ATI RN Fundamentals Online Practice 2023 B

Extract:

Nurses’ Notes
• The client reports a sudden onset of chest tightness and difficulty breathing starting approximately 30 minutes ago.
• The client is anxious and visibly distressed, clutching her chest intermittently.
• She has a history of hypertension and diabetes, which are being managed with medication.
• On examination, the client is sitting upright and appears to be in moderate respiratory distress.
• The client mentions feeling lightheaded and reports a slight headache.
• She is sweating profusely and her skin is pale.
• The client denies any recent physical exertion or known exposure to irritants.

Vital Signs
• Temperature: 37.2°C (99.0°F)
• Heart Rate: 104 beats per minute
• Respiratory Rate: 22 breaths per minute
• Blood Pressure: 158/92 mmHg
Physical Examination Results
• The client’s lungs exhibit bilateral wheezing and crackles upon auscultation.
• There is no visible swelling or edema in the extremities.
• The client has a dry cough that is intermittent.
• No cyanosis is noted around the lips or extremities.
• The client’s skin is cool and clammy.
• The client appears slightly disoriented when asked questions.
• There is no sign of trauma or injury.

Question 1 of 5

A 45-year-old female client is admitted to the emergency department with complaints of sudden shortness of breath and chest tightness. She has a history of hypertension and diabetes.Exhibits:A nurse is assessing the client at 0700 hrs. Which of the following actions should the nurse take first? A Initiate a cardiac enzyme panel

Correct Answer: D

Rationale: The correct answer is D: Obtain an electrocardiogram (ECG). The client's symptoms of sudden shortness of breath and chest tightness, along with her history of hypertension and diabetes, raise concerns for a possible cardiac event such as a heart attack. An ECG is crucial for promptly identifying any cardiac abnormalities and guiding further treatment. It provides valuable information on the heart's electrical activity, helping to assess for signs of ischemia or arrhythmias. Initiating a cardiac enzyme panel (choice
A) may be necessary later but obtaining an ECG takes priority for immediate assessment. Starting IV fluid therapy (choice
B), providing pain relief medication (choice
C), performing a comprehensive physical assessment (choice E) are important interventions but obtaining an ECG is the most urgent action to rule out a cardiac emergency in this scenario.

Extract:

Question 2 of 5

A nurse is educating a terminally ill patient about declining resuscitation in a living will. The patient asks, 'What would happen if I arrived at the emergency department and I had difficulty breathing?'

A. We would give you oxygen through a tube in your nose.' B. You would be unable to change your previous wishes about your care.' C. We would insert a breathing tube while we evaluate your condition.' D. We would consult the person appointed by your health care proxy to make decisions.'

Correct Answer: A

Rationale: The correct answer is A because providing oxygen through a tube in the nose is a non-invasive and supportive measure to help the patient breathe easier. It aligns with the patient's wishes to decline resuscitation and focuses on comfort care.
Choice B is incorrect because a living will allows patients to change their wishes at any time.
Choice C is incorrect as inserting a breathing tube may not align with the patient's wishes for comfort-focused care.
Choice D is incorrect as consulting the appointed person should only be done if the patient is unable to make decisions themselves.

Extract:

Diagnostic Results
Week 1:

Hematocrit (Hct): 42% (Normal range: 37% to 47%)
Hemoglobin (Hgb): 15 g/dL (Normal range: 12 to 16 g/dL)
White Blood Cell (WBC) count: 8,000/mm² (Normal range: 5,000 to 10,000/mm²)
Platelet count: 350,000/mm² (Normal range: 150,000 to 400,000/mm²)
Potassium: 3.7 mEq/L (Normal range: 3.5 to 5 mEq/L)
Week 2:

Hematocrit (Hct): 37% (Normal range: 37% to 47%)
Hemoglobin (Hgb): 12 g/dL (Normal range: 12 to 16 g/dL)
White Blood Cell (WBC) count: 6,000/mm² (Normal range: 5,000 to 10,000/mm²)
Platelet count: 100,000/mm² (Normal range: 150,000 to 400,000/mm²)
Potassium: 3.6 mEq/L (Normal range: 3.5 to 5 mEq/L)

Question 3 of 5

A nurse is caring for a female client. The following diagnostic results have been recorded over two weeks: Complete the following sentence by using the lists of options. The client is at risk for -----------------as evidenced by the-----------------------

Correct Answer: A,E

Rationale: Action to Take: A, E; Potential Condition: B; Parameter to Monitor: E, F.

Rationale: The correct answer is A, E because a decrease in platelet count (E) from 350,000/mm² to 100,000/mm² indicates a risk of bleeding. This is further supported by the decrease in hemoglobin levels (F) from 15 g/dL to 12 g/dL, indicating anemia. Monitoring platelet count (E) and hemoglobin levels (F) will help track the risk of bleeding and anemia. Other choices (C, D, G) are not directly supported by the diagnostic results provided.

Extract:

A home health nurse is conducting an admission assessment of an elderly patient who has their caregiver present.

Question 4 of 5

Which observation should the nurse identify as a potential sign of elder abuse?

A. The patient is in a wheelchair with the wheels locked. B. The patient reports receiving a full bath twice each week. C. The caregiver insists on staying in the room. D. The caregiver is the patient's financial power of attorney.

Correct Answer: C

Rationale: The correct answer is C because a caregiver insisting on staying in the room can be a potential sign of elder abuse, as it may indicate controlling behavior or a desire to monitor interactions. The other choices are less indicative of abuse: A could be related to mobility issues, B may reflect personal hygiene preferences, and D is a common legal arrangement for managing finances.

Extract:

Question 5 of 5

In which situation does the nurse demonstrate the ethical principle of veracity?

A. A client who has a prescription for a nasogastric tube refuses it, and the nurse complies with the client's wishes. B. A client who has a do-not-resuscitate (DNR) order experiences a cardiac arrest, and the nurse does not perform CPR despite requests from the client's family. C. A client who is about to undergo a painful procedure receives pain medication 30 minutes before the procedure, as the nurse had previously promised. D. A client who is unaware of their recent cancer diagnosis asks the nurse if they have cancer, and the nurse responds affirmatively.

Correct Answer: D

Rationale: The correct answer is D because the nurse is demonstrating the ethical principle of veracity, which refers to being truthful and honest. In this situation, the nurse responds affirmatively when the client asks if they have cancer, which aligns with the principle of veracity by providing the client with accurate information. This helps the client make informed decisions about their care.

Choice A is incorrect because complying with the client's wishes may not necessarily align with the principle of veracity if the nurse is aware of potential harm to the client by refusing the nasogastric tube.

Choice B is incorrect as not performing CPR despite a DNR order and family requests may be appropriate and align with respecting the client's autonomy, but it does not directly relate to the principle of veracity.

Choice C is incorrect as providing pain medication as promised is related to fidelity (keeping promises) rather than veracity.

In summary, the correct answer is D because it directly involves being truthful and honest with the client, while the

ATI RN Fundamentals Online Practice 2023 B | Nurselytic

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