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
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 3 of 9
A client admitted with the diagnosis of cardiomyopathy becomes short of breath with ambulation and eating and fatigued with routine care activities. Which nursing diagnosis does the nurse include in the client's plan of care?
Correct Answer: C
Rationale: Activity intolerance is the most appropriate nursing diagnosis for a client with cardiomyopathy who becomes short of breath with ambulation and eating and fatigued with routine care activities. Cardiomyopathy is a condition where the heart muscle becomes weakened, affecting its ability to pump blood effectively. As a result, the client may experience symptoms such as shortness of breath, fatigue, and decreased tolerance for physical activity. By identifying activity intolerance as a nursing diagnosis, the nurse can focus on addressing the client's limitations in performing activities and developing a plan of care to help improve the client's endurance and functional ability.
Question 4 of 9
A patient with gout asks, “Why is my blood being examined for uric acid?” How should the nurse respond to this patient?
Correct Answer: D
Rationale: The correct response is D, “A uric acid test is done to see if your gout medication is effective.” Uric acid is a waste product formed from the breakdown of purines, substances found in certain foods and also produced by the body. In conditions like gout, there is an abnormal accumulation of uric acid in the blood, leading to the formation of urate crystals in the joints, causing pain and inflammation. Monitoring uric acid levels helps in assessing the effectiveness of gout medications in lowering uric acid levels and preventing gout attacks. This test is essential for patients with gout to ensure that their treatment is working effectively and to prevent complications related to high uric acid levels like kidney stones and kidney damage.
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
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 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
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 9 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.