ATI PN Fundamentals Proctored (2023/2024) Exam V2| Scored 100%| Questions and Verified Answers
QUESTION
A nurse is contributing to the plan of care
... [Show More] for a client who is dying. Which of the following interventions should the nurse recommend to include the client's family in the plan of care? (Select all that apply.)
a. keep the family updated about the client's status
b. Suggest the family members return home at night to allow the client to rest
c. encourage the family to comb the clients hair
d. tell the client's family what to expect as the client's death nears
e. ask the family to encourage the client to eat
Answer:
a. keep the family updated about the client's status
-the nurse should keep the family updated about the client's status to assist the family in planning for the near future
b. Suggest the family members return home at night to allow the client to rest
the nurse should encourage a family member to stay throughout the night to lessen the client's feelings of isolation
c. encourage the family to comb the clients hair
-the nurse should find simple care activities for the family to perform, such as combing the client's hair
d. tell the client's family what to expect as the client's death nears
-Many family members do not know what to expect. The nurse should explain the manifestations of impending death to reduce the family members' anxiety and stress.
e. ask the family to encourage the client to eat
-The nurse should inform the family that forcing the client to eat can increase discomfort.
QUESTION
A nurse is checking a client for a pulse deficit after detecting an irregular heart rate. Which of the following actions should the nurse take?
a. count the client's radial and apical pulses simultaneously with another nurse.
b. calculate the client's pulse for 30 seconds and multiply by 2
c. assist the client to a side-lying position
d. auscultate the area of the client's chest over the Erb's point
Answer:
a. count the client's radial and apical pulses simultaneously with another nurse.
-The nurse should have another nurse count the radial pulse as he counts the apical pulse. A pulse deficit occurs when there are differences between the radial and apical pulse rates.
QUESTION
A nurse is reinforcing teaching with a client who is scheduled for a bladder scan. Which of the following instructions should the nurse include in the teaching?
a. "You will need to sign a consent form before we begin the procedure."
b. "I will place a gel pad directly above your pubic area before I place the probe."
c. "You will need to hold your urine for 1 hour prior to the procedure."
d. "You will receive a contrast dye through an IV catheter prior to the scan."
Answer:
b. "I will place a gel pad directly above your pubic area before I place the probe."
-The nurse should use a gel pad, which promotes ultrasound transmission and accurate measurement. The correct placement of the ultrasound device is just above the symphysis pubis.
QUESTION
A charge nurse is reinforcing teaching with a newly licensed nurse who is setting up a sterile field. Which of the following actions by the newly licensed nurse indicates an understanding of the teaching?
a. opening the first flap of a sterile package toward herself
b. dropping sterile gauze onto the field from a height of 7.5 cm (3 in)
c. removing and inverting a lid before placing it onto a nonsterile surface
d. maintaining the sterile field below waist level.
Answer:
c. removing and inverting a lid before placing it onto a nonsterile surface
-The nurse should invert the lid to prevent contamination of the inside surface prior to placing ti on a nonsterile surface
QUESTION
A nurse is caring for a client who has been vomiting excessively and has diarrhea. Which of the following findings should the nurse identify as an indication of fluid volume deficit?
a. BUN 18 mg/dL
b. a bounding pulse
c. urine specific gravity 1.045
d. prominent neck veins
Answer:
c. urine specific gravity 1.045
-The nurse should identify that a specific gravity higher than 1.025 indicates that the client's urine is more concentrated, which can be a manifestation of fluid volume deficit resulting from dehydration
QUESTION
A nurse is providing care to four clients in an acute care setting. The nurse should identify that which of the following client statements presents and ethical dilemma?
a. "I might file a lawsuit because of how my surgery went."
b. "Please don't tell my doctor, but I am taking my partner's oxycodone."
c. "Please don't get me out of bed this morning. It hurts too much."
d. "I don't want to take my medicine. It makes me sick to my stomach."
Answer:
b. "Please don't tell my doctor, but I am taking my partner's oxycodone."
-This situation poses an ethical dilemma for the nurse because there is a conflict between what the client asks the nurse and the nurse's responsibility to protect the client from harm during hospitalization. [Show Less]