ATI Fall24 (3) (1)

Terminal Illness and Client Care

• Indications of Hopelessness

  • Key behavior: decreased energy level (Option B).

Child Development

• Data Collection in Preschoolers

  • Behaviors indicating readiness to cooperate:

    • Allows nurse to touch his arm (Option A).

    • Plays with toys in the examining room (Option B).

    • Answers questions asked by the nurse (Option C).

    • Makes eye contact with the nurse (Option D).

Mental Health Priority Care

• Client Priority

  • First client to see: a client with schizophrenia experiencing command hallucinations (Option C).

New Mother Support

• Responses to Newborn Crying

  • Recommended nurse response: "Let me show you how to swaddle and cuddle him, then you try." (Option C).

Blood Glucose Monitoring

• Glucometer Use Guidelines

  • Proper procedures:

    • Test the first drop of blood after the puncture (Option A).

    • Keep the finger in a dependent position (Option C).

Medication Interaction

• Clopidogrel Precautions

  • OTC medication that interacts adversely: Naproxen (Option D).

Cast Care Assessment

• Complications of Leg Cast

  • Indication of complications: pale foot, weak pedal pulse, foot numbness.

  • Recommended action: Check for pain with passive movement (Option C).

Smoking Health Risks

• Adverse Effects of Cigarette Smoking

  • Include: Decreased hemoglobin (Option A).

Mental Health Medication Administration

• Medication Administration Without Court Hearing

  • Situations: if the client is attempting to hurt self or others (Option D).

Digoxin Teaching

• Client Instructions

  • Essential instruction: "Monitor for muscle weakness while taking the medication" (Option A).

Patient Confidentiality

• Sharing Client Information

  • Appropriate to share with: a social worker assigned to an involuntarily committed client (Option B).

Pregnancy Lab Values

• Abnormal Findings in Pregnancy

  • Report to provider: Urine protein 3+ (Option B).

Postoperative Care

• Priority Assessment

  • Immediate concern: Oxygen saturation 89% (Option C).

Hypertension Monitoring

• Findings to Report

  • Immediate reporting: Blurred vision (Option B).

Chest Pain Protocol

• First Actions During Chest Pain

  • Elevate head of the client's bed (Option D).

Blood Glucose Management

• Most Accurate Diabetes Management Test

  • Glycosylated hemoglobin (Option C).

Supervision of New Staff

• Intervention for Inappropriate Nurse Actions

  • Intervene with: nurse telling a client they will lose phone privileges if they do not take medication (Option B).

Seizure Precautions

• Materials for Seizure Precautions

  • Equipment: Oral suction equipment (Option A).

Dependent Personality Disorder Teaching

• Post-discharge Instructions

  • Encourage social interactions (Option C).

Practical Post-Hip Arthroplasty Care

• Post-surgery Instructions

  • Avoid crossing legs for 3 months (Option A).

Dietary Advice for Hyperemesis Gravidarum

• Recommended Practices

  • Eat small meals every 2 to 3 hours (Option B).

GERD Management

• Understanding Patient Education

  • Expect to remain upright for 1 hour after taking ranitidine (Option A).

Tuberculosis Care

• Isolation Precautions

  • Airborne precautions (Option A).

Nutrition for COPD Patients

• Nutritional Guidance

  • Suggest performing pulmonary hygiene 1 hour before meals (Option B).

Pancreatic Enzyme Outcome Expectation

• Expected Therapeutic Effect

  • Reduced fat in stools (Option D).

Paranoid Schizophrenia Care

• Nurse Response to Hallucinations

  • Response to use: "This must be very frightening for you. Let’s talk more about it." (Option D).

Care for Fractured Femur

• Buck's Traction Care

  • Ensure weights are hanging freely (Option B).

Oxygen Saturation Monitoring

• Validity of Readings

  • Peripheral vascular disease can affect saturation readings.

Identifying Xanthelasma

• Visual Indicators

  • Nodule on eyelid.

Isolation for Vancomycin-Resistant Enterococcus

• Recommended Precautions

  • Contact precautions (Option A).

Developing Health Brochures

• Communication Guidelines

  • Write at an 8th-grade reading level (Option D).

Adolescent Health Examination**

• Prioritization of Data Collection

  • Priority statement: "I would rather be alone than with my friends." (Option D).

Stage 1 Pressure Ulcer Dressing

• Appropriate Dressing Types

  • Use transparent film (Option C).

Pain Management for Older Adults

• Medications for Pain

  • Administer the medication to the client (Option B).

Performance Improvement Plan Development

• Tasks to Include

  • Set time frames for meeting goals (Option A).

  • Base goals on peer comments (Option C).

