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ATI practice (B)
ATI practice (B)
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1
A nurse is caring for a pt following application of a cast. Which of the following actions should the nurse take first?
Palpate the pulse distal to the cast
Teach the client to keep the cast clean and dry.
Position the casted extremity on a pillow
Place an ice pack over the cast.
2
A nurse is caring for a client with a hx of depression and experiencing a situational crisis. Which action should be 1st
Notify the client's support system
Teach the client relaxation techniques
Help the client's identify personal strengths
Confirm the client's preception of the event
3
A nurse is caring for a pt 2 hour postop following cardiac cath. Which is the priorty assessment finding?
Absence of pedal pulse in the affected extremity
Urinary output 25mL/hr
Report of burning sensation at the insetion site
Oxygen saturation 91%
4
A nurse is caring for pt receiving brachytherapy for tx of prostate cancer. Which action should the nurse take?
Discard the client’s linens in a double bag
Limit the client’s visitors to 30 min per day.
Discard the radioactive source in a biohazard bag
Cleanse equipment before removal from the client’s room.
5
A nurse in a mental health facility get change of shift report for four clients. Which should be assessed first?
A client who will be receiving her first ECT treatment today
A lcient who received a PRN dose of Haloperidol 2 hr ago for incr. anxiety
A client placed in restraints due to aggressive behavior
A newly admitted client w a hx of 4.5 kg (10 lbs) in past two months
6
A nurse in a ED is assessing a new pt experiencing drooling & hoarseness following a burn injury. What action is first?
Insert an 18-gauge IV catheter
Obtain a baseline ECG.
Administer 100% humidified oxygen.
Obtain a blood specimen for ABG analysis.
7
A nurse is caring for a client who is experiencing resp distress.What earlys/s of hypoxemia should the nurse notice SATA
Confusion
Bradycardia
Elevated blood pressure
Pale skin
8
Caring for pt who is to receive thrombolytic therapy. What factorshould the nurse recognize as a contraindication?
Elevated platelet count
Hip arthoplasty 2 weeks ago
Incident of exercise-induced asthma 1 week ago
Elevated sedimentation rate
9
A nurse is completing an admission assessment for a pt w narcissistic personality d/o. Which should the nurse expect?
Preoccupied with aging
Exhibits separation anxiety
Ritualistic behavior
Suspicious of others
10
A nurse is reviewing assessment data from several pts. Which client whould the nurse recommend referral to a dietician?
A lcient who has nonhealing leg ulcer
An older adult client who has presbyopia
An older adult client who has a BMI of 24
A client who has an albumin level of 3.7 g/dL
11
A nurse is planning care for pt w unilateral paralysis & dysphagia following a righthem stroke. Which should be included
Provide total care in performing the client’s ADLs.
Maintain the client on bed rest.
Place the client’s left arm on a pillow while he is sitting.
Place food on the left side of the client’s mouth when he is ready to eat.
12
A nurse is reviewing med rec of pt w schizophrenia and taking Clozapine. Which should the nurse identify as a contraind.
WBC count 2,900/mm3
Hgb 14 g/dL
Fasting blood glucose 100 mg/dL
heart rate 58/min
13
A nurse is caring for a child who has cystic fibrosis and requires postural drainage. Which action should be made?
Perform the procedure prior to meals
Hold hand flat to perform percussions on the child
Administer a bronchodilator after the procedure
perform the procedure twice a day
14
A nurse creating a plan of care for a new pt who has OCD. Whichof the following interventions should the nurse take?
Allow the client enough time to perform rituals.
Give the client autonomy in scheduling activities.
Discourage the client from exploring irrational fears
Provide negative reinforcement for ritualistic behaviors
15
A nurse is caring for pt receiving vecuronium for ARDS. Which medication should the nurse expect witht this med (SATA)
Furosemide
Midazolam
Famotidine
Fentanyl
16
A nurse is providing care for a client who is in the advanced stage of ALS.Which following referral is the priority?
Occupational therapist.
Speech-language pathologist
Psychologist
Social worker.
