Nursing Process Test Bank

Questions 68

ATI RN

ATI RN Test Bank

Nursing Process Test Bank Questions

Question 1 of 5

Hemodynamic monitoring by means of a multilumen pulmonary artery catheter can provide detailed information about:

Correct Answer: D

Rationale: The correct answer is D because a multilumen pulmonary artery catheter can provide detailed information about preload, afterload, and cardiac output. Preload refers to the volume of blood in the ventricles at the end of diastole, afterload is the resistance the heart has to overcome to eject blood, and cardiac output is the amount of blood pumped by the heart per minute. This catheter allows for direct measurement of these parameters by monitoring pressures in the pulmonary artery. Choices A, B, and C are incorrect individually as they do not encompass the full range of information that can be obtained with a multilumen pulmonary artery catheter.

Question 2 of 5

The nurse understands that for the parathyroid hormone to exert its effect, what must be present?

Correct Answer: D

Rationale: The correct answer is D: Increased calcium level. Parathyroid hormone functions to increase blood calcium levels. When calcium levels are low, the parathyroid gland releases PTH to stimulate the release of calcium from bones and increase calcium absorption from the intestines and kidneys. This helps to maintain normal calcium levels in the blood. Choices A, B, and C are incorrect because decreased phosphate level, functioning thyroid gland, and adequate vitamin D level are not direct requirements for the action of parathyroid hormone.

Question 3 of 5

When caring for Mr. Reyes, the nurse should assess for

Correct Answer: B

Rationale: The correct answer is B: Altered level of consciousness. This is crucial as it can indicate various underlying health issues affecting Mr. Reyes. Assessing for this helps in detecting potential neurological, metabolic, or cardiac issues. A: Decreased carotid pulses - While important, it is not as critical as altered level of consciousness in this scenario. C: Bleeding from oral cavity - This is important to address but does not take priority over assessing Mr. Reyes' level of consciousness. D: Absence of deep tendon-reflexes - This is more specific to neurological assessments and may not be as urgent as assessing his level of consciousness.

Question 4 of 5

Patients with Guillain-Barre Syndrome should be closely monitored. Which of the ff. parameters is most important to be checked regularly for acute complications?

Correct Answer: C

Rationale: The correct answer is C: ABG. Monitoring ABG in Guillain-Barre Syndrome patients is crucial as they are at risk for respiratory complications like respiratory failure due to muscle weakness. ABG provides information on oxygenation, ventilation, and acid-base balance. Regular monitoring helps detect early signs of respiratory distress and guide appropriate interventions. A: BUN and creatinine are important for assessing renal function, but they do not directly relate to acute complications in Guillain-Barre Syndrome. B: Hgb and Hct are markers for anemia, which is not a common acute complication in Guillain-Barre Syndrome. D: Serum potassium levels are important, but ABG monitoring takes precedence in patients with Guillain-Barre Syndrome due to the risk of respiratory issues.

Question 5 of 5

While bathing the client, the nurse observes the client grimacing. The nurse asks if the client is experiencing pain. The client nods yes and refuses to continue the bath. The nurse removes the wash basin, makes the client comfortable, and documents the event in the client�s chart. Which of the following actions clearly demonstrates assessing?

Correct Answer: C

Rationale: The correct answer is C because asking the client if they are experiencing pain is a direct action of assessment. This step involves gathering information directly from the client to understand their condition and needs. By asking the client about pain, the nurse is actively assessing the client's well-being. A: The nurse bathing the client is not an action of assessment but rather a task related to providing care. B: The nurse documenting the incident is important for recording the event but does not directly involve assessing the client's condition. D: The nurse removing the wash basin is a task related to the physical care process and does not involve direct assessment of the client's well-being.

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