ATI RN
Endocrinology Exam
1. When obtaining a client’s vital signs, the nurse assesses a blood pressure of 134/88 mm Hg. What is the nurse’s best intervention?
- A. Call the healthcare provider and report the finding.
- B. Reassess the client’s blood pressure at the next follow-up appointment.
- C. Administer an additional antihypertensive medication to the client.
- D. Teach the client lifestyle modifications to decrease blood pressure.
Correct answer: D
Rationale: The correct answer is to teach the client lifestyle modifications to decrease blood pressure. A blood pressure reading of 134/88 mm Hg falls within the prehypertension range. The initial approach to managing prehypertension involves lifestyle modifications such as dietary changes, exercise, and stress reduction techniques. Calling the healthcare provider without attempting non-pharmacological interventions first is premature. Reassessing blood pressure at the next follow-up appointment may delay necessary interventions. Administering additional antihypertensive medication is not indicated at this stage as lifestyle modifications are the first line of treatment for prehypertension.
2. A patient is being cared for by a nurse who has stomatitis following radiation treatment. Which of the following is an appropriate intervention for the nurse to take?
- A. Serve foods without sauces or gravies
- B. Offer mouth rinses with normal saline and water
- C. Serve foods while still at a hot temperature
- D. Instruct the client to drink liquids without a straw
Correct answer: B
Rationale: Offering mouth rinses with normal saline and water is an appropriate intervention for a nurse caring for a patient with stomatitis following radiation treatment. This intervention can help soothe and clean the mouth, promoting comfort and oral hygiene. Choice A is incorrect because serving foods without sauces or gravies does not directly address the client's stomatitis. Choice C is incorrect because serving hot foods can exacerbate discomfort in the client's mouth. Choice D is incorrect because using a straw can help in preventing further irritation in the client's mouth.
3. When examining heredity, mental disorders are almost always ________.
- A. influenced by one particular gene.
- B. influenced by multiple genes.
- C. influenced by recessive genes.
- D. not influenced by genes.
Correct answer: B
Rationale: When examining heredity and mental disorders, it is important to note that these conditions are influenced by multiple genes working together. Mental disorders are complex traits that arise from the interplay of various genetic and environmental factors. Therefore, choice B, 'influenced by multiple genes,' is the correct answer. Choice A, 'influenced by one particular gene,' is incorrect because mental disorders typically do not result from the action of a single gene. Choice C, 'influenced by recessive genes,' is incorrect as it oversimplifies the genetic basis of mental disorders. Choice D, 'not influenced by genes,' is also incorrect as genes play a significant role in the development of mental disorders.
4. A patient with diabetes is admitted with high blood sugar levels. What is the nurse's priority intervention?
- A. Administer insulin as prescribed.
- B. Encourage the patient to exercise regularly.
- C. Encourage the patient to drink water.
- D. Provide the patient with a low-sugar diet.
Correct answer: A
Rationale: Administering insulin is the priority intervention for a patient admitted with high blood sugar levels because it helps lower the blood sugar levels effectively and rapidly. Insulin is a crucial medication for managing hyperglycemia in diabetes. Encouraging exercise (choice B) can be beneficial in the long term for managing blood sugar levels but is not the most immediate priority. While staying hydrated (choice C) is important, it is not the priority intervention when dealing with high blood sugar levels. Providing a low-sugar diet (choice D) is essential for long-term diabetes management but is not the immediate action needed to address high blood sugar levels in an admitted patient.
5. The healthcare provider should consider the following when assessing the child for chest indrawing EXCEPT
- A. Chest indrawing should be present at all times
- B. The lower chest wall does not move in when the child breathes in
- C. The lower chest moves in when the child breathes in
- D. The child should be calm
Correct answer: A
Rationale: When assessing a child for chest indrawing, it is important to note that chest indrawing should NOT be present at all times, as this would suggest a significant respiratory distress. Chest indrawing is an abnormal inward movement of the lower chest wall during inhalation, indicating increased work of breathing. Therefore, the absence of chest indrawing during normal breathing is a normal finding. The healthcare provider should observe for the lower chest moving in with each breath, which is abnormal, while ensuring that the child is calm during the assessment.
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