ATI RN
Professional Nursing Concepts and Challenges Test Bank Questions
Question 1 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 2 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 3 of 9
The nurse is planning care for a group of clients. Which client should the nurse identify as having the greatest risk for developing deep venous thrombosis (DVT)?
Correct Answer: D
Rationale: The client recovering from knee replacement surgery has the greatest risk for developing deep venous thrombosis (DVT). Knee replacement surgery is a major orthopedic procedure that involves prolonged immobility and disruption of the normal blood flow in the lower extremities, which increases the risk of developing DVT. Postoperative patients are at a higher risk for developing blood clots due to reduced mobility, surgical trauma, and alterations in blood flow. Therefore, it is essential for healthcare providers to implement preventive measures to reduce the risk of DVT, such as early mobilization, compression stockings, and pharmacological prophylaxis.
Question 4 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 5 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 6 of 9
Which is believed to be the cause of preeclampsia?
Correct Answer: A
Rationale: Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to other organ systems, most often the liver and kidneys. Placental dysfunction is believed to be the main cause of preeclampsia. In a normal pregnancy, blood vessels in the placenta develop to supply the fetus with nutrients and oxygen. In preeclampsia, these blood vessels don't develop or function properly, leading to inadequate blood flow and reduced supply of nutrients to the placenta. This can result in high blood pressure and affect the function of other organs.
Question 7 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 8 of 9
A home health nurse is admitting a new client to the agency who was recently discharged from the hospital with a new diagnosis of pulmonary fibrosis. What is the best way for the nurse to evaluate whether the client is able to set up and administer a nebulizer treatment?
Correct Answer: A
Rationale: Direct observation of behavior is the best way for the nurse to evaluate whether the client is able to set up and administer a nebulizer treatment. By directly observing the client, the nurse can assess the client's understanding and ability in performing the necessary steps correctly and safely. This approach allows for real-time evaluation and correction if needed, ensuring that the client can effectively manage their nebulizer treatment at home. Written or oral descriptions may not accurately reflect the client's actual competency in performing the task, and relying on the client's self-report during a follow-up appointment may not provide a complete picture of their ability.
Question 9 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.