Review ATI Community- leadership- disaster and Neuro

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ATI Community- leadership- disaster and Neuro

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Total Questions : 45

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Question 1:

A nurse is caring for a client brought to the Emergency Department as one of the first victims of a train accident. The nurse assesses the client, noting a respiratory rate of 38, a weak, rapid pulse, and uncontrolled bleeding. Using NATO guidelines, the nurse assigns which priority tag?

A. Red tag B. Black tag C. Green tag D. Yellow tag

Answer and Explanation

Choice A:

A red tag is assigned to patients who require immediate medical attention and intervention to survive. These patients have life-threatening injuries but have a high chance of survival if treated promptly. In this scenario, the client has a respiratory rate of 38, a weak and rapid pulse, and uncontrolled bleeding. These symptoms indicate severe physiological distress and potential shock, necessitating immediate intervention to prevent death. According to NATO triage guidelines, such critical conditions warrant a red tag to prioritize urgent care1.

Choice B:

A black tag is used for patients who are deceased or have injuries so severe that survival is unlikely even with immediate medical intervention. This category is also known as “expectant” and is used to allocate resources to those with a higher chance of survival. The client in this scenario, despite having severe symptoms, is not described as being beyond the possibility of survival, thus a black tag would not be appropriate1.

Choice C:

A green tag is assigned to patients with minor injuries who can wait for medical treatment without immediate risk to life. These patients are often referred to as “walking wounded.” The client’s symptoms of a high respiratory rate, weak and rapid pulse, and uncontrolled bleeding are far too severe to be classified under this category. Assigning a green tag would delay critical care, potentially leading to fatal outcomes1.

Choice D:

A yellow tag is for patients who have serious injuries but whose treatment can be delayed without immediate risk to life. These patients need medical attention but are stable enough to wait for a short period. Given the client’s symptoms, particularly the uncontrolled bleeding and signs of shock, delaying treatment could result in rapid deterioration. Therefore, a yellow tag would not be suitable in this case1.

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Question 2:

A charge nurse is making a room assignment for a client who has scabies. In which of the following rooms should the nurse place the client?

A. A negative-pressure isolation room B. A private room C. A semi-private room with a client who has pediculosis capitis D. A positive-pressure isolation room

Answer and Explanation

Choice A:

A negative-pressure isolation room is typically used for patients with airborne infections, such as tuberculosis or measles, to prevent the spread of infectious agents through the air. Scabies, however, is primarily transmitted through direct skin-to-skin contact and occasionally through contact with contaminated clothing or bedding. Therefore, a negative-pressure isolation room is not necessary for a scabies patient1.

Choice B:

A private room is the most appropriate choice for a client with scabies. This type of room helps prevent the spread of the infestation to other patients and allows for better control of the environment. Scabies is highly contagious and can spread through direct contact with the infested person or indirectly through contaminated items. Isolating the patient in a private room minimizes the risk of transmission and allows for proper infection control measures to be implemented2.

Choice C:

Placing a scabies patient in a semi-private room with another patient, even one with a different parasitic infection like pediculosis capitis (head lice), is not advisable. Both conditions are highly contagious, and cohabitation increases the risk of cross-contamination and further spread of both infestations. Each condition requires specific treatment and isolation protocols to effectively manage and prevent outbreaks3.

Choice D:

A positive-pressure isolation room is designed to protect immunocompromised patients from external contaminants by ensuring that air flows out of the room rather than in. This type of room is not suitable for a scabies patient, as it does not address the primary mode of transmission for scabies, which is direct contact. The focus for scabies management should be on preventing direct and indirect contact with others4.

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Question 3:

A charge nurse is making a room assignment for a client who has scabies. In which of the following rooms should the nurse place the client?

A. A negative-pressure isolation room B. A private room C. A semi-private room with a client who has pediculosis capitis D. A positive-pressure isolation room

Answer and Explanation

Choice A:

A negative-pressure isolation room is designed to prevent the spread of airborne infectious diseases by ensuring that air flows into the room but not out of it. This type of room is typically used for patients with diseases such as tuberculosis, measles, or COVID-19, which are spread through airborne particles. Scabies, however, is spread through direct skin-to-skin contact or by sharing personal items like bedding or clothing. Therefore, a negative-pressure isolation room is not necessary for a patient with scabies, as the primary mode of transmission is not airborne.

