the first step in decontamination is
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Nursing Elites

ATI RN

Nutrition ATI Test

1. What is the first step in decontamination?

Correct answer: D

Rationale: The correct first step in decontamination is to remove the patient's clothing and jewelry to prevent further exposure and then rinse the patient with water. This helps to eliminate any contaminants on the patient's body. Choice A is incorrect because applying a chemical decontamination foam should come after removing clothing. Choice B is incorrect as washing and rinsing the patient should follow the removal of clothing. Choice C is incorrect as personal protective equipment should be worn by the individual performing the decontamination, not applied to the patient.

2. The nurse cares for a hospitalized adolescent with the diagnosis of anorexia nervosa. Which nursing goal is a priority for this client?

Correct answer: C

Rationale: In the treatment of anorexia nervosa, stopping weight loss or restoring weight is a critical priority. This helps address the immediate health risks associated with severe malnutrition and supports the client's physical well-being. Encouraging effective coping skills, restoring normal eating habits, and promoting a realistic self-image are essential aspects of treatment but may come later in the care plan once the immediate risk of severe weight loss has been addressed.

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. One of the most common factors that compromise the vitamin D status of older adults, particularly those living in assisted living communities is _____.

Correct answer: D

Rationale: The correct answer is 'D: lack of exposure to sunlight.' Older adults, especially those in assisted living communities, are at risk of vitamin D deficiency due to spending most of their time indoors, which reduces their exposure to sunlight. Sunlight is essential for the body to produce vitamin D. Choices A, B, and C are less likely to be major factors in compromising vitamin D status. While a decreased intake of fruits and vegetables and lack of physical activity can impact overall health, they are not as directly related to vitamin D status. Malabsorption due to atrophic gastritis may affect the absorption of certain nutrients, but vitamin D synthesis primarily depends on sunlight exposure.

5. A healthcare provider is providing teaching about nutrition to a group of clients. The healthcare provider should include that which of the following foods contains the highest level of thiamine per serving?

Correct answer: C

Rationale: Whole grain wheat flour contains the highest level of thiamine per serving compared to the other options provided. Thiamine, also known as Vitamin B1, is essential for energy metabolism. While eggs, dried pears, and Brussels sprouts are nutritious foods, they do not contain as high a level of thiamine as whole grain wheat flour. Therefore, the correct choice is whole grain wheat flour in this case.

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