ATI RN
ATI Community Health Proctored Exam 2019
1. Which action exemplifies a policy-level intervention in community health?
- A. Providing health education to the community
- B. Advocating for legislative changes
- C. Implementing new treatment protocols
- D. Developing health policies
Correct answer: B
Rationale: Advocating for legislative changes is a policy-level intervention as it involves influencing and promoting changes in laws and regulations that can have a broad impact on community health outcomes. This type of intervention aims to address systemic issues and create sustainable improvements in public health by shaping policies at a higher level.
2. Which type of nutritional deficiency results from inadequate absorption?
- A. Unmeasurable
- B. Primary deficiency
- C. Secondary deficiency
- D. Codependent
Correct answer: C
Rationale: The correct answer is C: Secondary deficiency. A nutritional deficiency resulting from decreased intake is called a primary deficiency. On the other hand, a secondary deficiency refers to a vitamin deficiency caused by inadequate absorption or use, increased requirements, excretion, or destruction. Choice A, 'Unmeasurable,' is incorrect as it does not describe a type of nutritional deficiency. Choice B, 'Primary deficiency,' is incorrect as it refers to a deficiency caused by decreased intake, not inadequate absorption. Choice D, 'Codependent,' is incorrect as it is unrelated to the context of nutritional deficiencies.
3. A patient newly diagnosed with cancer is scheduled to begin chemotherapy treatment and the nurse is providing anticipatory guidance about potential adverse effects. When addressing the most common adverse effect, what should the nurse describe?
- A. Pruritis (itching)
- B. Nausea and vomiting
- C. Altered glucose metabolism
- D. Confusion
Correct answer: B
Rationale: Nausea and vomiting are among the most common and distressing side effects of chemotherapy. Chemotherapy drugs target rapidly dividing cells, including cancer cells, but they also affect healthy cells in the gastrointestinal (GI) tract, triggering the release of chemicals that stimulate the brain’s vomiting center. These side effects can occur immediately (acute), be delayed, or even anticipatory, and often require management with antiemetic (anti-nausea) medications to improve the patient’s comfort and quality of life during treatment.
4. A nurse is caring for a client who has a new diagnosis of Crohn's disease. Which of the following findings should the nurse expect?
- A. Bloody diarrhea
- B. Fatty stools
- C. Weight gain
- D. High fever
Correct answer: B
Rationale: Clients with Crohn's disease often experience fatty stools (steatorrhea) due to malabsorption of fats. This occurs because the inflammation caused by Crohn's disease can affect the small intestine, impairing the body's ability to absorb nutrients. Bloody diarrhea is more commonly associated with ulcerative colitis. Weight gain is not a typical symptom of Crohn's disease; instead, weight loss is more common due to malabsorption and decreased appetite. High fever can occur during acute flare-ups but is not a primary finding of Crohn's disease.
5. A client hospitalized with deep vein thrombosis has been on IV heparin for 5 days. The provider prescribes oral warfarin (Coumadin) without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following is an appropriate nursing response?
- A. The Coumadin takes several days to work, so the IV heparin will be used until the Coumadin reaches a therapeutic level.
- B. I will call the provider to get a prescription for discontinuing the IV heparin today
- C. Both heparin and Coumadin work together to dissolve the clots.
- D. The IV heparin increases the effects of the Coumadin and decreases the length of your hospital stay.
Correct answer: The Coumadin takes several days to work, so the IV heparin will be used until the Coumadin reaches a therapeutic level.
Rationale: The correct answer is, 'The Coumadin takes several days to work, so the IV heparin will be used until the Coumadin reaches a therapeutic level.' Warfarin (Coumadin) is an oral anticoagulant that takes time to reach its full effect, typically a few days. In the meantime, IV heparin is used to provide immediate anticoagulation until the Coumadin levels become therapeutic. Option B is incorrect because discontinuing the IV heparin abruptly without reaching a therapeutic level with Coumadin can increase the risk of clot formation. Option C is incorrect because heparin and Coumadin do not work together to dissolve clots; they both have anticoagulant effects but work differently. Option D is incorrect because IV heparin does not directly increase the effects of Coumadin; they have different mechanisms of action.
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