Choice B:

A private room is the most appropriate setting for a client with scabies. Scabies is highly contagious and can spread through direct skin-to-skin contact or by sharing personal items. Placing the client in a private room helps to prevent the spread of the mites to other patients and staff. In a private room, the client can be isolated effectively, and healthcare workers can implement contact precautions, such as wearing gloves and gowns, to minimize the risk of transmission. This approach ensures that the client receives appropriate care while protecting others from potential exposure.

Choice C:

A semi-private room with a client who has pediculosis capitis (head lice) is not suitable for a client with scabies. Although both conditions involve infestations, they are caused by different parasites and have different modes of transmission. Pediculosis capitis is spread through direct contact with infested hair or personal items, while scabies is spread through prolonged skin-to-skin contact. Placing a client with scabies in a semi-private room with another infested patient increases the risk of cross-contamination and further spread of both conditions. Therefore, this option is not recommended.

Choice D:

A positive-pressure isolation room is designed to protect immunocompromised patients from airborne pathogens by ensuring that air flows out of the room but not into it. This type of room is used for patients who need to be protected from infections, such as those undergoing chemotherapy or with severe immune deficiencies. Since scabies is not an airborne disease and does not pose a risk to immunocompromised patients in this manner, a positive-pressure isolation room is not appropriate for a client with scabies. The primary concern with scabies is preventing direct contact transmission, which is best managed in a private room.

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Question 4:

A nurse is delegating tasks to the assistive personnel (AP). The nurse should direct the AP to complete which of the following tasks first?

A. Assisting a client with a bed bath who has a history of falls. B. Providing a snack to a diabetic client who is feeling lightheaded. C. Feeding a client who has bilateral casts due to upper arm fractures. D. Ambulating a postoperative client for the first time.

Answer and Explanation

Choice A:

Assisting a client with a bed bath who has a history of falls is important for maintaining hygiene and preventing skin breakdown. However, this task does not address an immediate physiological need. While it is essential to ensure the safety of clients with a history of falls, this task can be scheduled after more urgent needs are met. The priority in nursing care is to address tasks that have the most immediate impact on a client’s health and safety.

Choice B:

Providing a snack to a diabetic client who is feeling lightheaded is the most urgent task. Lightheadedness in a diabetic client can be a sign of hypoglycemia, which requires immediate intervention to prevent serious complications such as loss of consciousness or seizures. Hypoglycemia occurs when blood sugar levels drop too low, and providing a quick source of glucose can help stabilize the client’s condition. This task addresses an immediate physiological need and is critical for the client’s safety and well-being.

Choice C:

Feeding a client who has bilateral casts due to upper arm fractures is necessary to ensure the client receives adequate nutrition. However, this task does not address an immediate threat to the client’s health. While it is important to assist clients who are unable to feed themselves, this task can be performed after more urgent needs are addressed. Prioritizing tasks that address immediate physiological needs is essential in nursing care.

Choice D:

Ambulating a postoperative client for the first time is important for preventing complications such as deep vein thrombosis, pneumonia, and muscle weakness. Early ambulation is a key component of postoperative care and helps promote recovery. However, this task can be scheduled after addressing more immediate physiological needs. Ensuring the safety and stability of clients with urgent conditions takes precedence over routine postoperative care activities.

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Question 5:

A nurse is caring for a client who was injured by a blast of high-order explosives. Medics report secondary injuries from the explosion. The nurse anticipates what type of injuries?

A. Blunt force trauma B. Hollow organ damage C. Post-trauma stress disorder D. Penetrating injuries

Answer and Explanation

Choice A:

Blunt force trauma refers to injuries caused by impact with a blunt object, resulting in contusions, abrasions, lacerations, or fractures. While blunt force trauma can occur in explosions, it is typically associated with tertiary blast injuries, where the victim is thrown against a solid object. Secondary injuries from high-order explosives are more specifically related to penetrating injuries caused by flying debris and shrapnel.

Choice B:

Hollow organ damage is a type of primary blast injury caused by the overpressure wave from an explosion. This wave can cause significant damage to gas-filled organs such as the lungs, intestines, and ears. However, secondary injuries are not typically characterized by hollow organ damage. Secondary injuries are more commonly associated with penetrating trauma from debris and shrapnel.

