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ATI RN · Nursing Process · Nursing Process Test Bank

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Showing all 5 practice questions with expert explanatory rationales.

Question 1 of 5

Of the following types of nursing diagnoses, which one is validated by the presence of major defining characteristics?

A. Risk nursing diagnosis

B. Actual nursing diagnosis

C. Possible nursing diagnosis

D. Wellness diagnosis

Expert Explanatory Rationale

Correct Answer: Actual nursing diagnosis

Question 2 of 5

A post-TURP patient experiences dribbling following removal of his catheter. Which action should the nurse take?

A. Have him restrict fluid intake to 1000 mL/day

B. Teach him to perform Kegel's exercises 10 to 20 times per hour

C. Reinsert the Foley catheter until he regains urinary control

D. Reassure him that incontinence never lasts more than a few days

Expert Explanatory Rationale

Correct Answer: Teach him to perform Kegel's exercises 10 to 20 times per hour

Question 3 of 5

Which of the ff should the nurse identify as the earliest symptom of heart failure in many older clients?

A. Increased urine output

B. Dyspnea on exertion

C. Swollen joints

D. Nausea and vomiting

Expert Explanatory Rationale

Correct Answer: Dyspnea on exertion

Question 4 of 5

A client metastatic ovarian cancer is prescribed cisplatin (Platinol). Before administering the first dose, the nurse reviews the client's medication history for drugs that may interact with cisplatin. Which drug may cause significant interactions when given concomitantly with cisplatin?

A. Erythromycin

B. A cephalosporin

C. A tetracycline

D. An amino glycoside Situation: A client with ovarian cancer is prescribed hydroxyurea (Hydrea), an antimetabolite drug.

Expert Explanatory Rationale

Correct Answer: An amino glycoside Situation: A client with ovarian cancer is prescribed hydroxyurea (Hydrea), an antimetabolite drug.

Question 5 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?

A. BUN and creatinine

B. Hgb and Hct

C. ABG

D. Serum potassium

Expert Explanatory Rationale

Correct Answer: ABG