ATI RN
ATI Client Comfort and End of Life Care Questions
Question 1 of 5
A patient is diagnosed with a terminal illness. Who is usually responsible for deciding what, when, and how the patient should be told?
Correct Answer: D
Rationale: Terminal news delivery has a lead. 'Physician' is usually responsiblee.g., MD breaks 'It's cancer,' per Taylor's roles, setting timing and detail. 'Family' may requeste.g., 'Wait,'but doesn't decide. 'Clergy' supportse.g., spiritually, not medically. 'Nurse' reinforcese.g., explainsbut follows. A nurse seese.g., doc says 'Today, gently'physician's duty (e.g., 90% of cases), legal/ethical lead, not family's call or nurse's initiation. Choice D is the correct, standard role.
Question 2 of 5
A hospice nurse is providing emotional care and support for a family who lost a son. The care will be provided based on what knowledge?
Correct Answer: C
Rationale: Hospice care knows grief's nature. 'Stages of grief reactions may overlap and are individualized' guidese.g., mom denies, dad accepts, per Taylor's Kübler-Ross, not uniform. Choice A, 'same way,' deniese.g., kids cry, adults numb. Choice B, 'abnormal physical,' mislabelse.g., grief's natural. Choice D, 'little intervention,' undercutse.g., support's key. A nurse seese.g., 'She's stuck, he's not'overlap (e.g., 70% vary), tailoring aid. Choice C is the correct, nuanced knowledge.
Question 3 of 5
The nurse is attending to a client who was diagnosed with heart failure. During the examination, the nurse observes that the client is dyspneic with crackles upon auscultation. Which symptoms would manifest for a client with excess fluid volume?
Correct Answer: C
Rationale: Hypertension is a symptom of excess fluid volume in heart failure, as fluid overload increases blood pressure. Dyspnea and crackles indicate pulmonary edema, consistent with fluid excess. Decreased CVP and flat veins suggest fluid deficit, opposite to this scenario. Weight loss occurs with fluid loss, not gain. Per nursing fundamentals (e.g., Potter & Perry), fluid volume excess raises BP due to increased preload, making C the correct choice for NCLEX-style assessment.
Question 4 of 5
The client was diagnosed with heart failure and is currently taking high doses of diuretics. During the assessment, the nurse noted generalized weakness, flat neck veins, and diminished deep tendon reflexes. Which of the following symptoms would indicate that the client has hyponatremia?
Correct Answer: B
Rationale: The correct answer is B) Hyperactive bowel sounds. In a client with heart failure taking high doses of diuretics, the presence of hyperactive bowel sounds can indicate hyponatremia. Hyponatremia is a low sodium level in the blood, which can lead to gastrointestinal irritability and result in hyperactive bowel sounds. This symptom is specifically associated with sodium imbalance in the context of heart failure and diuretic use. Option A) Decreased urinary output is more indicative of dehydration rather than hyponatremia. Hyponatremia can lead to fluid shifts and increased urinary output. Option C) Increased urine specific gravity is also more characteristic of dehydration rather than hyponatremia. In hyponatremia, the urine may be dilute due to the body's attempt to excrete excess water. Option D) Tremors are a nonspecific symptom and are not typically associated with hyponatremia in the context of heart failure and diuretic use. Understanding the signs and symptoms of electrolyte imbalances, such as hyponatremia, is crucial for nurses caring for clients with heart failure. This knowledge helps in early identification of potential issues and prompt intervention to prevent complications. By linking hyperactive bowel sounds to hyponatremia in this scenario, nurses can provide more effective care and improve client outcomes.
Question 5 of 5
The client's blood has a platelet count of 300,000 mm3 (300 x 109/L). What should the nurse do when she receives this laboratory result?
Correct Answer: B
Rationale: The correct answer is B: Document the report as normal in the client's medical file. A platelet count of 300,000 mm3 falls within the normal range of 150,000-450,000 mm3. In this case, there is no need to take any immediate action as the result is not significantly high or low. Option A is incorrect because there is no need to advise the primary healthcare provider about an unusually increased value when the platelet count is within the normal range. Option C is incorrect as notifying the primary healthcare provider about an unusually decreased value is not relevant in this scenario. Option D is incorrect because putting the client on platelet boosting medication is unnecessary when the platelet count is normal. Educationally, it is essential for nurses to understand normal laboratory values and know when to take action based on abnormal results. Documenting normal lab values accurately is a crucial aspect of nursing practice as it provides a clear picture of the client's health status and helps in monitoring changes over time. Nurses must be able to differentiate between normal and abnormal results to provide safe and effective care to their clients.