Choice C:

Post-trauma stress disorder (PTSD) is a psychological condition that can develop after experiencing or witnessing a traumatic event. While PTSD is a serious and common consequence of exposure to explosions and other traumatic events, it is not classified as a secondary injury. Secondary injuries refer to physical injuries caused by flying debris and shrapnel, not psychological conditions.

Choice D:

Penetrating injuries are the hallmark of secondary blast injuries. These injuries occur when fragments from the explosive device or surrounding materials are propelled at high velocity, causing wounds that penetrate the skin and underlying tissues. These injuries can be severe and life-threatening, requiring immediate medical attention. The nurse should anticipate and be prepared to manage penetrating injuries in clients exposed to high-order explosives.

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Question 6:

A nurse advises a client with osteoporosis to have three servings of milk or dairy products daily. Which of the following levels of prevention is being used by the nurse?

A. Secondary prevention B. Primary prevention C. Proactive prevention D. Tertiary prevention

Answer and Explanation

Choice A:

Secondary prevention involves early detection and treatment of disease to halt its progression. Examples include screening tests and early interventions. Advising a client with osteoporosis to consume dairy products is not aimed at early detection but rather at preventing the onset of complications by ensuring adequate calcium intake.

Choice B:

Primary prevention aims to prevent the onset of disease or injury before it occurs. This includes measures such as vaccinations, lifestyle modifications, and dietary recommendations. Advising a client with osteoporosis to consume three servings of milk or dairy products daily is a primary prevention strategy. It helps to maintain bone density and prevent fractures by ensuring adequate calcium and vitamin D intake.

Choice C:

Proactive prevention is not a standard term used in public health or medical practice. The recognized levels of prevention are primary, secondary, and tertiary. Therefore, this option is not applicable in this context.

Choice D:

Tertiary prevention focuses on managing and mitigating the effects of an existing disease to prevent further complications and improve quality of life. This includes rehabilitation and ongoing treatment for chronic conditions. While advising a client with osteoporosis to consume dairy products can be part of managing the condition, it is primarily a preventive measure to avoid further bone loss and fractures, aligning more with primary prevention.

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Question 7:

The nurse is preparing for an initial home care visit for a client with diabetes. Which action by the nurse is appropriate? SELECT ALL THAT APPLY.

A. Going automatically into the client’s bedroom. B. Thanking the client for arranging a home visit. C. Arranging mutual future visits. D. Asking how they are managing at home. E. Sitting down and discussing with the client and family members.

Answer and Explanation

Choice A:

Going automatically into the client’s bedroom without permission is inappropriate and can be seen as an invasion of privacy. The nurse should always seek consent and respect the client’s personal space. Building trust and maintaining professional boundaries are crucial in home care settings.

Choice B:

While it is courteous to thank the client for arranging a home visit, it is not a critical action that directly impacts the care provided. The focus should be on assessing the client’s needs and establishing a care plan.

Choice C:

Arranging mutual future visits is an appropriate action. It helps to establish a consistent care schedule, ensuring that the client receives ongoing support and monitoring. This is particularly important for managing chronic conditions like diabetes, where regular follow-up is essential for effective management.

Choice D:

Asking how the client is managing at home is a crucial part of the initial assessment. It provides the nurse with valuable information about the client’s current health status, challenges, and needs. This information is essential for developing a personalized care plan that addresses the client’s specific circumstances.

Choice E:

Sitting down and discussing with the client and family members is an important step in the initial home care visit. It helps to build rapport, understand the client’s support system, and involve family members in the care process. This collaborative approach ensures that everyone is informed and can contribute to the client’s care and well-being.

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Question 8:

A nurse is caring for a client who has had a hemorrhagic stroke following a ruptured cerebral aneurysm. Which of the following manifestations should the nurse expect?

A. Gradual onset of headache. B. Changes in consciousness. C. Gradual onset of several hours. D. History of neurologic deficits lasting less than 1 hr.

Answer and Explanation

Choice A:

A gradual onset of headache is more characteristic of other types of headaches or conditions, such as tension headaches or migraines. Hemorrhagic strokes, particularly those caused by a ruptured cerebral aneurysm, typically present with a sudden and severe headache, often described as the “worst headache of my life.” This sudden onset is due to the rapid accumulation of blood in the brain, which increases intracranial pressure and causes immediate symptoms.

