ATI RN
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1. The nurse is taking a health history from a 29-year-old pregnant patient at the first prenatal visit. The patient reports no personal history of diabetes but has a parent who is diabetic. Which action will the nurse plan to take first?
- A. Teach the patient about administering regular insulin.
- B. Schedule the patient for a fasting blood glucose level.
- C. Discuss an oral glucose tolerance test for the twenty-fourth week of pregnancy.
- D. Provide teaching about an increased risk for fetal problems with gestational diabetes.
Correct answer: B
Rationale: The correct answer is B. Given the family history of diabetes, the initial action the nurse should take is to schedule the patient for a fasting blood glucose level. This will help in assessing if the patient has developed gestational diabetes. Choice A is incorrect because teaching about administering regular insulin is premature without confirming the diagnosis. Choice C is incorrect as an oral glucose tolerance test is typically done earlier in pregnancy. Choice D is incorrect as discussing fetal problems related to gestational diabetes should come after a confirmed diagnosis.
2. Following a child's return from exploratory surgery due to a gunshot wound to the abdomen, which nursing intervention should be excluded from the plan of care?
- A. Immediate initiation of oral feedings
- B. Assessment of the surgical site
- C. Administration of opioid narcotics for pain management
- D. Visitation at the bedside
Correct answer: A
Rationale: Immediate initiation of oral feedings should be excluded from the plan of care post-abdominal surgery due to the risk of bowel complications like paralytic ileus or anastomotic leak. Starting oral feedings immediately can increase these risks and hinder healing. It is crucial to wait until bowel function returns and the patient shows signs of tolerance before introducing oral feedings. Assessment of the surgical site is necessary to monitor for any signs of infection or complications. Administration of opioid narcotics for pain management is essential for ensuring the patient's comfort post-surgery. Visitation at the bedside provides emotional support and can aid in the patient's recovery. Therefore, the correct answer is to exclude immediate initiation of oral feedings.
3. What procedure uses a catheter to open up a blocked or narrowed coronary artery, often involving the placement of a stent?
- A. Angioplasty
- B. Echocardiogram
- C. CT angiography
- D. Coronary artery bypass graft (CABG)
Correct answer: A
Rationale: The correct answer is Angioplasty. Angioplasty is a procedure that uses a catheter to open up a blocked or narrowed coronary artery, often involving the placement of a stent. Echocardiogram is a diagnostic test that uses sound waves to create images of the heart. CT angiography is a type of imaging test that looks at blood vessels, but it does not involve the placement of a stent. Coronary artery bypass graft (CABG) is a surgical procedure to improve blood flow to the heart muscle by bypassing blocked coronary arteries.
4. What is the primary role of community health nurses in disaster preparedness?
- A. Developing emergency response plans
- B. Providing direct patient care
- C. Coordinating care among various providers
- D. Conducting health screenings
Correct answer: A
Rationale: Community health nurses primarily focus on developing emergency response plans in disaster preparedness. This involves creating strategies to address various aspects of a disaster, such as evacuation procedures, resource management, and communication plans. While providing direct patient care and coordinating care among providers are important aspects of nursing, in the context of disaster preparedness, the emphasis is on planning and preparedness to ensure an effective response in times of crisis.
5. The nurse is instructing a client to perform a testicular self-examination (TSE). What information should the nurse provide about the procedure?
- A. To examine the testicles while lying down
- B. That the best time for the examination is after a shower
- C. To gently feel the testicle with one finger to feel for a growth
- D. That testicular self-examinations should be done at least every 6 months
Correct answer: B
Rationale: The correct answer is B. The best time to perform a testicular self-examination is after a warm shower when the scrotal skin is relaxed. This makes it easier to detect any abnormalities. Choice A is incorrect because the examination should ideally be done while standing. Choice C is incorrect as the client should use both hands to roll each testicle between the thumb and fingers to feel for any lumps or changes in size. Choice D is incorrect because testicular self-examinations are recommended to be done monthly, not every 6 months, to monitor changes in the testicles.
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