Questions 14

ATI RN

ATI RN Test Bank

Nursing a Concept Based Approach Test Bank Questions

Question 1 of 5

Following a kidney transplant, the nurse notes that a patient’s urine is cloudy. What should the nurse do about this finding?

Correct Answer: A

Rationale: Cloudy urine following a kidney transplant may be a common occurrence and could be due to various factors such as dehydration, medication side effects, or the presence of mucus, cells, or proteins in the urine. The nurse should first record the finding and then further assess the patient by checking for other signs and symptoms like pain, fever, or abnormal odors in the urine. If the cloudy urine is persistent or accompanied by other concerning symptoms, then the nurse should notify the physician for further evaluation. However, initially recording the finding allows for documentation and monitoring of the patient's condition, providing a baseline for further assessment and intervention if necessary. It is important to remember that cloudy urine alone may not always indicate a serious issue, but thorough assessment and documentation are essential steps in ensuring the patient's well-being.

Question 2 of 5

The nurse is planning care for an older adult client with chronic venous insufficiency. Which will the nurse include in the client's teaching plan?

Correct Answer: B

Rationale: Elastic compression therapy, such as wearing elastic hose (compression stockings), is an essential component of managing chronic venous insufficiency. Compression stockings help improve venous return, reduce edema, and alleviate symptoms such as pain and swelling. They work by applying external pressure to the legs, promoting better circulation and preventing blood from pooling in the veins. The nurse should ensure that the client wears the compression stockings as prescribed to maximize their effectiveness in managing the condition.

Question 3 of 5

For a client with coronary artery disease, what can the nurse recommend to the client to help decrease cardiac workload and sympathetic nervous system stimulation?

Correct Answer: A

Rationale: For a client with coronary artery disease, physical rest is important to help decrease cardiac workload and sympathetic nervous system stimulation. Physical rest helps reduce the demand on the heart muscle, allowing the heart to work more efficiently. By minimizing physical activity, the client can prevent further strain on the heart and lower the risk of complications such as angina or heart attack. Additionally, reducing physical activity can help lower blood pressure and heart rate, which in turn decreases the workload on the heart. Thus, recommending physical rest is essential in managing and improving outcomes for clients with coronary artery disease.

Question 4 of 5

The nurse is assessing a toddler diagnosed with tetralogy of Fallot (TOF). Which clinical manifestations does the nurse anticipate during the physical assessment? Select all that apply.

Correct Answer: A

Rationale: 1. A palpable thrill in the pulmonic area is a common finding in children with tetralogy of Fallot (TOF). This sensation is caused by turbulent blood flow across the pulmonic valve due to the structural abnormalities present in TOF.

Question 5 of 5

A client diagnosed with disseminated intravascular coagulation (DIC) is currently bleeding through the gastrointestinal tract. Which does the nurse anticipate administering to this client as a first line treatment?

Correct Answer: C

Rationale: Disseminated intravascular coagulation (DI
C) is a serious condition characterized by widespread clot formation in the small blood vessels, leading to bleeding tendencies. In DIC, the body consumes clotting factors and platelets faster than they can be replaced, resulting in both bleeding and clotting. Because of this complex pathophysiology, the first line treatment for DIC-related bleeding is to provide replacement of the consumed clotting factors and platelets. Fresh frozen plasma contains clotting factors, and platelets help in stopping bleeding by aiding in clot formation.
Therefore, the administration of fresh frozen plasma and platelets helps to correct the coagulopathy in DIC and manage the bleeding episodes effectively. Aspirin, Warfarin (Coumadin), and Heparin are anticoagulants and would not be appropriate in the treatment of DIC-related bleeding as they can exacerbate the bleeding tendency in this condition.

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