Choice B:

Changes in consciousness are a common manifestation of a hemorrhagic stroke. The sudden bleeding into the brain can disrupt normal brain function, leading to symptoms such as confusion, lethargy, or loss of consciousness. These changes occur rapidly and are a key indicator of a serious neurological event. The nurse should be vigilant for any alterations in the client’s level of consciousness, as this can signify worsening of the condition and the need for immediate medical intervention.

Choice C:

A gradual onset of several hours is not typical for hemorrhagic strokes. These strokes usually present with sudden and severe symptoms due to the abrupt rupture of a blood vessel in the brain. The rapid increase in intracranial pressure from the bleeding causes immediate and severe symptoms, rather than a slow progression over hours.

Choice D:

A history of neurologic deficits lasting less than 1 hour is more indicative of a transient ischemic attack (TIA), also known as a mini-stroke. TIAs are temporary and resolve within a short period without causing permanent damage. In contrast, a hemorrhagic stroke caused by a ruptured cerebral aneurysm results in immediate and severe symptoms that do not resolve quickly and require urgent medical attention.

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Question 9:

A nurse is teaching the family of a client who has a new diagnosis of epilepsy about actions to take if the client experiences a seizure. Which of the following instructions should the nurse include in the teaching?

A. “Insert a padded tongue blade into the client’s mouth.” B. “Restrain the client.” C. “Move objects away from the client.” D. “Place the client on his back.”

Answer and Explanation

Choice A:

Inserting a padded tongue blade into the client’s mouth is not recommended and can be dangerous. During a seizure, there is a risk of causing injury to the client’s mouth or teeth, and it can also obstruct the airway. The correct approach is to ensure the client’s safety by preventing injury, not by inserting objects into their mouth.

Choice B:

Restraining the client during a seizure is not advised. Restraints can cause additional harm and do not prevent the seizure from occurring. Instead, the focus should be on protecting the client from injury by ensuring a safe environment and allowing the seizure to run its course.

Choice C:

Moving objects away from the client is a crucial step in ensuring their safety during a seizure. This action helps prevent the client from hitting or injuring themselves on nearby objects. Creating a safe space around the client is one of the primary goals during a seizure to minimize the risk of injury.

Choice D:

Placing the client on their back is not recommended during a seizure. Instead, the client should be placed on their side if possible, to help keep the airway clear and reduce the risk of aspiration. This position also allows for better monitoring of the client’s breathing and overall condition.

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Question 10:

Which of the following statements indicate the importance of epidemiology to the community health nurse? SELECT ALL THAT APPLY.

A. Epidemiology interprets legislation in the community. B. Epidemiology evaluates the effectiveness of nursing interventions. C. Epidemiology analyzes and examines the root causes of health outcomes. D. Epidemiology defines the burden of disease and determinants of health. E. Epidemiology relates to the health status of a population.

Answer and Explanation

Choice A:

While epidemiology provides valuable data that can inform public health policies and legislation, it does not directly interpret legislation. The role of epidemiology is to gather and analyze data on health outcomes, which can then be used by policymakers to create informed legislation. Therefore, this statement does not accurately reflect the primary functions of epidemiology.

Choice B:

Epidemiology evaluates the effectiveness of nursing interventions by analyzing data on health outcomes before and after the implementation of specific interventions. This helps determine whether the interventions are successful in improving health and reducing disease incidence. Community health nurses rely on this data to make evidence-based decisions and improve their practice.

Choice C:

Epidemiology analyzes and examines the root causes of health outcomes by studying patterns, causes, and effects of health and disease conditions in populations. This analysis helps identify risk factors and underlying causes of diseases, which is essential for developing effective prevention and intervention strategies.

Choice D:

Epidemiology defines the burden of disease and determinants of health by quantifying the incidence, prevalence, and impact of diseases within a population. This information is crucial for public health planning and resource allocation, as it highlights the most pressing health issues and their contributing factors.

Choice E:

Epidemiology relates to the health status of a population by providing comprehensive data on health trends, disease outbreaks, and overall health outcomes. This information helps community health nurses understand the health needs of their populations and tailor their interventions accordingly.

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ATI Community- leadership- disaster and Neuro

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