ATI RN
Fundamental Concepts and Skills for Nursing Test Bank Questions
Question 1 of 5
The nurse is assessing a client being treated for congestive heart failure (CHF). Which physical findings would indicate that the client's condition is not improving? Select all that apply.
Correct Answer: D
Rationale: Wheezing breath sounds in all lobes indicate airway obstruction or narrowing, which may be a sign of worsening heart failure leading to pulmonary congestion. Wheezing can be a result of fluid accumulation in the lungs (pulmonary edema) due to inadequate pumping of the heart in CHF. Monitoring for respiratory symptoms such as wheezing is crucial in assessing the effectiveness of treatment for congestive heart failure. In this case, the presence of wheezing suggests that the client's condition is not improving and requires further evaluation and intervention.
Question 2 of 5
A client is scheduled for temporary pacemaker insertion. What instruction will this client need prior to discharge?
Correct Answer: D
Rationale: The correct instruction for a client who is scheduled for temporary pacemaker insertion is to use battery-powered equipment. This is because temporary pacemakers are powered by an external power source, typically a battery pack worn by the client. Therefore, it is important for the client to be aware of this and ensure that they have access to the necessary battery-powered equipment at home for the pacemaker to function properly. The other options are not appropriate instructions for a client with a temporary pacemaker.
Question 3 of 5
The nurse caring is caring for a client who is recovering from a hysterectomy. Which clinical manifestation supports that the client is experiencing a pulmonary embolism (PE)?
Correct Answer: C
Rationale: Pulmonary embolism (PE) is a serious condition where a blood clot travels to the lungs and blocks blood flow, which can be life-threatening. Common clinical manifestations of PE include sudden onset of dyspnea (difficulty breathing), chest pain (sharp, stabbing pain that may worsen with deep breaths), tachypnea (rapid breathing), tachycardia (rapid heart rate), and possibly cough or hemoptysis (coughing up blood). In the context of a client recovering from a hysterectomy, it is crucial to recognize the signs of PE as early intervention is essential to prevent serious complications. Nausea, decreased urine output, and activity intolerance are not typical clinical manifestations of a pulmonary embolism and should not be the primary focus when suspecting a PE in this scenario.
Question 4 of 5
A client is receiving intravenous nitroprusside (Nipride) for shock. Which adverse reactions will the nurse assess this client for when administering the infusion? Select all that apply.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 5 of 5
A patient is being treated for a condition where the pituitary gland is producing an increased amount of antidiuretic hormone (ADH). What finding would the nurse most likely assess in this patient?
Correct Answer: B
Rationale: An increased amount of antidiuretic hormone (ADH) leads to the condition known as syndrome of inappropriate antidiuretic hormone (SIADH). This condition results in the kidneys absorbing more water, which leads to decreased urine output (oliguria) and concentrated urine. The increased ADH levels cause the body to retain fluid, leading to a decrease in urine output and potential complications such as hyponatremia (low sodium levels), which can be harmful. Increased facial hair growth or decreased testosterone production are not directly related to an overproduction of ADH.