ATI RN
jarvis health assessment test bank Questions
Question 1 of 5
What is the most appropriate nursing intervention for a client with acute pain after surgery?
Correct Answer: B
Rationale: The correct answer is B: Encourage fluid intake. Adequate hydration helps in pain management by promoting circulation and reducing inflammation. Opioids (choice A) should only be used if non-pharmacological interventions fail. Administering oxygen (choice C) is not typically indicated for pain management. Monitoring electrolyte levels (choice D) is important but not the most immediate intervention for acute pain post-surgery.
Question 2 of 5
What is the most appropriate intervention for a client with suspected deep vein thrombosis (DVT)?
Correct Answer: A
Rationale: The correct answer is A: Administer anticoagulants. Anticoagulants are crucial in treating DVT as they prevent blood clots from getting larger and stop new clots from forming. They help reduce the risk of complications like pulmonary embolism. Administering analgesics (B) may help with pain but does not address the root cause. Diuretics (C) are used to treat conditions like fluid retention, not DVT. Applying a warm compress (D) can actually worsen DVT by promoting blood flow. Anticoagulants are the gold standard treatment for DVT.
Question 3 of 5
What should be the nurse's first action when a client develops chest pain after surgery?
Correct Answer: A
Rationale: The correct answer is A: Administer oxygen. The first action should be to ensure the client's oxygenation as chest pain could indicate decreased oxygen supply. Administering oxygen helps improve oxygen levels and can be crucial in managing potential complications. Summary of other choices: B: Administering morphine may mask the pain but doesn't address the underlying issue. C: Administering anticoagulants is not appropriate as the cause of chest pain is not related to clotting. D: Applying a warm compress is not indicated and may delay proper assessment and intervention for the chest pain.
Question 4 of 5
What is the priority nursing intervention for a client experiencing chest pain and a history of heart disease?
Correct Answer: A
Rationale: The correct answer is A: Administer nitroglycerin. This is the priority intervention because nitroglycerin helps dilate blood vessels, reducing chest pain in clients with heart disease. It improves blood flow to the heart, relieving ischemia. Morphine (B) can mask symptoms and should be used if pain persists after nitroglycerin. Beta blockers (C) are beneficial in chronic management but not for immediate relief. Aspirin (D) helps prevent clot formation but is not the priority in acute chest pain.
Question 5 of 5
A nurse is providing education to a patient with diabetes. Which of the following statements by the patient indicates the need for further education?
Correct Answer: C
Rationale: The correct answer is C because stopping insulin when blood sugar is normal can lead to hyperglycemia. Choice A shows understanding of managing diabetes. Choice B indicates monitoring blood sugar, crucial for diabetes management. Choice D demonstrates adherence to medication schedule, essential for controlling blood sugar levels. Stopping insulin prematurely can disrupt the balance and result in complications.
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