17
A nurse is planning care for pt who is recovering from an acute MI that occurred3 days ago. Which should be included?
Place the client in a supine position while resting
Obtain a cardiac rehabilitation consultation
Draw a troponin level every 4hr
Perform an ECG every 12 hr.
18
Nurse is preparing an in service for a group of nurses about mapractice. Which of the following should be included?
Placing a yellow bracelet on a client who is at risk for falls
Leaving an NG tube clamped after administering oral medications
Administer potassium via IV bolus
Documenting communication with a provider in the progress notes of med rec.
19
A nurse in a provider’s office is reviewing the laboratory results of a group of clients. Which to report?
Herpes Simplex
Candidiasis
Chlamydia
HPV
20
A nurse is caring for a pt who is experiencing acute mania. Which of the following foods should the nurse provide for pt
Oatmeal with butter
Peanut Butter Sandwhich
Celery sticks
Chicken noodle soup
21
A nurse is teaching about Digoxin to parents of toddler w heart failure. Which should the nurse include in the teaching?
Limit your child's potassium intake while she is taking this medication
You can add the medication to a half cup of your child's favorite juice
Repeat the dose if your child vomits within 1 hr after taking medication
Have your child drink a small glass of water after swallowing medication
22
A nurse is caring for pt who request the creation of a living will. Which of the following actions shouldthe nurse take?
Request a conference with the client’s family.
Schedule a meeting between the hospital ethics committee and the client
Determine the client’s preferences about post mortem care
Evaluate the client’s understanding of life-sustaining measures
23
Nurse in a mental health clinic receives request from pt undergoing psychotherapy to obtain a copy of therapist notes...
"I don't think you will benefit from reviewing your therapist's notes now"
"We can provide a copy of your records but therapist notes aren't included"
"Why are you interested in seeing your therapist's notes"
"Are you happy with your treatment"
24
A nurse is assessing pt w left-sided heart failure. Which should the nurseidentify as a manifestation of pulm congestion
bradypnea
jugular vein distention
weight gain
frothy pink sputum
25
Which statement by a client indicates understanding of infection prevention teaching?
I should wash my hands for 10 sec with hot water after working in garden
I can visit my nephew with chickenpox 5 days after the sores have crusted
I can clean my cat's litter box during my pregnancy
I should take antibiotics when I have a virus
26
A nurse doing physical therapy for pt w Parkinson’s disease. What statement by the client indicates understanding
“I have been experiencing more tremors in my left arm than before”
“Sometimes, I feel I am making a chewing motion when I’m not eating”
“I noticed that I am having a harder time holding on to my toothbrush”
“Lately, I feel like my feet are freezing, as they are stuck to the ground”
27
A nurse is caring for pt with new prescription of INH w TB. What should the client report as an adverse effect?
“You might experience loss of appetite.”
“You might notice tingling of your hands.”
“You might notice yellowing of your skin.”
“You might experience pain in your joints.”
28
A nurse is preparing a dose of a new prescription of prednisone to pt wCOPD. Monitor for which adverse effects of med?
Hypokalemia
Black.tarry stools
Fluid Restriction
Nausea
29
Nurse is preparing a sterile wound irrigation and dressing change. What breaks surgical aseptic technique?
Balancing the bottle on the sterile basin while pouring the liquid
Applying a sterile gown after applying a sterile mask
Placing the supplies on the sterile field and leaving a 1 inch perimeter
Putting on sterile gloves after preparing the sterile field
30
A nurse is caring for a client in labor who has received an epidural. Which action should the nurse take?
Monitor the client for HTN
Reposition the client side to side each hour
Have protamine sulfate available at the bedside
Decrease the maintenance infusion rate of IV fluid
31
The nurse is teaching a pt with CKD receiving hemodialysis. Which should the nurse include in the teaching?
drink at least 3 L of fluid daily
eat 1g/kg or protein per day
consume foods high in potassium
Take magnesium hydroxide for indigestion
32
Nurse is assessing pt with sinusitis, which technique should the nurse use to identify manifestations of the disorder?