  • Include standards the AP should meet (Option E).

Radiation Therapy Nursing Teaching

• Post-Radiation Guidelines

  • Avoid exposure to cold on the neck (Option D).

Fall Precautions for Impaired Mobility Clients

• Implemented Interventions

  • Apply rubber-soled slippers (Option B).

Intermittent Catheterization Teaching

• Education for Residual Urine Measurement

  • Use a leg bag for urine (Option C).

Supporting Client's Autonomy in Terminal Illness

• Encouraging Autonomy

  • Allow client to choose treatment times (Option B).

Breastfeeding Support for Postpartum Clients

• Feeding Guidelines

  • Feed newborn 8 to 12 times every 24 hours (Option C).

School-Aged Child Admission Care

• Initial Actions for Admission

  • Place child on bed rest for 24 to 48 hours (Option B).

Recommended Diet for Cirrhosis Clients

• Client Nutritional Needs

  • Measure abdominal girth daily (Option C).

Preventing Diarrhea with Antibiotics

• Diet Recommendations

  • Suggest yogurt to lessen diarrhea (Option D).

Increased Intracranial Pressure Care

• Wound Monitoring

  • Elevate the head of the bed to 30 degrees (Option C).

Addressing Ankle Edema in 3rd Trimester Pregnancy

• Interventions to Alleviate Edema

  • Apply support stockings (Option C).

Delirium Interventions

• Caring Measures

  • Remind the client of the day and time often (Option A).

Toddler Choking Hazards

• Food Inclusions to Avoid

  • Grapes (Option C).

Discharge Instructions for Tuberculosis Clients

• Teaching Point

  • Schedule sputum examination every 4 weeks (Option A).

Non-Stress Test in Pregnancy

• Actions Prior to NST

  • Explain that nonreactivity might require immediate medication (Option A).

Dysphagia Care Recommendations

• Meal Safety Protocols

  • Tilt head forward during meals (Option C).

Monitoring Hypertension During Pregnancy

• Signs to Report

  • Report persistent headache (Option D).

Language and Grief Counseling for the Bereaved

• Group Approach for Sharing

  • Engage the partner by discussing what support is needed (Option C).

Addressing Patient Experience in Previous Hospitalization

• Nurse Response

  • "That must have been a difficult experience for you." (Option A).

Mandatory Reporting for Communicable Diseases

• Infection Reporting Protocol

  • Neisseria gonorrhoeae (Option A).

Post-admission Expectations in Bacterial Meningitis

• Client Symptoms

  • Nuchal rigidity (Option B).

Expected Findings in End Stage Kidney Disease

• Laboratory Value Expectation

  • Creatinine 15 mg/dL (Option A).

Warfarin and INR Monitoring

• Expected Provider Instructions

  • Administer protamine sulfate (Option C).

Identifying Fluid Volume Excess in Post-surgical Clients

• Fluid Volume Excess Indicators

  • Distended neck veins (Option C).

Teaching for Pavlik Harness Care

• Instructions for Parents

  • Place the diaper over the strap of the harness (Option A).

Medication Error Documentation

• Where to Document

  • Incident report (Option C).

Preparing for Sterile Dressing Changes

• Sterile Technique Practices

  • Place sterile objects 2.5 cm from the edge of the sterile field (Option A).

Ethical Considerations in Client Care

• Boundary Crossing in Care

  • Provide client a meal before nurse bathing (Option D).

Herpes Simplex Precautions

• Isolation for Herpes Simplex

  • Contact precautions (Option A).

Noting Blank Spaces in Documentation

• Corrective Action

  • Draw a horizontal line through the space and sign at the end (Option A).

Cleaning Contaminated Surfaces

• Disinfection Solution for Blood Spill

  • Bleach (Option B).

Home Safety Risks for Older Adults

• Identified Risk for Falls

  • Electrical wires run under carpeting (Option B).

Informed Consent Process

• Client Rights in the Informed Consent Process

  • Notify client of their right to change their mind about signing (Option C).

Communicating with Adolescents about Health Practices

• Personal Care Practices in Different Cultures

  • Rubbing coin lengthwise on the child’s back (Option C).

Eye Care Medications

• Timolol Teaching for Open-Angle Glaucoma

  • Check heart rate while taking this medication (Option C).

Expected Findings in Severe Dehydration in Children

• Severe Dehydration Assessment

  • Weight loss of 10% (Option C).

Considerations in Older Adult Medication Administration

• Physiological Changes with Aging

  • Decreased liver function (Option A).

Appropriate Referrals for Medication Management

• Referrals to Nutritionists

  • Referral for dietary concerns to a dietician.

