ATI RN
Professional Nursing Concepts and Challenges Test Bank Questions
Question 1 of 5
A client admitted with the diagnosis of cardiomyopathy becomes short of breath with ambulation and eating and fatigued with routine care activities. Which nursing diagnosis does the nurse include in the client's plan of care?
Correct Answer: C
Rationale: Activity intolerance is the most appropriate nursing diagnosis for a client with cardiomyopathy who becomes short of breath with ambulation and eating and fatigued with routine care activities. Cardiomyopathy is a condition where the heart muscle becomes weakened, affecting its ability to pump blood effectively. As a result, the client may experience symptoms such as shortness of breath, fatigue, and decreased tolerance for physical activity. By identifying activity intolerance as a nursing diagnosis, the nurse can focus on addressing the client's limitations in performing activities and developing a plan of care to help improve the client's endurance and functional ability.
Question 2 of 5
The nurse is planning care for a group of clients. Which client should the nurse identify as having the greatest risk for developing deep venous thrombosis (DVT)?
Correct Answer: D
Rationale: The client recovering from knee replacement surgery has the greatest risk for developing deep venous thrombosis (DVT). Knee replacement surgery is a major orthopedic procedure that involves prolonged immobility and disruption of the normal blood flow in the lower extremities, which increases the risk of developing DVT. Postoperative patients are at a higher risk for developing blood clots due to reduced mobility, surgical trauma, and alterations in blood flow. Therefore, it is essential for healthcare providers to implement preventive measures to reduce the risk of DVT, such as early mobilization, compression stockings, and pharmacological prophylaxis.
Question 3 of 5
A nurse is assessing a client during labor and delivery. Which condition should the nurse recognize as a risk factor for disseminated intravascular coagulation (DIC)?
Correct Answer: C
Rationale: Placental abruption is the separation of the placenta from the uterine wall before delivery. This condition is a significant risk factor for disseminated intravascular coagulation (DIC) because the sudden detachment can lead to massive internal bleeding. The release of large amounts of tissue factor from the placenta into the maternal circulation triggers widespread activation of the coagulation cascade, leading to the consumption of clotting factors and platelets. This uncontrolled activation of the clotting system can result in both excessive clot formation and bleeding, characteristic of DIC. Gestational diabetes, polyhydramnios, and placenta previa are not direct risk factors for DIC.
Question 4 of 5
The nurse instructs a client about the medication nifedipine (Procardia) for hypertension. Which client statement indicates that additional teaching is needed?
Correct Answer: A
Rationale: Swelling of the ankles (edema) is a common side effect of nifedipine (Procardia), especially when starting the medication. However, it is important for the client to understand that while edema is a known side effect, it is not considered normal and should be monitored. The client should report any significant or concerning swelling to their healthcare provider. Options B, C, and D demonstrate good understanding of the medication and its management.
Question 5 of 5
Which is believed to be the cause of preeclampsia?
Correct Answer: A
Rationale: Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to other organ systems, most often the liver and kidneys. Placental dysfunction is believed to be the main cause of preeclampsia. In a normal pregnancy, blood vessels in the placenta develop to supply the fetus with nutrients and oxygen. In preeclampsia, these blood vessels don't develop or function properly, leading to inadequate blood flow and reduced supply of nutrients to the placenta. This can result in high blood pressure and affect the function of other organs.