tony is to be discharged in the afternoon of the same day after tonsillectomy and adenoidectomy you as the rn will make sure that the family knows to
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Nursing Elites

ATI RN

Nutrition ATI Test

1. Tony is to be discharged in the afternoon of the same day after tonsillectomy and adenoidectomy. You, as the RN, will make sure that the family knows to:

Correct answer: B

Rationale: After tonsillectomy and adenoidectomy, it is crucial to provide soft foods for a week to minimize discomfort while swallowing. This helps prevent irritation to the surgical site and allows for easier healing. Offering pureed foods (Choice A) may not be necessary as soft foods are usually sufficient. While Vitamin C is beneficial for healing, it is not necessary to supplement it immediately after surgery with Vitamin C-rich juices (Choice C). Clear liquids are typically recommended before surgery and not after, as the focus shifts to soft foods to aid in recovery, making Choice D incorrect.

2. Scurvy is caused by a deficiency of ascorbic acid (Vitamin C) because ascorbic acid is required for collagen synthesis. Is this statement true or false?

Correct answer: A

Rationale: The statement is accurate. Scurvy is indeed caused by a deficiency in ascorbic acid, which is another name for Vitamin C. This vitamin plays a crucial role in the synthesis of collagen, a protein that helps in the formation and strength of skin, blood vessels, tissues, and bones. When the body lacks Vitamin C, it cannot produce enough collagen, leading to symptoms associated with scurvy such as bleeding gums and weakened immunity. The choice 'False' is incorrect because it contradicts the proven medical and scientific understanding of the causes of scurvy. Choices 'C' and 'D' are marked as 'Not applicable' because the question only requires a true or false answer.

3. While on Bryant’s traction, which of these observations of Graciela and her traction apparatus would indicate a decrease in the effectiveness of her traction?

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

4. Where should a nurse auscultate the apex beat?

Correct answer: A

Rationale: The correct location to auscultate the apex beat is at the fifth intercostal space, along the midclavicular line. This is where the apical impulse, also known as the point of maximal impulse (PMI), can be best heard. Choices B, C, and D are incorrect anatomical locations for auscultating the apex beat, which makes them incorrect choices. Auscultating at the correct location allows healthcare providers to assess the heart's function and detect any abnormalities in heart sounds, which is crucial for comprehensive patient care.

5. For an incontinent elderly client who frequently wets his bed and develops redness and skin excoriation at the perianal area, what is the best nursing goal?

Correct answer: A

Rationale: The best nursing goal for an incontinent elderly client with skin excoriation is to ensure that the bed linen is always dry. This helps in preventing further skin breakdown and promoting skin integrity. Choice B, to frequently check the bed for wetness and keep it dry, may not address the issue of prevention if the linen is not consistently dry. Choice C, placing a rubber sheet under the client's buttocks, focuses more on protecting the mattress rather than addressing the client's skin condition directly. Choice D, keeping the patient clean and dry, is important but does not specifically address the preventive aspect of maintaining dry bed linen.

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