ATI - Comprehensive Final Questions and Answers 2023

ATI - Comprehensive Final Questions and Answers 2023 A nurse is teaching the parent of a child who has severe reactive airway disease about glucocorticoid therapy. The parent asks why her child has to inhale the medication instead of taking it orally. Which of the following information should the nurse provide the parent? Oral glucocorticoids are more like to slow linear growth in children. (Chronic use of oral glucocorticoids in high doses by children can result in decreased linear growth. Inhaled glucocorticoids deliver the anti-inflammatory agent directly to the local target area (pts airways) resulting in an decreased risk for adrenal suppression). A nurse is providing teaching to a client who has come to the family planning clinic requesting an intrauterine device (IUD). Which of the following information should the nurse provide the client? "Your risk of ectopic pregnancy increases with an IUD." [An IUD is a family planning device the provider inserts through the cervix into the uterus to prevent pregnancy. The IUD works by changing the lining of the uterus and fallopian tubes, making fertilization in the uterus more difficult. Consequently, an IUD increases the risk for ectopic pregnancy.] A nurse is assessing a preschooler who has recurrent and persistent otitis media. When obtaining the child's history from her parent, which of the following questions should the nurse ask? "Does anyone smoke around or in the same house as your child?" [Otitis media is an infection of the middle ear. Passive smoking promotes adherence of respiratory pathogens to the lining of the middle ear space. It also prolongs the inflammation and impedes drainage from the ear.] A nurse is providing teaching to a client who has a new prescription for sertraline. The client asks the nurse if he should continue to take St. John's wort for depression. Which of the following instructions should the nurse give the client? Stop taking the herbal supplement while taking the medication. [Taking the antidepressant sertraline and the herbal supplement St. John's wort together puts the client at risk for serotonin syndrome.] A nurse is caring for a client who is receiving bleomycin IV to treat lymphoma. Which of the following assessments is the nurse's priority? Pulmonary function [The nurse should apply the safety and risk reduction priority-setting framework. This framework assigns priority to the factor or situation posing the greatest safety risk to the client. When there are several risks to client safety, the one posing the greatest threat is the highest priority. The nurse should use Maslow's Hierarchy of needs, the ABC priority-setting framework, or nursing knowledge to identify which risk poses the greatest threat to the client. Bleomycin can cause severe lung injury, including pneumonitis and pulmonary fibrosis, and it affects a significant percentage of clients receiving this medication; therefore, pulmonary function is the priority assessment.] A nurse is teaching a client how to use an albuterol metered dose inhaler. After removing the cap from the inhaler and shaking the canister, identify the sequence of instructions the nurse should give the client. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.) 1. The client should hold the mouthpiece 2-4 cm (1-2 in) from his mouth 2. Tilt his head back slightly, and then open his mouth 3. Next, he should depress the medication canister while taking a deep breath to facilitate delivery of the medication through the airway 4. After holding his breath for 10 seconds, the client should resume his usual breathing pattern. A nurse is reviewing the laboratory report for a client who has chronic kidney disease (CKD). The nurse finds the following laboratory test results: potassium 6.8 mEq/L, calcium 7.4 mg/dL, hemoglobin 10.2 g/dL, and phosphate 4.8 mg/dL. Which of the following findings is the priority for the nurse to report to the provider? Hyperkalemia [The nurse should apply the urgent versus nonurgent priority-setting framework when caring for this client. Using this framework, the nurse should consider urgent needs the priority need because they pose more of a threat to the client. The nurse may also need to use Maslow's hierarchy of needs, the ABC priority-setting framework, or nursing knowledge to identify which finding is the most urgent. Therefore, hyperkalemia, which can cause life-threatening cardiac dysrhythmias, is the priority for the nurse to report to the provider. A nurse is facilitating a group discussion with preschool teachers about child abuse. Which of the following data should the nurse use as a common example of a suggestive finding? Arm cast for a spiral fracture of the forearm [Spiral fractures occur from twisting of an extremity. In most instances, spiral fractures of the arm result from an abusive injury.] Due to staffing shortages, a nurse manager floats a medical-surgical nurse to the pediatric unit. The nurse has limited experience with children. Which of the following actions should the nurse manager take? Assign a unit nurse to act as a resource to act as a resource for the medical-surgical nurse. [Assigning a nurse who usually works on the pediatric unit to work with the medical-surgical nurse will provide consistent support] A nurse is developing a plan of care for a client who has gastroesophageal reflux disease (GERD). The nurse should plan to monitor the client for which of the following complications? Aspiration [Aspiration is a common complication of GERD, which results when the esophageal sphincter malfunctions, allowing gastric acid and undigested food to back up into the esophagus. This places the client at risk for aspiration. GERD causes effortless, uncontrolled regurgitation whether the client is in an upright position or reclining. The most common results of regurgitation are heartburn and indigestion; however, aspiration is also possible. Therefore, the nurse should monitor the client for crackles in the lung fields, which is an indication of aspiration.] A client at a routine prenatal care visit asks the nurse if it is common to develop vaginal yeast infections during pregnancy. Which of the following responses should the nurse make? "The hormonal changes of pregnancy change the acidity of the vagina, making yeast infections more common." [This is an information-seeking question; therefore, the therapeutic response is an answer that provides the client with the information she requested.] A community health nurse is performing client triage while participating in a disaster drill. The nurse should recommend that which of the following clients receives treatment first? Hemothorax [The nurse should apply the survival potential priority-setting framework. The nurse should reserve the use of this framework for mass casualty situations, when resources are scarce and he must allocate resources to save the greatest number of lives. While it might seem that the client least likely to survive should receive priority care, this is the client who is the lowest priority. The nurse should assign the highest priority to the client who has injuries that are severe but has the potential to survive with treatment. Therefore, the nurse should recommend that the client who has a hemothorax receive treatment first. A hemothorax is life-threatening, but with chest-tube insertion and stabilization the client is likely to survive. A nurse is providing teaching to a school-age child who has just had a fiberglass cast application following lower extremity fracture. Which of the following instructions should the nurse give the child and his parents about care during the first 48 hours? "Keep the cast above the level of your heart." [Immediately following the injury, and for at least the first 48 hours, the child should keep the affected limb above the level of the heart to help prevent edema and pain and to promote venous return.] A nurse is assessing a toddler who has AIDS. The nurse should identify which of the following findings as an indication of an opportunistic infection? Candidiasis [Candidiasis, or oral thrush, results from the overgrowth of Candida albicans, an opportunistic fungus that commonly infects the oral cavity of clients who have immature or compromised immune systems. Candidiasis appears as a cheesy, white plaque that looks like milk curds on the buccal mucosa and tongue. Thrush is often the initial opportunistic infection in an HIV-positive child who is developing AIDS.] A nurse is assessing a client who has an abdominal aortic aneurysm (AAA). Which of the following findings should indicate to the nurse that the AAA is expanding? Report of sudden, severe back pain [An aortic aneurysm is a weak spot in the wall of the aorta, the primary artery that carries blood from the heart to the head and extremities, that allows the aorta to expand and increase in diameter. Sudden and increasing lower abdominal and back pain indicates that the aneurysm is extending downward and pressing on the lumbar sacral nerve roots.] A nurse is providing discharge teaching to a client who does not speak the same language as the nurse. The client's neighbor, who speaks the client's native language and the nurse's, arrives to drive the client home. Which of the following actions should the nurse take? Obtain the services of an interpreter [Federal mandates require that a professional medical interpreter translate the client's health care information into the client's native language.]