ATI RN
Professional Nursing Concepts and Challenges Test Bank Questions
Question 1 of 9
The nurse identifies that a patient with immobility is at risk for the development of urolithiasis. What should the nurse include when planning this patient’s care?
Correct Answer: D
Rationale: Immobility can contribute to the development of urolithiasis (the formation of urinary calculi or stones) due to decreased mobility leading to stagnant urine flow, which can result in the concentration of crystal-forming substances in the urine. Increasing fluid intake helps prevent urinary stasis and dilutes the urine, reducing the risk of stone formation. Adequate hydration can also help flush out any existing crystals or small stones before they grow larger. Therefore, increasing fluid intake to 3000 mL/day is essential in preventing urolithiasis in patients with immobility. Monitoring urine pH, administering calcium supplements, or maintaining an indwelling urinary catheter are not appropriate interventions for preventing urolithiasis in this situation.
Question 2 of 9
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 3 of 9
A client with peripheral vascular disease (PVD) asks the nurse what types of exercise would improve the client's condition and overall health. Which type of exercise will the nurse include in the response to the client?
Correct Answer: C
Rationale: For a client with peripheral vascular disease (PVD), the nurse would recommend low-impact exercises that promote circulation and improve overall health without overstressing the cardiovascular system. Yoga is a beneficial form of exercise for individuals with PVD because it involves gentle movements, controlled breathing, and mindfulness practices that can help improve flexibility, strength, and blood flow. Additionally, yoga can help reduce stress and improve relaxation, which can be beneficial for managing symptoms associated with PVD. Weight lifting and team sports may be too strenuous for individuals with PVD, and passive ROM exercises may not provide the cardiovascular benefits needed for this condition.
Question 4 of 9
The nurse is reviewing laboratory values for a patient with an acute attack of gout. Which laboratory value should the nurse expect to be increased?
Correct Answer: A
Rationale: In a patient with an acute attack of gout, the nurse should expect the uric acid level to be increased. Gout occurs due to the buildup of uric acid crystals in the joints, leading to inflammation and pain. Monitoring the uric acid level is important in diagnosing and managing gout, as elevated levels indicate an increased risk of crystal formation and gout attacks. Therefore, an increased uric acid level is a key laboratory finding in patients experiencing gout flares.
Question 5 of 9
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 6 of 9
The nurse identifies that a patient with immobility is at risk for the development of urolithiasis. What should the nurse include when planning this patient’s care?
Correct Answer: D
Rationale: Immobility can contribute to the development of urolithiasis (the formation of urinary calculi or stones) due to decreased mobility leading to stagnant urine flow, which can result in the concentration of crystal-forming substances in the urine. Increasing fluid intake helps prevent urinary stasis and dilutes the urine, reducing the risk of stone formation. Adequate hydration can also help flush out any existing crystals or small stones before they grow larger. Therefore, increasing fluid intake to 3000 mL/day is essential in preventing urolithiasis in patients with immobility. Monitoring urine pH, administering calcium supplements, or maintaining an indwelling urinary catheter are not appropriate interventions for preventing urolithiasis in this situation.
Question 7 of 9
The nurse is caring for a child with a fractured femur who complains of sudden chest pain and difficulty breathing. Which test would the nurse question if it was ordered by the physician?
Correct Answer: A
Rationale: The nurse would question the order for a D-dimer test in this case. A D-dimer test is a blood test used to help rule out or diagnose blood clots. However, in a child with a fractured femur complaining of sudden chest pain and difficulty breathing, the symptoms suggest the possibility of a pulmonary embolism (PE). In this scenario, a D-dimer test may not be necessary because the clinical presentation warrants more advanced imaging studies such as V/Q scans, CT pulmonary angiography, or MR pulmonary angiography to definitively diagnose or rule out a PE. Therefore, the focus should be on imaging studies rather than a D-dimer test in this situation.
Question 8 of 9
The nurse is providing teaching to the parents of a child born with tetralogy of Fallot (TOF). Which statement should the nurse include in her teaching regarding this defect?
Correct Answer: B
Rationale: Tetralogy of Fallot (TOF) involves four cardiac defects, as described in option B: pulmonic stenosis, right ventricular hypertrophy, ventricular septal defect, and an overriding aorta. These four defects result in mixing of oxygen-poor and oxygen-rich blood in the heart, leading to decreased oxygen levels in the blood that is pumped to the body. This characteristic results in cyanosis (blue discoloration of the skin). Providing accurate information about the specific defects involved in TOF helps parents understand the complexity and potential complications associated with their child's condition. This knowledge can aid in their ability to recognize symptoms and seek timely medical intervention when needed.
Question 9 of 9
The nurse is instructing the spouse of a client with a stroke on how to do passive range-of- motion exercises to the affected limbs. Which rationale for this intervention will the nurse include in the teaching session?
Correct Answer: D
Rationale: Passive range-of-motion exercises are beneficial in maintaining joint flexibility in clients with stroke. These exercises involve moving the client's limbs through a full range of motion, which helps prevent joint contractures and stiffness. Joint flexibility is crucial for maintaining mobility and preventing secondary complications such as pressure ulcers. While passive range-of-motion exercises may indirectly impact muscle strength, cardiorespiratory function, and endurance, the primary rationale for this intervention is to maintain joint flexibility.