Documenting Allergies in Oil Therapy

• Signs of Allergic Reaction

  • Dyspnea (Option C).

Inter-Professional Recommendations for Nutritional Needs

• Care Plan Conferences to Facilitate Needs

  • For clients with low serum albumin levels.

Infection Control Knowledge Reinforcement

• Understanding Infection Control Protocols

  • Soiled dressings in biohazard receptacle (Option A).

Vitamin K Administration for Newborns

• Purpose of Vitamin K

  • Decrease hemorrhage risk (Option A).

Diabetic Ketoacidosis Monitoring

• Findings to Report

  • Fruity breath odor (Option A).

Vacuum-Assisted Wound Care Protocol

• Expected Care Actions

  • Replace the wound dressing every 12 hours (Option B).

Indicators of Informed Consent

• Understanding Client’s Concerns

  • Client's awareness of postoperative examinations (Option D).

Seizure Actions for Clients**

• Emergency Protocol During Tonic-clonic Seizure

  • Measure duration of the seizure (Option A).

Client Emotional State during Pregnancy

• Expressing Divergent Feelings

  • Many women experience ambivalence during pregnancy (Option D).

Informed Consent Procedures Monitoring

• Documentation of lawful protocols in client care

  • Signed consent for invasive procedures (Option B).

Data Collection Prioritization in Client Assessment**

• Initial Assessment Focus

  • A preschooler with epiglottitis (Option A).

Medications and Compliance Monitoring Postoperative**

• Assessment for Respiratory Efficacy

  • Measure the movements of the chest wall (Option D).

Hysterectomy Informed Consent Indications

• Awareness of Post-procedure Changes

  • Client's understanding about surgeon follow-ups (Option C).

Reassessing a Child's Post-Cancer Understanding

• Adjusting Approach of Care given Children’s Development

  • More of a tendency to revert to earlier stages of learning and development (Option D).

Implications of Alcohol Use**

• Withdrawal Treatment Medications

  • Anticipate administering Lora for detoxification (Option A).

Teaching for Pregnant Adolescents**

• Weight Gain Expectation

  • Adjustment guidelines for overweight mothers (Option B).

Care Following ECT**

• Monitor for Post-Procedure Side Effects

  • In expected care for post-ECT procedures: disorientation should be anticipated (Option C).

Bulimia Nerves Nursing First Steps**

• Initial Strategies to Intervene

  • Observing during/after meals to prevent purging (Option C).

Post-operative Care Protocol**

• Priority of Data Review Process

  • Without any change to nutritional assessment (Option A).

Change of Shift Report Considerations**

• Inclusion of Vital Information

  • Information on last pain management for priority intervention (Option D).

Education for Bipolar Disorder Medication**{c}

• Reinforcing Client Knowledge

  • Importance of avoiding grapefruit juice (Option D).

Conflict Resolution Strategies in Nursing**

• Navigating Nurse’s Personal Conflict with Task Assignments

  • Invite discussion of concerns in a private area (Option B).

Arthritis Education for Joint Health**

• Impact Activities to Reduce Joint Pain

  • Low-impact aerobic exercises to facilitate recovery (Option A).

Managing Indwelling Catheters Sucess**

• Postplacement Protocol

  • Educating on elevation during ambulation (Option C).

Supporting Survivors of Intimate Partner Violence**

• Prioritize Self-Determined Choices

  • Recognize important personal relationship changes as a step toward autonomy (Option C).

Process for Calcium Supplementation Therapy**

• Expected Calibration Interventions

  • Calcium levels normalized for follow-ups (Option D).

Implementing a Nutrition Intervention for Client's Health**

• Education around Snack Options

  • Consider choosing healthier, low-sodium snacks with more fruits (Option D).

Maintaining Client Security Measures Following Childbirth in Facilities**

• Validation of Protective Supplies

• Presence of matching security ID bracelets for newborns (Option D).

Breast Cancer Surgery Post-op Impact**

• Monitor the emotional state of clients

  • Emphasis on ensuring they can manage their concerns constructively at each phase of recovery (Option B).

Effectiveness of Safety Precautions for Hypertension**

• Healthier Codes or Recipes for Daily Implementing

  • Reduce risk features or lower calorie recommendations (Option C).

Understanding Manifestations of Narcissistic Behaviors**

• Subsequent Consequences of Treatments

  • Decide on cautious measures throughout (Option B).

Preventative Safety Programs in Assisted Living Facilities**

• Awareness of Environmental Safety Risks

  • Never manage cords or automation below anticipated floor levels (Option D).

Gaining Consensus in Informed Care Procedures**

• Manage Confidentiality from Start to End

  • Be sure documents delineate clear impairments and respond accordingly (Option E).