ATI RN
Multi Dimensional Care | Exam | Rasmusson
1. Which client is at highest risk of compromised immunity?
- A. A client who just had surgery
- B. A client who just delivered a baby
- C. A client with extreme anxiety
- D. A client who is awaiting surgery
Correct answer: A
Rationale:
2. The nurse is providing medication for a client with osteomyelitis. What teaching should the nurse indicate in the education?
- A. The most common adverse e effect for nonsteroidal anti-inflammatory drugs (NSAIDS)are liver failure and tinnitus
- B. The main side effect of acetaminophen is gastrointestinal GI bleeding
- C. You should not take more than 4000 mg of acetaminophen a day
- D. Nonsteroidal anti-inflammatory drugs (NSAIDS) are very safe and are known to have no side effects
Correct answer: A
Rationale:
3. A client just received a diagnosis of cancer. Which statement by the nurse demonstrates empathy?
- A. "This must be hard news to hear. Tell me more about it."?
- B. "I believe you can overcome this because I have seen how strong you are."?
- C. "Tomorrow will be better."
- D. "What is your biggest fear about this diagnosis?"?
Correct answer: A
Rationale:
4. What is the priority nursing diagnosis for a client with metastatic bone disease?
- A. Chronic pain
- B. Impaired mobility
- C. Risk for falls
- D. Risk for infection
Correct answer: C
Rationale: The correct answer is 'Risk for falls.' In clients with metastatic bone disease, weakened bones can lead to an increased risk of falls, making it a priority nursing diagnosis. Chronic pain (choice A) may be present but addressing the risk for falls is more critical in this situation. While impaired mobility (choice B) can be a consequence of metastatic bone disease, preventing falls takes precedence. Risk for infection (choice D) is not the priority in this case, as falls pose a more immediate threat to the client's safety.
5. The client states, “the doctor says I am nearsighted. I do not get it.” What would be the best response by the nurse?
- A. I am sorry you did not understand. Would you like a different doctor?
- B. Nearsighted, or myopia means that you have difficulty seeing things at a distance.
- C. You will need to have glasses.
- D. This means you won’t ever need glasses.
Correct answer: B
Rationale: The correct response is to explain to the client what nearsightedness means, which is having difficulty seeing distant objects, as known as myopia. Choice A is not helpful as changing doctors is not necessary for this situation. Choice C is premature as wearing glasses is a possible solution but not the only one. Choice D is incorrect as nearsightedness (myopia) often requires glasses for correction.
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