ATI RN
ATI Capstone Week 9 Exam Questions
Extract:
Question 1 of 5
A nurse is assessing a client who has diabetes insipidus. Which of the following findings should the nurse expect?
Correct Answer: C
Rationale: The correct answer is C: Poor skin turgor. In diabetes insipidus, there is excessive urination leading to dehydration. Poor skin turgor indicates dehydration due to the loss of fluid. Moist mucous membranes (
A) would not be expected due to dehydration. Bounding pulses (
B) are associated with fluid overload, not dehydration. Bradycardia (
D) is not typically seen in dehydration.
Question 2 of 5
A nurse is caring for a client who is undergoing initial peritoneal dialysis. Which of the following should the nurse report immediately to the provider?
Correct Answer: A
Rationale: The correct answer is A: Purulent dialysate outflow. This should be reported immediately to the provider because it indicates a possible infection in the peritoneal cavity, which can lead to peritonitis. Purulent discharge may be a sign of bacterial contamination and requires prompt medical intervention to prevent serious complications. Reporting this promptly allows for timely treatment initiation. Blood-tinged dialysate outflow (choice
B) may be a normal finding initially. Reporting of fullness with dialysate dwelling (choice
C) could indicate inadequate drainage or fluid overload, but it is not as urgent as an infection. Discomfort during dialysate inflow (choice
D) could be due to catheter placement issues or improper technique, which can be addressed after ensuring there is no infection.
Question 3 of 5
A nurse is preparing a teaching session about reducing the risk of complications of diabetes mellitus. Which of the following information should the nurse plan to include in the teaching? (Select all that apply.)
Correct Answer: A,C,D,E
Rationale: The correct answers are A, C, D, and E.
A: Reducing cholesterol and saturated fat intake helps in managing blood lipid levels and reduces the risk of cardiovascular complications often associated with diabetes.
C: Maintaining optimal blood pressure is crucial to prevent kidney damage, as high blood pressure can worsen kidney function in diabetic patients.
D: Increasing physical activity and daily exercise helps in managing blood glucose levels, improving insulin sensitivity, and reducing the risk of cardiovascular complications.
E: Enrolling in a smoking cessation program is important because smoking increases the risk of cardiovascular disease and other complications in individuals with diabetes.
Incorrect choices:
B: Sustaining hyperglycemia is incorrect as it can lead to nerve damage and other complications in diabetes management.
Question 4 of 5
A nurse is caring for a client who has an acute respiratory failure (ARF). The nurse should monitor the client for which of the following manifestations of this condition? (Select all that apply.)
Correct Answer: A,B,C,E
Rationale: The correct manifestations to monitor for in a client with acute respiratory failure (ARF) are decreased level of consciousness (
A), hypercarbia (
B), severe dyspnea (
C), and tachycardia (E). 1) Decreased level of consciousness indicates poor oxygenation to the brain due to inadequate gas exchange. 2) Hypercarbia, an increased level of carbon dioxide in the blood, is a common finding in ARF as the lungs fail to adequately remove CO2. 3) Severe dyspnea is a hallmark sign of ARF, indicating the body's struggle to obtain adequate oxygen. 4) Tachycardia is the body's compensatory response to hypoxia and respiratory distress.
Choices D, F, and G are incorrect because nausea is not a typical manifestation of ARF, and options F and G are not provided.
Extract:
Nurses' Notes
Day 1:
1000:
Client alert and oriented x3. Lung fields clear, heart rhythm regular bowel sounds normoactive x4; ate 75% of morning meal. Denies pain. Left forearm arteriovenous (AV) fistula, skin warm, brachial and radial pulses 2+
1600:
Client returned from dialysis, lethargic, not hungry, tried to eat a few crackers but vomited them up. Capillary blood glucose 134 mg/dL. AV fistula site skin warm, bruit and thrill noted, brachial and radial pulses palpable.
Day 2:
0700:
Client reports not sleeping well last night; capillary blood glucose 75 mg/dL; crackles in left lower lobe: unproductive cough: AV fistula site ecchymotic, warm, bruit and thrill noted. Oriented to person, place, and time.
A nurse is caring for a client receiving hemodialysis.
Vital Signs
Nurses' NotesVital SignsMedical History
Day 1:
1000:
Temperature 36.3°C (97.3°F)
Heart rate 70/min
Respiratory rate 16/min
Blood pressure 144/72 mm Hg
Oxygen saturation 94% on room air
Weight 90 kg (198 lb)
1600:
Temperature 37.1 °C (98.7°F)
Heart rate 62/min
Respiratory rate 16/min
Blood pressure 112/54 mm Hg
Oxygen saturation 95% on room air
Day 2:
0700:
Temperature 36.7°C (98.1°F)
Heart rate 62/min
Respiratory rate 12/min
Blood pressure 118/52 mmHg
Oxygen saturation 95% on room air
Weight 86.4 kg (190)
A nurse is caring for a client receiving hemodialysis.
Medical History
Nurses' NotesVital SignsMedical History
Client has a history of type 2 diabetes mellitus, and hemodialysis with Arteriovenous fistula.
A nurse is caring for a client receiving hemodialysis.
Question 5 of 5
A nurse is caring for a client who has received hemodialysis. Which of the following assessment findings require follow-up?
Correct Answer: B,E,F
Rationale: The correct answer is B, E, and F. Weight monitoring is crucial in patients receiving hemodialysis due to fluid shifts. Changes in lung sounds can indicate fluid overload or pulmonary edema. Assessing the AV fistula site is important to ensure patency and prevent infection. Vital signs are typically monitored during hemodialysis sessions and should be stable. Blood glucose levels are not directly impacted by hemodialysis. Presence of bruit and thrill at the fistula site is a normal finding indicating good blood flow.