ADPIE Nursing Process Questions

Questions 75

ATI RN

ATI RN Test Bank

ADPIE Nursing Process Questions Questions

Question 1 of 5

After reviewing the database, the nurse discovers that the patient�s vital signs have not been recorded by the nursing assistive personnel (NAP). Which clinical decision should the nurse make? Administer scheduled medications assuming that the NAP would have reported

Correct Answer: C

Rationale: The correct answer is C because it is essential for the nurse to ensure accurate and up-to-date vital signs before administering medications. By asking the NAP to record the patient's vital signs, the nurse can make informed decisions about the patient's condition and prevent any potential complications. Choice A is incorrect because administering medications without knowing the patient's vital signs, particularly if they are abnormal, can be dangerous. Choice B is not the best course of action as it delays the crucial step of obtaining the vital signs. Choice D is incorrect as omitting vital signs without assessment could compromise patient safety. Therefore, choice C is the most appropriate response to ensure patient well-being and medication safety.

Question 2 of 5

Which of the ff nursing interventions is involved when caring for a client with influenza?

Correct Answer: C

Rationale: The correct answer is C: Immediate recognition of respiratory distress. This is crucial when caring for a client with influenza as the virus can lead to respiratory complications. Prompt recognition allows for timely intervention and prevents further deterioration. A: Maintaining airborne transmission is incorrect as the goal is to prevent the spread of influenza through droplet precautions, not airborne transmission. B: Oxygen administration may be necessary for severe cases of influenza, but immediate recognition of respiratory distress takes precedence in the nursing interventions. D: Complete bed rest is not recommended for influenza as mobilization and deep breathing exercises are important to prevent complications like pneumonia.

Question 3 of 5

A client who was diagnosed with type I diabetes mellitus 14 years ago is admitted to the medical-surgical unit with abdominal pain. On admission, the client�s blood glucose level is 470 mg/dl. Which finding is most likely to accompany this blood glucose level?

Correct Answer: B

Rationale: The correct answer is B: Arm and leg trembling. With a blood glucose level of 470 mg/dl in a client with type I diabetes mellitus, the most likely finding is arm and leg trembling, which is a common symptom of hypoglycemia. This occurs due to the body's response to low blood sugar levels, causing tremors as a compensatory mechanism to increase glucose utilization. The other choices are incorrect because cool, moist skin is a sign of hypoglycemia, rapid thready pulse is a sign of shock or hypovolemia, and slow shallow respirations are not typically associated with high blood glucose levels in this scenario.

Question 4 of 5

Nursing assessment for a patient with metabolic alkalosis includes evaluation of laboratory data for all of the following except:

Correct Answer: C

Rationale: The correct answer is C: Hypoglycemia. In metabolic alkalosis, the blood pH is elevated due to an excess of bicarbonate. Hypoglycemia is not directly related to metabolic alkalosis but can be seen in other conditions like diabetes or fasting. Evaluating for hypocalcemia (A) is important as alkalosis can lead to decreased ionized calcium levels. Hypokalemia (B) is common in metabolic alkalosis due to potassium loss. Hypoxemia (D) is not directly related to metabolic alkalosis but can occur in severe cases due to respiratory compensation. Therefore, hypoglycemia is the least relevant in assessing metabolic alkalosis.

Question 5 of 5

The most effective pharmacologic agent for the treatment of Parkinson�s disease is:

Correct Answer: A

Rationale: The correct answer is A: Levodopa. Levodopa is the most effective pharmacologic agent for treating Parkinson's disease because it is converted to dopamine in the brain, replenishing the deficient dopamine levels in Parkinson's patients. Selegiline and Symmetrel are also used in treating Parkinson's, but they are typically used as adjunctive therapy rather than the primary treatment. Permax has been withdrawn from the market due to safety concerns, making it an incorrect choice.

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