ATI RN
jarvis health assessment test bank Questions
Question 1 of 5
A 30-year-old woman who was born in Canada brings her 68-year-old mother to hospital. The nurse notes that the mother is reluctant to follow the plan of care, but her daughter, who is a dental hygienist, is insisting that she do so. This is an example of:
Correct Answer: B
Rationale: The correct answer is B: dominant health care culture. The scenario illustrates the influence of the dominant health care culture, where the daughter, as a dental hygienist, is advocating for her mother to follow the plan of care based on her professional knowledge and beliefs. This highlights the power dynamics and authority within the healthcare system, where individuals with certain expertise may exert influence over others, even family members. This is distinct from generational differences (A) which focus on age-related disparities, lack of respect for independence (C) which emphasizes autonomy and decision-making, and critical cultural perspective (D) which involves a deeper analysis of cultural influences on healthcare interactions.
Question 2 of 5
What should be the nurse's first action when caring for a client with suspected meningitis?
Correct Answer: A
Rationale: The correct answer is A: Perform a lumbar puncture. This is the first action because diagnosing meningitis requires cerebrospinal fluid analysis obtained through a lumbar puncture. It helps identify the specific type of meningitis (bacterial, viral, or fungal) and guides appropriate treatment. Administering pain relief (B) or oxygen (C) may be necessary but not the initial priority. Administering antibiotics (D) should be based on the results of the lumbar puncture to ensure targeted therapy.
Question 3 of 5
Which nursing diagnosis applies to a client stating they feel incomplete due to infertility?
Correct Answer: B
Rationale: The correct answer is B: Body Image Disturbance. Infertility can impact one's perception of self and body image, leading to feelings of incompleteness. This nursing diagnosis addresses the emotional distress related to altered self-perception. A: Risk for Self Harm is not directly related to the client's statement about feeling incomplete due to infertility. C: Ineffective Role Performance doesn't specifically address the client's feelings of incompleteness related to infertility. D: Powerlessness may not fully capture the client's emotional struggle with their body image and feelings of incompleteness due to infertility.
Question 4 of 5
What is the most effective action when a client with acute respiratory distress syndrome (ARDS) develops hypoxemia?
Correct Answer: A
Rationale: The correct answer is A: Administer oxygen. In ARDS, the primary issue is hypoxemia due to impaired gas exchange in the lungs. Administering oxygen helps to increase the oxygen levels in the blood, improving oxygenation to vital organs. Corticosteroids (B) are not indicated as they have not shown consistent benefit in ARDS treatment. Bronchodilators (C) are not effective as ARDS is not primarily a bronchoconstrictive disorder. Applying an ice pack to the chest (D) is not relevant and will not address the underlying hypoxemia. Administering oxygen is the most effective and essential intervention to correct hypoxemia in ARDS.
Question 5 of 5
A nurse is preparing to assess a hospitalized patient who is experiencing significant shortness of breath. How should the nurse proceed with the assessment?
Correct Answer: A
Rationale: The correct answer is A because it focuses on prioritizing the assessment by first addressing the immediate problem of shortness of breath. By examining only the body areas related to the current issue, the nurse can quickly gather essential information to manage the patient's respiratory distress effectively. Once the critical issue is stabilized, a complete assessment can be conducted to identify any underlying problems or potential complications. This approach ensures that the nurse addresses the most urgent needs first before proceeding to a comprehensive assessment. Choice B is incorrect because it suggests only examining body areas directly related to the hospitalization problem, which may overlook other critical issues contributing to the shortness of breath. Choice C is incorrect as shortness of breath is not a normal finding and should not be dismissed without further evaluation. Choice D is incorrect as examining the entire body without focusing on the immediate issue may delay appropriate interventions for the patient's respiratory distress.
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