Auscultation of the Trachea
palpation of the orbital areas
Perscussion of posterior lobes of lungs
Inspection of the orbital areas
33
A nurse is developing an in service about personality disorders. Which should be included on borerline personality d/o
The client is overly concerned about minor details
The client exhibits impulsive behavior
The client is exceptionally clingy to others
The client might act seductively
34
A nurse is developing plan of care for pt w preeclampsia and is to receive mag sulf via IV. Which should be included?
Measure the client's u/o every hour
Give the client protamine sulfate if signs of mag sulfate oxicity occur
Monitor the FHR via doppler every 30 minutes
Restrict the client's total fluid intake to 250 mL/hr
35
Nurse is teaching group of new nurses about measures to take when caring for a pton contact precautions. Which is right?
Remove the protective gown after the client’s room.
Wear gloves when providing care to the client.
Place the client in a room with negative pressure
Wear a mask when changing the linens in the client’s room.
36
A nurse is teaching at a health fair about electrical fire prevention. Whichinformation should the nurse include?
Check the tingling sensations around the cord to ensure electricity works
Use three pronged grounded plugs.
Remove the plug from the socket by pulling the cord
Cover extension cords with a rug.
37
A nurse is caring for an adolescent w sickle-cell anemia. Which indicates acute chest syndrome & needs reporting to PCP?
Hematuria.
Substernal retractions.
Sneezing.
Temperature 37.9 C (100.2 F).
38
A nurse is teaching a client who has TB. Which of the following statements should the nurse include in the teaching?
“You will need to wear a mask at all times.”
“You will need to continue to take the multi-med regimen for 4 months.”
“You need to provide sputum samples every 4wks to monitor the effect of med
“You will need to remain hospitalized for treatment.
39
Nurse in the ED is assessing a pt who has a suspected flail chest. Which of finding should the nurse expect (SATA)
Hypotension
Paradoxic chest movement
Cyanosis
Dyspnea
40
A nurse is reviewing prescriptions for pt w pneumothorax. Which of the followingactions should the nurse perform first?
Administer Lorazepam
Prepare for chest tube insertion
Assess the client's pain
Obtain large bore IV needle for decompresion
41
A nurse is assessing a pt following a bronchoscopy. Which of the findings should the nurse report to the provider?
Sore throat
Blood tinged sputum
Dry, nonproductive cough
Bronchospams
42
Nurse is administering a scheduled med to pt. The pt reports that the med appearsdifferent than what they take at home..
“I recommend that you take this medication as prescribed”
“I will call the pharmacist now to check on this medication”
“Do you know why this medication is being prescribed to you?”
“Did the dr discuss with you that there was a change in this medication?”
43
A nurse is planning care for pt w SARS. Which of the following actions should be included in the plan of care (SATA)
Provide supplemental oxygen
Maintain ventilaroty support
Administer bronchodilators
Administer antibiotics
44
A nurse is teaching about Albuterol. Which statement by the pt indicates understanding of the teaching?
“I can have mouth sores while taking this medication.”
“I can have an increase in my heart rate while taking this medication.”
“This medication can increase my blood sugar levels.”
“This medication can decrease my immune response.”
45
A nurse is preparing to administer an autologous blood product to pt. Whichactions should the nurse take to identify pt?
Ask the pt to state the blood type and date of their last blood donation.
Confirm the prescription matches the number on the blood component.
Ensure that the pt’s identification band matches number on the blood unit
Match the client’s blood type with the type and cross match specimens.
46
A nurse is caring for a client who has vision loss. Which of the following actions should the nurse take? (SATA)
Allow extra time for the client to perform tasks.
Keep objects in the client’s room in the same place
Approach the client from the side.
Ensure there is high-wattage lighting in the client’s room
47
A nurse is teaching a pt w heart failure and a new prescription for furosemide. Which statement should the nurse make?
Taking furosemide can cause your potassium levels to be high
taking furosemide can cause you to be overhydrated
eat foods high in sodium
Rise slowly when getting out of bed
48
Nurse is caring for a pt in labor, requires augmentation of labor. Which is a contrindiction to oxytocin?
