at hand.
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