ATI RN
Client Comfort and End of Life Care ATI Questions
Question 1 of 5
Nurse Margareth is revising a client's care plan. During which step of the nursing process does such revision take place?
Correct Answer: D
Rationale: The nursing process is a dynamic, cyclical framework guiding patient care, and revision of a care plan occurs during the evaluation step (Choice D). In evaluation, the nurse assesses whether the established goals (set during planning) were met, partially met, or unmet, using outcome criteria. If goals aren't achievede.g., a patient's pain remains uncontrolledthe nurse revises the plan, adjusting interventions or goals based on new data. Assessment (Choice A) is data collection, not revision, though it informs the process. Planning (Choice B) involves creating the initial care plan, not modifying it. Implementation (Choice C) is executing the plan, not evaluating or revising it. For example, if a wound isn't healing despite dressings, evaluation reveals the need for a new approach (e.g., different dressings), prompting revision. This step ensures care remains patient-centered and effective, adapting to changes in condition. Thus, Choice D, evaluation, is where revision occurs, making it the correct answer.
Question 2 of 5
A newly hired charge nurse assesses the staff nurses as competent individually but ineffective and nonproductive as a team. In addressing her concern, the charge nurse should understand that the usual reason for such a situation is:
Correct Answer: B
Rationale: Team ineffectiveness despite individual competence often stems from poor group dynamics, with unexpected feelings and emotions among staff (Choice B) being the usual culprit. Emotions like mistrust, resentment, or unresolved conflict disrupt communication and collaboratione.g., a nurse feeling undervalued might withhold input. Unhappiness about leadership change (Choice A) could contribute but isn't universal; new leaders can inspire if communication is strong. Fatigue from overwork (Choice C) reduces productivity but typically affects individuals uniformly, not just teamwork. Failure to involve staff in decisions (Choice D) is a factor, but emotions underlie its impacte.g., feeling ignored breeds frustration. Research (e.g., Tuckman's group development) shows emotional undercurrents derail forming cohesive teams. Addressing feelings via open forums or team-building restores function, making Choice B the correct and most common reason.
Question 3 of 5
A nurse is caring for a patient who is sleeping for abnormally long periods of time. This condition may be caused by injury to which of the following body structures?
Correct Answer: C
Rationale: Excessive sleep, or hypersomnia, often stems from central nervous system dysfunction, particularly the hypothalamus , which regulates sleep-wake cycles via the suprachiasmatic nucleus (SCN) and orexin neurons. Injury heree.g., from trauma or tumordisrupts circadian rhythm and arousal, causing prolonged sleep, as seen in conditions like narcolepsy or post-traumatic hypersomnia. The spinal cord conducts signals but doesn't control sleep; injury might cause paralysis, not hypersomnia. The pancreas manages glucose, and while hypoglycemia can induce fatigue, it doesn't directly govern sleep duration. The thyroid influences metabolism; hypothyroidism causes lethargy, but not abnormally long sleep periods distinct from fatigue. For example, a hypothalamic lesion might reduce orexin, a wake-promoting neurotransmitter, leading to 16-hour sleep days versus a normal 7-9. Nursing assessments would note this brain region's role in sleep homeostasis, per Taylor's text, confirming Choice C as the correct answer.
Question 4 of 5
A patient who previously was a smoker has recently stopped smoking but reports having a lot of trouble sleeping at night. How would the nurse respond?
Correct Answer: C
Rationale: Nicotine withdrawal disrupts sleep due to its stimulant loss, but this resolves. 'Sleep problems from stopping smoking are temporary' is correct; insomnia peaks 1-3 weeks post-cessatione.g., nicotine's absence drops arousal, yet cravings wake patientsbut normalizes within months, per sleep research. Choice A, 'decide what's more important,' dismisses the patient's struggle, lacking empathy. Choice B, 'it might be better to smoke,' undermines cessation's health benefits (e.g., reduced cancer risk) and contradicts nursing ethics. Choice D, 'this will always be a problem,' is false; chronic insomnia isn't inevitable post-smokinge.g., most ex-smokers sleep normally by 6 months. A nurse, per Taylor, reassures with evidencee.g., 'Your brain's adjusting, it'll pass'promoting resilience. Choice C is the supportive, accurate response.
Question 5 of 5
What is the rationale for using CPAP to treat sleep apnea?
Correct Answer: A
Rationale: CPAP (continuous positive airway pressure) treats sleep apnea, typically obstructive (OSA). 'Positive air pressure holds the airway open' is the rationale; it splints the pharynxe.g., 10 cmH2O pressure prevents collapse during inhalation, per AASM guidelines. Choice B, 'negative air pressure holds the airway closed,' is opposite and nonsensicale.g., worsening obstruction. Choice C, 'delivery of oxygen facilitates respiratory effort,' aids hypoxemia but isn't CPAP's mechanism; it's pressure, not O2, per se. Choice D, 'alternating waves of air,' fits BiPAP, not CPAP's constant flowe.g., no 'waves' in standard use. A nurse might adjust CPAP for a patient with 30 apneas/hour, per Taylor's respiratory care, ensuring patency. Choice A is the correct, mechanistic answer.