Post term with oligohydramnios
shoulder presentation
Chorioamnionitis
DM
49
Nurse is reviewing labs for a pt who has chronic kidney disease. Which of the followingfindings should the nurse expect?
increased bicarbonate
increased creatnine
increased hemoglobin
increased calcium
50
A nurse is caring for pt who is newly dx with pancreatic cancer w questions about thedisease. Which is most reliable?
Health Source
ProQuest
CINAHL
MEDLINE
51
Pt has new dx of TB placed on multi-med regimen. WHuch instruction should the nurse give related to Ethambutol.
“Your urine can turn a dark orange.”
“Take vitamin B6 daily.”
“Watch for a change in the sclera of your eyes.”
“Watch for any changes in vision.”
52
A nurse is orientating a new nurse on the purpose of administering vecuronium to pt with ARDS. Which shows understanding
“This medication is given to treat infection.”
“This medication is given to decrease inflammation.”
“This medication is given to reduce anxiety.”
“This medication is given to facilitate ventilation.”
53
A nurse is reviewing legal issues in health care with a group of new nurses. Which recommendation should the nurse make
Overestimate client's acuity to prevent short staffing
Obtain personal professional liability insurance coverage
Ensure that each client has a living will on file prior to the treatment
Place copies of incident reports in client's medical records
54
A nurse is reviewing health records of five pt. Which client is at risk for developing ARDS. (SATA)
A client who experienced a near-drowning incident
A client following coronary artery bypass graft surgery
A client who has dysphagia
A client who experienced a drug overdose
55
Caring for apt in a seclusion room following violent behavior. The pt continues aggressive behavior. The nurse should...
Stand within 30 cm (1 ft) of the client when speaking with them.
Confront the client about this behavior.
Express sympathy for the client’s situation.
Speak assertively to the client.
56
A nurse is caring for pt w depression and reports taking ST. John’s wort, with citalopram.Which should be wacthed for?
seretonin syndrome
pseudo parkinsonism
tardive dyskinesia
acute dystonia
57
A nurse is to instruct a pt on how to do pursed-lip breathing. Which should the nurse include in the plan of care?
Puff your cheeks upon exhalation
Take a deep breath in through your nose
Place you hand over your stomach.
Take quick breaths upon inhalation
58
A nurse is orienting a new nurse on the care of a line placed for hemodynamic monitoring. Which indicates understanding?
“The client should be positioned on the left side during the procedure.”
“A chest x-ray is needed to verify placement after the procedure.”
“Air should be instilled into the monitoring system prior to procedure.”
“The transducer should be level w the 2nd interc space after line placed.”
59
A nurse is caring for group of pts. Which clients are at risk for pulmonary embolism? (Select all that apply.)
A client who has chronic atrial fibrillation
A client who has a fractured femur
A female client who is postmenopausal
A client who has a BMI of 30
60
Nurse preparing to administer IV meds to pt, puntures bag and it leaks out. Which med requires handling of biohaz mat.
Phenytoin
Metronidazole
Doxorubicin Hydrochloride
Ampicillin
61
A nurse in a clinic is assessing a 6 month old infant. Which of the following should the nurse report to the provider?
Pulse 140/min
Closed anterior fontanel
Abdominal breathing
Respiratory rate 26/min
62
Nurse is reviewing discharge instructions for pt w pneumothorax. Which statement should the nurse use when teaching pt?
“Notify your provider if you experience a productive cough.”
“Notify the provider if you experience weakness.”
“You should be able to return to work in 1 week.”
“You need to wear a mask when in crowded areas.”
63
Nurse is reviewing the med-record of a pt who requests combination oral contraceptives.Which condition is a contraind.?
Hyperthyroidism.
Thrombophlebitis
Hypocalcemia.
Diverticulosis.
64
A nurse is teaching a pt trying to conceive. Which should the nurse instruct to eat to prevent neural tube defects?
