ATI Leadership Final Exam Complete Review 2022/2023
The outpatient surgical unit has admitted multiple clients currently awaiting early morning
... [Show More] procedures. What client should the nurse assess first?
1. The client awaiting repair of hiatal hernia reporting chest pain.
2. The client with a torn right rotator cuff reporting shoulder pain.
3. The client with an inguinal hernia repair reporting skin irritation.
4. The client awaiting a hemorrhoidectomy reporting rectal bleeding.
1. Correct: A hiatal hernia occurs when a portion of the stomach pushes up through the esophageal ring (hiatus) of the diaphragm. Surgical intervention is generally a last resort and only when there is evidence of serious complications. Although chest pain could be the result of reflux within the esophagus, it could also indicate a strangulated hiatal hernia. The nurse needs to assess this client immediately.
2. Incorrect: A torn rotator cuff is generally only repaired when other treatment options have been ineffective, such as rest, ice, NSAIDs and even steroid injections. This client has been ordered a surgical repair, indicating other therapies have failed. Shoulder pain on the affected side is to be expected and not an urgent need.
3. Incorrect: An inguinal hernia is the protrusion of intestine through abdominal muscles, creating a painful bulge which worsens with lifting, bending, or straining. Skin irritation usually results from wearing a supportive garment known as a truss. The purpose of this belted device is to apply pressure and provide support to the area of the hernia until surgical repair. Skin irritation is not the nurse's priority.
4. Incorrect: Large or engorged rectal hemorrhoids may require surgical repair because of excessive bleeding, pain, or prolapse. This type of bleeding is not unexpected nor does it present any major concerns about shock. This client would not need to be seen first.
At a monthly staff meeting in a long-term care facility, the charge nurse requests staff input to create new activities for the clients. An RN has been assigned to gather information for staff consideration. What method would provide the RN with the best data for this project?
1. Ask clients' families which activities they would like to have available.
2. Research professional articles for guidelines to activities in long-term care.
3. Have clients peruse a variety of games and select what interests them.
4. Contact other facilities to inquire what types of programs they provide.
2. Correct: Research based criteria generally have a high rate of success because the testing has been completed under controlled circumstances and are practice based. [Show Less]