test bank foundations of nursing

Questions 102

ATI RN

ATI RN Test Bank

test bank foundations of nursing Questions

Question 1 of 5

The clinic nurse is assessing a child who has been brought to the clinic with signs and symptoms that are suggestive of otitis externa. What assessment finding is characteristic of otitis externa?

Correct Answer: C

Rationale: The correct answer is C: Pain on manipulation of the auricle is characteristic of otitis externa. This is because otitis externa is an infection or inflammation of the outer ear canal, causing pain and tenderness when the ear is touched or manipulated. A: Tophi on the pinna and ear lobe is characteristic of gout, not otitis externa. B: Dark yellow cerumen in the external auditory canal is common and not specific to otitis externa. D: Air bubbles visible in the middle ear are associated with otitis media, not otitis externa. In summary, pain on manipulation of the auricle is a key assessment finding in otitis externa, distinguishing it from other ear conditions.

Question 2 of 5

A 6-year-old child is brought to the pediatric clinic for the assessment of redness and discharge from the eye and is diagnosed with viral conjunctivitis. What is the most important information to discuss with the parents and child?

Correct Answer: A

Rationale: Step 1: Handwashing is crucial in preventing the spread of viral conjunctivitis, which is highly contagious. Step 2: Children often touch their eyes and then surfaces, aiding in disease transmission. Step 3: Educating parents and the child on proper hand hygiene can help contain the infection. Step 4: Antibiotics are not effective against viral infections, so compliance is not necessary. Step 5: Complications like meningitis and septicemia are extremely rare with viral conjunctivitis. Step 6: Surgery is not indicated for viral conjunctivitis, as it is a self-limiting condition.

Question 3 of 5

A nurse is planning discharge education for a patient who underwent a cervical diskectomy. What strategies would the nurse assess that would aid in planning discharge teaching?

Correct Answer: A

Rationale: Correct Answer: A - Care of the cervical collar Rationale: 1. Care of the cervical collar is essential post-cervical diskectomy to ensure proper immobilization and support. 2. Proper care prevents complications and promotes healing. 3. It is a crucial aspect of discharge education to prevent injury and promote recovery. Summary of other choices: B: Technique for performing neck ROM exercises - Important for rehabilitation but not directly related to discharge education post-cervical diskectomy. C: Home assessment of ABGs - Irrelevant to post-cervical diskectomy discharge education. D: Techniques for restoring nerve function - Important for recovery but not a primary focus of discharge education.

Question 4 of 5

Which assessment in a patient diagnosed with preeclampsia who is taking magnesium sulfate would indicate a therapeutic level of medication?

Correct Answer: C

Rationale: The correct answer is C: Normal deep tendon reflexes. This indicates a therapeutic level of magnesium sulfate as it shows that the medication is effectively preventing hyperreflexia, a common sign of magnesium toxicity. Drowsiness (choice A) can indicate toxicity. Urinary output of 20 mL/hour (choice B) is not specific to magnesium sulfate levels. Respiratory rate of 10 to 12 breaths per minute (choice D) is indicative of respiratory depression, a sign of magnesium toxicity. Thus, choice C is the best assessment to indicate a therapeutic level of medication in a patient with preeclampsia taking magnesium sulfate.

Question 5 of 5

A nurse is caring for a 33-year-old male who has come to the clinic for a physical examination. He states that he has not had a routine physical in 5 years. During the examination, the physician finds that digital rectal examination (DRE) reveals stoney hardening in the posterior lobe of the prostate gland that is not mobile. The nurse recognizes that the observation typically indicates what?

Correct Answer: C

Rationale: The correct answer is C: Evidence of a more advanced lesion. A stoney hardening in the posterior lobe of the prostate gland that is not mobile is indicative of a more advanced lesion, such as prostate cancer. This finding suggests that the lesion has progressed beyond the early stages. In early prostate cancer, the prostate gland may feel firm but not stoney hard, and the lesion is usually mobile. Metastatic disease would involve spread of the cancer to other parts of the body, which is not evident from the DRE alone. A normal finding would not present as stoney hardening and lack of mobility in the prostate gland during a DRE.

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