ATI RN
Test Bank Pharmacology and the Nursing Process Questions
Question 1 of 5
Which scenario best illustrates the nurse using data validation when making a nursing clinical decision for a patient? The nurse determines to remove a wound dressing when the patient reveals the time
Correct Answer: A
Rationale: The correct answer is A because the nurse is using data validation by comparing the time of the last dressing change with the appearance of old and new drainage. This process ensures that the decision to remove the wound dressing is based on accurate and relevant information. By assessing both the time of the last dressing change and the characteristics of the drainage, the nurse is validating the need for the intervention. Option B is incorrect because administering pain medicine based solely on a patient's report of increased pain without further validation does not demonstrate data validation. Option C is incorrect as the nurse immediately requesting an order of potassium without further assessment of the patient's condition is not an example of data validation. Option D is incorrect as elevating a leg cast based solely on a patient's report of decreased mobility without further assessment does not involve data validation.
Question 2 of 5
For which of the ff conditions would the use of salt tablets be considered?
Correct Answer: A
Rationale: Rationale: - Salt tablets are used for mild deficits of serum sodium to help restore electrolyte balance. - Sodium is crucial for fluid balance, nerve function, and muscle contraction. - Severe deficits of serum magnesium, potassium, and calcium require specific electrolyte replacement therapy, not salt tablets. Summary: - Choice A is correct because salt tablets are used for mild deficits of serum sodium. - Choices B, C, and D are incorrect because they involve severe deficits of different electrolytes that require specific replacement therapy.
Question 3 of 5
How can the nurse help monitor effectiveness of therapy for the patient with a pneumothorax and chest-drainage system?
Correct Answer: C
Rationale: The correct answer is C: Auscultate lung sounds. By auscultating lung sounds, the nurse can assess for changes in breath sounds which can indicate improvement or deterioration in the patient's condition. This helps monitor the effectiveness of therapy for a pneumothorax and chest-drainage system. Palpating for crepitus (A) is not directly related to monitoring therapy effectiveness. Documenting sputum color and amount (B) is important but does not specifically monitor therapy effectiveness. Monitoring suction level (D) is crucial but does not directly assess the patient's response to therapy.
Question 4 of 5
A client receives a sealed radiation implant to treat cervical cancer. When caring for this client, the nurse should:
Correct Answer: A
Rationale: The correct answer is A because bodily fluids and excretions (urine, feces, vomitus) can become contaminated with radiation from the implant. Therefore, they should be considered highly radioactive and handled appropriately. Choice B is incorrect because the client may remain radioactive for a longer period than 10 days post-implant removal. Choice C is incorrect because soiled linens should be handled according to radiation safety protocols and removed promptly. Choice D is incorrect because bed rest is not necessary unless specifically indicated by the healthcare provider; the client should be encouraged to move around as tolerated to prevent complications.
Question 5 of 5
Why should the nurse closely monitor a client to ensure that the venous access device remains in the vein during a transfusion?
Correct Answer: B
Rationale: The correct answer is B: It minimizes the risk of circulatory overload. When a venous access device dislodges during a transfusion, there is a risk of the infusion going into the surrounding tissues instead of the vein, leading to circulatory overload. This can result in fluid overload and potentially lead to serious complications such as heart failure. Monitoring the device ensures that the medication is delivered safely and effectively into the bloodstream. Choices A, C, and D are incorrect: A: Monitoring the device does not directly minimize the risk of phlebitis, which is inflammation of the vein. C: Monitoring the device does not directly minimize the risk of pulmonary complications, which are not typically associated with a dislodged venous access device. D: Monitoring the device does not directly minimize the risk of localized edema embolism, which is a blockage caused by a blood clot, air bubble, or other material in a blood vessel.
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