ATI RN
test bank foundations of nursing Questions
Question 1 of 5
The nurse is caring for a patient who has just had a radical mastectomy and axillary node dissection. When providing patient education regarding rehabilitation, what should the nurse recommend?
Correct Answer: C
Rationale: The correct answer is C: Avoid lifting objects heavier than 10 pounds. This recommendation is crucial post-mastectomy as it helps prevent lymphedema and promotes healing without causing strain on the surgical site. Lifting heavy objects can lead to complications such as lymphedema or disruption of the healing process. Options A, B, and D are incorrect as avoiding exercise of the arm for 2 months may lead to stiffness and reduced range of motion, keeping cuticles clipped neatly does not directly affect rehabilitation, and using a sling is not necessary unless specifically advised by the healthcare provider.
Question 2 of 5
A nurse is assessing the skin integrity of a patient who has AIDS. When performing this inspection, the nurse should prioritize assessment of what skin surfaces?
Correct Answer: A
Rationale: The correct answer is A: Perianal region and oral mucosa. In patients with AIDS, these areas are more prone to opportunistic infections due to decreased immune function. The perianal region can be affected by conditions like anal warts or herpes, while the oral mucosa can develop oral thrush or other oral infections. By prioritizing assessment of these areas, the nurse can promptly identify any potential issues and initiate appropriate interventions. Choice B: Sacral region and lower abdomen are not typically high-risk areas for skin integrity issues in AIDS patients. Choice C: Scalp and skin over the scapulae are not commonly affected by opportunistic infections related to AIDS. Choice D: Axillae and upper thorax are not as commonly affected as the perianal region and oral mucosa in AIDS patients.
Question 3 of 5
An adolescent patients history of skin hyperreactivity and inflammation has been attributed to atopic dermatitis. The nurse should recognize that this patient consequently faces an increased risk of what health problem?
Correct Answer: D
Rationale: The correct answer is D: Asthma. Atopic dermatitis is associated with a heightened immune response and inflammation, which can predispose individuals to developing asthma. Both conditions involve an overactive immune response and can coexist in patients due to shared genetic and environmental factors. Asthma commonly presents alongside atopic dermatitis in individuals with atopic tendencies. Bronchitis (choice A) is a respiratory condition caused by inflammation of the bronchial tubes and is not directly linked to atopic dermatitis. Systemic lupus erythematosus (choice B) and rheumatoid arthritis (choice C) are autoimmune diseases that primarily affect the joints and other organs, but they are not typically associated with atopic dermatitis.
Question 4 of 5
Which of the following nurses actions carries the greatest potential to prevent hearing loss due to ototoxicity?
Correct Answer: D
Rationale: The correct answer is D because being aware of patients' medication regimens allows nurses to identify and monitor ototoxic medications that can cause hearing loss. By collaborating with other professionals, nurses can adjust medications or recommend alternative treatments to prevent or minimize ototoxicity. This proactive approach directly targets the root cause of potential hearing loss. A: Understanding types of hearing loss is important but does not directly prevent ototoxicity. B: Educating about age-related changes in hearing does not address ototoxicity prevention. C: Educating about noise exposure risks is important for overall hearing health but does not specifically prevent ototoxicity.
Question 5 of 5
A nurse is caring for a pregnant patient with active herpes. The teaching plan for this patient should include which of the following?
Correct Answer: A
Rationale: The correct answer is A because babies can become infected with the herpes virus if delivered vaginally. During childbirth, the virus can be passed to the infant, leading to serious health complications. This information is crucial for the patient to understand in order to make informed decisions about delivery options. Choice B is incorrect because excision of herpes lesions is not the recommended treatment during pregnancy. Treatment typically involves antiviral medications to manage symptoms and reduce the risk of transmission to the baby. Choice C is incorrect because herpes outbreaks can indeed be painful during pregnancy due to hormonal changes and a weakened immune system. Pain management strategies should be discussed as part of the teaching plan. Choice D is incorrect because pregnancy can pose a risk to the infant if the mother has active herpes. It is important to manage the condition appropriately to prevent transmission to the baby.
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