unlicensed assistive personnel uap is assisting a client in traction which of these actions requires immediate intervention unlicensed assistive personnel uap is assisting a client in traction which of these actions requires immediate intervention
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Nursing Elites

ATI RN

Multi Dimensional Care | Final Exam

1. Unlicensed assistive personnel (UAP) is assisting a client in traction. Which of these actions requires immediate intervention?

Correct answer: A

Rationale: The correct answer is A because traction weights should hang freely to maintain their effectiveness. Choice B is incorrect because providing pillows to cushion unaffected extremities is appropriate. Choice C is also incorrect as emptying the catheter bag is a routine nursing task. Choice D is incorrect as teaching the client to use the call light promotes client safety.

2. 1.A nurse prepares to insert a peripheral venous catheter in an older adult client. Which action should the nurse take to protect the clients skin during this procedure?

Correct answer: Place a washcloth between the skin and tourniquet

Rationale:

3. A healthcare professional is providing information about tuberculosis to a group of clients at a local community center. Which of the following manifestations should the professional NOT include in the teaching?

Correct answer: Weight gain

Rationale: Weight gain is not a typical manifestation of tuberculosis. The characteristic symptoms of tuberculosis include a persistent cough, fatigue, and night sweats. Weight loss, not weight gain, is a common symptom associated with tuberculosis due to the impact of the infection on the body's metabolism. Therefore, the healthcare professional should exclude weight gain from the teaching on tuberculosis manifestations.

4. A client with a history of tuberculosis (TB) is experiencing a recurrence of symptoms. Which diagnostic test should the nurse anticipate being ordered?

Correct answer: C

Rationale: A chest x-ray is the most appropriate diagnostic test for a client with a history of tuberculosis experiencing a recurrence of symptoms. A chest x-ray is commonly used to visualize the lungs and check for signs of active tuberculosis, such as abnormal shadows or nodules. While a sputum culture (Choice A) can confirm the presence of TB bacteria, it may not be the initial test ordered for a recurrence. Bronchoscopy (Choice B) and CT scan of the chest (Choice D) are more invasive and usually reserved for cases where the chest x-ray is inconclusive or to further assess complications, rather than as the initial diagnostic test for a recurrence of tuberculosis.

5. A client practicing Orthodox Judaism informs the nurse they are observing the Passover holiday. Which action should the nurse include in the plan of care?

Correct answer: C

Rationale: During the Passover holiday, individuals practicing Orthodox Judaism follow dietary restrictions that include consuming unleavened bread. This symbolizes the haste with which the Israelites left Egypt and the lack of time for bread to rise. Providing chicken with cream sauce (Choice A) is not aligned with Passover dietary restrictions. Avoiding serving fish with fins and scales (Choice B) is a general dietary law in Judaism but not specific to Passover. Similarly, avoiding foods containing lamb (Choice D) is not a specific requirement during Passover.

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