Zinc
Iron
Folate
Calcium
65
A nurse is reviewing the lab results of pt w rheumatoid arthritis. Whichfollowing finding should the nurse report to PCP
Aspartate aminotransferase 10 units/L.
Erythrocyte sedimentation rate 75 mm/hr
WBC count 8,000/mm3
Platelets 150,000/mm3.
66
A nurse is caring for pt w fibromyalgia and requests pain meds. Which of the followingmeds should the nurse administer?
Pregabalin
Codeine
Lorazepam
Colchicine
67
A nurse is caring for an infant w/ coarctation of the aorta. Which of the following should be identified as expected?
upper extremity hypotension
increased ICP
weak femoral pulses
frequent nosebleeds
68
A nurse is preforming a gastric lavage for a pt with an upper GI bleed. Which following action should the nurse take?
Insert a large-bore NG tube.
Instruct the client to lie on his right side.
Use a cold irrigation solution.
Instill 500 ml of solution through the NG tube
69
A nurse is caring for a client who asks for inormation regarding organ donation. Which responses should the nurse make?
Your name cannot be removed once you are listed on the organ donor list
You must be at least 21 years of age to become an organ donor
Your desire to be an organ donor must be documented in writing
I cannot be a witness for your consent to donate
70
Nurse is giving discharge teaching on a diet to a pt who has a new prescription for Phenelzine.What food is safe to eat.
Avocados
Smoked salmon
Whole grain bread
Pepperoni pizza
71
A nurse is building a therapeutic relationship with a new pt. Which should the nurse plan to add in orientation phase?
Establish the reponsibilities of the nurse and client
Facilitate the client's probelm solving skills
Assit the client in expressing alternative behaviors
Determine the previous coping skills used by the client
72
A public health nurse is managing several projects. Which should the nurse identify as a prevention strategy?
Providing crisis intervention through a mobile counseling unit
Teaching parenting skills to expectant mothers and their partners.
Referring clientwho have obesity to community exercise programs.
Conducting mental health screenings at the local community center
73
A nurse is assisting a procider with the removal of chest tube, what should the nurse instruct patient to do?
Cough at regular intervals
Perform the Valsalva maneuver.
Lie on it left side.
Use the incentive spirometer.
74
A nurse is caring for a client who wears glasses. Which of the following actions should the nurse take?
Clean the glasses with a paper towel.
Clean the glasses with hot water.
Store the glasses on the bedside table
Store the glasses in a labeled case.
75
A nurse is caring for pt w generalized petechiae & ecchymoses. The nurse should expecta prescription for which lab test?
potassium level
prealbumin
creatnine
platelet count
76
A nurse is reviewing the lab report of pt who has been having lithium carbonate for the past 12mo. Lithium level =0.8
administer the medication
increase the dosage
withhold the next dose
discontinue the medication
77
A nurse is providing discharge teaching about car seat safety to a parent of newborn.Which statement shows understanding
I will place my baby in a forward facing car seat in my back seat
I will position my baby at a 45 degree angle in the car seat
I can place my baby in the front seat with the airbag turned off
I can turn my baby's car seat around wen she weighs 15 pounds
78
A nurse is discussing group tx & therapy with pt. The nurse includes which as a characteristic of the therapeutic group?
The group encourages members to focus on a particular issue
The group encourages clients to form dependent relationships
The group must be led by a licensed psychiatrist
The group is organized in an autocraticstructure.
79
A nurse is teaching about the g-tube feedings to the parents of a school age pt.Which instruction should the nurse make?
Administer the feeding over 30 min.
Place the child in as supine position after the feeding
Warm the formula in the microwave prior to administration
Change the feeding bag and tubing every 3 days.
80
Nurse is caring for pt with O2 of 91%, audible wheezes, and uses assessory muscles. Which med should the nurse expect?
Beta blocker
Beta2 agonist
Antibiotic
Antiviral
81
Nurse is reviewing female client's med recs. The nurse should recommend increased dietary intake which vitamins?
Vitamin A
Vitamin K
Vitamin B12
Vitamin D
82
ED, pt MVC, absent breath sounds in LLL, dyspnea, BP 118/68, HR 124, RR 38, temp 38.6 (101.4F), O2 92% on RA. First act?
