ATI RN
Client Comfort and End of Care Questions
Question 1 of 5
The nurse would expect which client to be the best candidate for a transcutaneous electrical nerve stimulation (TENS) unit?
Correct Answer: B
Rationale: The nurse expects a client with chronic back pain to be the best candidate for a TENS unit, as it's most effective for localized, chronic musculoskeletal pain, like back issues, by stimulating nerves to block pain signals and release endorphins. It's less invasive and suits long-term management. Choice A, acute postoperative pain, may benefit briefly, but TENS isn't primaryopioids or PCA dominate early post-op. Choice C, a fractured leg, involves acute pain; TENS could help, but immobilization and analgesics are standard initially. Choice D, abdominal pain, is less idealvisceral pain responds poorly to TENS, needing systemic treatment. Choice B is correct, reflecting TENS' evidence-based use in chronic conditions, guiding nurses to apply it for back pain relief, adjusting settings for comfort, and monitoring efficacy in outpatient or home settings.
Question 2 of 5
The nurse is caring for a client who reports chronic pain that is not relieved by medication. What would the nurse do next?
Correct Answer: B
Rationale: The nurse would assess for other pain relief methods when chronic pain persists despite medication, as unrelieved pain may need multimodal approachesnonpharmacological (e.g., heat, TENS) or adjuvants (e.g., gabapentin)tailored to pain type or tolerance. Assessment explores alternatives. Choice A, telling the client to try harder, is dismissive and unhelpfuleffort doesn't overcome ineffective treatment. Choice C, administering a placebo, is unethical and delays real care; it's not a clinical solution. Choice D, suggesting to ignore the pain, neglects the client's sufferingchronic pain demands action, not avoidance. Choice B is correct, reflecting nursing's proactive stanceassessing pain characteristics (e.g., neuropathic) or barriers (e.g., dose limits) ensures comprehensive management, potentially adding therapies to enhance relief, addressing the complexity of chronic pain beyond single-drug failure.
Question 3 of 5
The nurse is assessing a client who reports pain in the right arm. Which finding would suggest the pain is somatic rather than neuropathic?
Correct Answer: C
Rationale: A dull ache suggests somatic pain, as it arises from musculoskeletal tissues (e.g., muscles, bones) due to injury or strain, producing a localized, aching qualityunlike neuropathic pain's neural quirks. Choice A, burning sensation, fits neuropathy (e.g., nerve damage), not somatic's mechanical feel. Choice B, tingling, also indicates neuropathy (e.g., pinched nerve), not somatic's deeper pain. Choice D, numbness, reflects nerve dysfunction, not painsomatic pain is felt, not absent. Choice C is correct, guiding nurses to identify somatic paine.g., from arm strainprompting treatments like rest or NSAIDs, distinct from neuropathic options, ensuring accurate care based on the pain's tissue origin.
Question 4 of 5
A female patient is diagnosed with deep-vein thrombosis. Which nursing diagnosis should receive highest priority at this time?
Correct Answer: D
Rationale: Deep-vein thrombosis (DVT) involves a blood clot in a deep vein, typically in the leg, obstructing venous return and causing impaired blood flow. The nursing diagnosis 'Altered peripheral tissue perfusion related to venous congestion' (Choice D) takes priority because it directly addresses the primary pathophysiological issue: reduced circulation distal to the clot, risking tissue ischemia or infarction. Impaired gas exchange (Choice A) is incorrect because DVT primarily affects venous, not arterial, flow, and gas exchange relates to pulmonary issues like embolism, not the initial DVT state. Fluid volume excess (Choice B) isn't indicated, as DVT doesn't inherently cause systemic fluid overload; edema is localized. Risk for injury related to edema (Choice C) is a concern but secondary, as it's a symptom rather than the core problem. Prioritizing tissue perfusion aligns with the ABCs (airway, breathing, circulation) and Maslow's hierarchy, where physiological needs like circulation supersede safety risks. If untreated, poor perfusion can lead to tissue damage or pulmonary embolism, making Choice D the most urgent and correct diagnosis.
Question 5 of 5
A male client in a behavioral-health facility receives a 30-minute psychotherapy session, and provider uses a current procedure terminology (CPT) code that bills for a 50-minute session. Under the False Claims Act, such illegal behavior is known as:
Correct Answer: C
Rationale: Under the False Claims Act, billing for a higher level of service than provided is illegal. Using a CPT code for a 50-minute psychotherapy session when only 30 minutes were delivered is upcoding (Choice C), as it inflates reimbursement by misrepresenting the service's intensity or duration. Unbundling (Choice A) involves billing separate components of a bundled service individually, not applicable here. Overbilling (Choice B) is a broader term for excessive charges but doesn't specifically describe coding mismatches. Misrepresentation (Choice D) is vague and not a legal term in this context. Upcoding violates federal regulations, risking penalties, because it falsely claims more resources were used. For example, CPT code 90834 (45-50 minutes) pays more than 90832 (30 minutes), and choosing the former for a shorter session is fraudulent. Accurate coding ensures ethical billing, making Choice C the precise and correct answer.