ATI RN
Client Comfort and End of Life Care ATI Questions
Question 1 of 5
A nurse assesses a terminally ill patient with a DNR order, with findings of decreased blood pressure, urinary and bowel incontinence, loss of reflexes, and Cheyne-Stokes respirations. Based on these findings, the nurse recognizes which of the following?
Correct Answer: A
Rationale: End-stage signs signal finality. 'These are signs of impending death' is recognizede.g., BP drops (e.g., 60/40), incontinence, no reflexes, and Cheyne-Stokes (irregular breathing), per Taylor's dying process, hours away. Choice B, 'no abnormality,' deniese.g., these aren't normal. Choice C, 'resuscitation,' violates DNRe.g., unethical. Choice D, 'family leave,' excludese.g., they stay for closure. A nurse notese.g., 'It's near'preparing family (e.g., 90% show these), not fighting. Impending death's physiologye.g., organ shutdownguides palliative care, making Choice A the correct, clinical call.
Question 2 of 5
A nurse who provides bereavement counseling is working with the family of a child who recently died from cancer. Which of the following statements may be a common expression of grief and guilt by a family member?
Correct Answer: D
Rationale: Grief often twists into guilt. 'Sister: It is all my fault; I wanted him to die' is commone.g., survivor guilt, per Taylor's bereavement, irrational blame in kids. Choice A, 'prepare for death,' reflectse.g., not guilt. Choice B, 'at peace,' resolvese.g., no self-blame. Choice C, 'for the best,' rationalizese.g., not personal. A nurse hearse.g., 'I wished it once'sibling guilt (e.g., 30% of kids), needing counsel. Choice D is the correct, typical expression.
Question 3 of 5
A client diagnosed with Cushing's disease has a potassium level of 2.3 mEq/L (2.3 mmol/L). Based on the result, which pattern would the nurse be monitoring for on the cardiac monitor?
Correct Answer: B
Rationale: Prominent U wave is a hallmark of hypokalemia (2.3 mEq/L) in Cushing's, reflecting repolarization delay. Prolonged ST and ST elevation are unrelated. Tall T waves indicate hyperkalemia. Nurses, per NCLEX, monitor U waves in hypokalemia for arrhythmia risk, making B correct.
Question 4 of 5
Which client is most likely to develop a potassium level of 6.2 mEq/L (6.2 mmol/L)?
Correct Answer: B
Rationale: A traumatic burn causes hyperkalemia (6.2 mEq/L) from cell destruction releasing potassium. Laxatives , colitis , and Cushing's risk hypokalemia. Nurses, per NCLEX, monitor burns for potassium shifts, making B correct.
Question 5 of 5
The responsibility of taking a 47-year-old female client's vital signs who was diagnosed with right breast cancer post-mastectomy has been assigned to the newly graduated nurse. Which of the following vital sign procedures should be considered?
Correct Answer: A
Rationale: Pulse oximeter on the left finger avoids the right mastectomy side, preventing lymphedema risk. Right finger and right arm BP are contraindicated. Left BP is okay but less specific here. Nurses, per NCLEX, protect surgical sides, making A correct.