Administer oxygen via high flow mask
Obtain chest x-ray
Prepare for chest tube insertion
Initiate IV access
83
Nurse caring for pt with new prescription for Heparin. What statments should indicate immediate concern for the nurse?
“It hurts to take a deep breath.”
“I had a blood clot in my leg several years ago.”
“I take antacids several times a day.”
“I am allergic to morphine.”
84
5 mo infant with s/s of severe dehydration and prescription of paternal fluid therapy. What to tell the parents?
“Your baby needs an IV because her heart rate is decreasing”
“Your baby needs an IV because she is breathing slower than normal”
“Your baby needs an IV because she is not producing any tears”
“Your baby needs an IV because her fontanels are budging”
85
A nurse is caring for pt who is comatose, advance directives that indicate the pt doesn'twant life-sustaining measures..
Complete an incident report.
Support the family’s decision and initiate life-sustaining measures
Arrange for an ethics committee meeting to address the family’s concerns
Encourage the family to contact an attorney
86
A nurse is caring for a client who is receiving intermittent enteral tube feedings. What places the pt at r/f aspiration
History of GERD
A residual of 65 mL 1 hour postprandial
Receiving a high osmolarity formula
Sitting in a high fowler position during the feeding
87
Which manifestations should the nurse include in the teaching about tubercuolosis in a community center?
Fatigue
Purulent Sputum
Night sweats
Persistent cough
88
A charge nurse is recommending postpartum client discharge following a local disaster. Which should the nurse recommend?
A 15-year-old client who delivered via emergency cesarean birth 1 day ago
A client who received 2 units of packed RBCs 6 hr. ago for a PP hemorrhage
A 42-year-old client who has preeclampsia and a BP of 166/110 mm Hg.
A client who delivered 36 hr. ago. with a second-degree perineal laceration
89
A nurse is administering digoxin 0.125 mg Po to an adult pt. For which finding shouldthe nurse report to the provider?
Potassium level 4.2 mEq/L.
Digoxin level 1 ng/ml.
Apical pulse 58/min.
Constipation for 2 days.
90
A school nurse is teaching a parent about absence seizures. Which of the following information should the nurse include?
This type of seizure has a gradual onset
This type of seizure lasts 30-60 seconds
The child usually has an aura prior to onset
This type of seizure can be mistaken for daydreaming
91
A nurse is teaching an adolescent who has peptic ulcer disease. Which of the following indicates understanding?
I will decrease my daily protein intake to 15 grams per day
I will take sucralfate with meals three times per day
I will use ibuprofen as needed to control abdominal pain
I will avoid food and beverages that contain caffeine
92
A nurse is assessing pt following a gunshot wound to the chest. Nurse should monitor for which sign of a pneumo (SATA)
Bradycardia
Tachypnea
Pleuritic pain
Deviation of trachea
93
A nurse is reviewing the medical records of four pts. The nurse should identify which of the pt needs follow up care.
A client who is scheduled for a colonoscopy and is taking sodium phosphate
A client who received a Mantoux test 48 hr ago and has an induration
A client who is taking warfarin and has INR of 1.8
A client who is taking bumetanide and has a K+ level of 3.6 MEq/L
94
A nure is assessing a client who is receiving packing RBCs. Which folliwing findings indicate fluid overload?
low back pain
dyspnea
hypotension
thready pulse
95
A nurse is assessing pt who is 30 min postop following an arterial thrombectomy. Which finding should be reported?
incisional pain
Chest pain
cool, moist skin
muscle spasms
96
A nurse is assessing a pt who has experienced a left-hemispheric stroke. Which of the followingis an expected finding?
Loss of depth perception
Inability to recognize familiar objects
Impulse control difficulty
Poor judgement
97
A nurse is assessing a client who is in active labor. Which of the following findings should the nurse report to PCP?
Temperature 37.4C (99.3F)
Early deceleration in the FHR
Contractions lasting 0 seconds
FHR baseline 170/min
