ATI
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,A nurse is assessing a client who received 2 units of hemoglobin 14.9 g/dL
packed RBCs 48 hrs ago. Which of the following findings
should indicate to the nurse that the therapy has been
effective?
a nurse working in an emergency department is triaging a middle adult client who has unstable vital signs
four clients. which of the following clients should the
nurse recommend for treatment first?
a nurse is caring for a client who has fluid volume measure the client's daily weight
overload. which of the following tasks should the nurse
delegate to an assistive personnel?
a nurse is preparing to administer mannitol 0.2 g/kg IV 18 g
bolus over 5 min as a test dose to a client who has
severe oliguria. The client weighs 198 lb. what is the
amount in grams the nurse should administer?
a nurse is conducting a physical examination for an Moving the leg away from the midline of the body (off to the side, not to the front)
adolescent and is assessing the rang of motion of the
legs, which of the following images indicates the
adolescent is abducting the hip joint?
a nurse is caring for a client who has hyperthyroidism. tremors
which of the following findings should the nurse expect?
tachycardia, diaphoresis, weight loss, insomnia, exopthalmia
hypothyroidism has dry corase hair, bradycardia, and periorbital edema
a nurse is assessing a school age child who has nuchal rigidity
bacterial meningitis. which of the following findings
should the nurse expect? also weight loss
a nurse is assessing a newborn's heart rate. which of the auscultate the apical pulse at least 1 min
following actions should the nurse take?
a nurse is preparing to assist with a thoracentesis for a instruct the client to avoid coughing during the procedure
client who has pleurisy. the nurse should plan to perform
which of the following actions?
a nurse is the emergency department is assessing a the child exhibits discomfort while walking
preschooler who has a facial laceration. the nurse should
identify which of the following findings as a potential
indication of child sexual abuse?
a nurse is preparing to teach about dietary management fiber - reduce diarrhea and inflammation
to a client who has crohn's disease and an enteroenteric
fistula. which of the following nutrients should the nurse
instruct the client to decrease in their diet?
a nurse is caring for a client who has a prescription for a Turn off the CPM machine during mealtime
continuous passive motion CPM machine following a
total knee arthroplasty. which of the following actions promote client comfort and dietary intake
should the nurse take?
a nurse is preparing to initiate IV access for an older radial vein of the inner arm
adult client. Which of the following sites should the nurse
select when initiating the IV for this client?
a nurse is developing a client education program about sedentary lifestyle
osteoporosis for older adult clients. the nurse should
include which of the following variables as a risk factor also, small framed body with a thin build, estrogen deficiency
for osteoporosis?
,a nurse in an emergency department is caring for a child initiate transmission based precautions
who has a fever and fluid filled vesicles on the trunk and
extremities. which of the following interventions should
the nurse identify as the priority?
a nurse is caring for a client who has a clogged change the position of the client
percutaneous gastrostomy feeding tube. which of the
following actions should the nurse take first?
a home health care nurse is developing a teaching plan empty the appliance when it is one third to one half full
for a client who has a new ileostomy. which of the
following instructions should the nurse include?
a nurse is reviewing the laboratory report of a client who sodium 148 mEq/L
has end stage kidney disease and received hemodialysis
24 hr ago. Which of the following laboratory values
should the nurse report to the provider?
a nurse is caring for four clients. which of the following Arrange the lunch tray for a client who has a hip fracture
tasks should the nurse delegate to an assistive
personnel?
a nurse is preparing a client for a paracentesis. which of instruct the client to void
the following actions should the nurse take?
a nurse has received change of shift report on four a client who is receiving an MAOI and is requesting a cheeseburger for dinner
assigned clients. for which of the following clients should
the nurse intervene to prevent a potential food and
medication interaction?
a nurse is planning care for a client who has rheumatoid allow for frequent rest periods throughout the day
arthritis and has moderate to severe pain in multiple
joints. which of the following actions should the nurse
plan to take?
a nurse is caring for a client who is receiving continuous irrigate the catheter with 0.9% sodium chloride irrigation
bladder irrigation following a transurethral resection of
the prostate. the client reports bladder spasms, and the
nurse observes a decreased urinary output. which of the
following actions should the nurse take?
a nurse is assessing a client who has COPD. which of pH 7.31
the following findings should the nurse expect?
a nurse in a community center is providing an abdominal bloating
educational session to a group of client about ovarian
cancer. which of the following manifestations of ovarian increase in abdominal girth, pelvic or abdominal pain, early satiety, urinary
cancer should the nurse include in the teaching? frequency of urgency
a nurse is caring for a client who has active tuberculosis Have the client wear a surgical mask while being transported outside the room
TB. which of the following actions should the nurse plan
to take to prevent the transmission of the disease?
a nurse is caring for a group of clients. which of the an older adult client who is anxious and attempting to pull out an IV line
following clients should the nurse attend to first?
an RN is observing a licensed practical nurse LPN and The LPN and the AP grasp the client under his arms to lift him up in bed
an assistive personnel AP move a client up in bed. for
which of the following situations should the nurse
intervene?
a nurse is preparing to administer insulin to a client via a hold the insulin pen device perpendicular to the client's skin to inject the
pen device. which of the following actions should the medication
nurse take?
, a nurse is caring for a client who has monitor the client's mouth every 8 hours
immunosuppression and a continuous IV infusion. which
of the following actions should the nurse take?
a nurse is providing teaching about advance directives to "I can designate my partner as my health care surrogate"
a middle adult client. which of the following client
responses indicates an understanding of the teaching?
a nurse is assessing a client following a vaginal delivery oxytocin
and notes heavy lochia and a boggy fundus. which of the
following medications should the nurse expect to
administer?
a nurse manager is planning to use a democratic seeks input from the other nurses
leadership style with the nurses on the unit. Which of the
following actions by the nurse manager demonstrates a
democratic leadership style?
a nurse is assigning task roles for a group of clients in a noting the progress of the group toward assigned goals
community mental health clinic. which of the following
tasks should the nurse assign to the member of the
group functioning as the orienteer?
a nurse is creating a plan of care for a newly admitted Administer high dose antibiotic therapy
child. which of the following actions should the nurse
include in the plan? cystic fibrosis kid with lung infection
a nurse is caring for a newborn immediately after use a protective cover on the scale when weighing the infant
delivery. which of the following interventions should the
nurse implement to prevent heat loss by conduction?
a nurse is caring for a client who has abdominal surgery assist with deep breathing and coughing
24 hr ago. which of the following actions is the nurse's
priority?
a nurse in an outpatient mental health clinic is caring for a client who channels their energy into a new hobby following the loss of their job
four clients. the nurse should recognize that which of the
following clients is effectively using sublimation as a
defense mechanism?
a nurse is assessing for correct placement of a client's aspirate contents from the tube and verify the pH level
NG feeding tube prior to administering a bolus feeding.
which of the following actions should the nurse take?
an antepartum nurse is caring for four clients. for which a client who is at 33 weeks of gestation and has severe gestational hypertension
of the following clients should the nurse initiate seizure
precautions?
a nurse is providing discharge teaching to a client who is wear clothing made with cotton fabrics while oxygen is in use
to receive home oxygen therapy. which of the following
instructions should the nurse include in the teaching? use water soluble lubricant not petroleum based lubricant
a nurse is providing teaching for a client who has a use a three point gait
fracture of the right fibula with a short leg cast in place a
new prescription for crutches. The client is non weight
bearing for 6 weeks. which of the following instructions
should the nurse include in the teaching?
a nurse is preparing to transfer a client from the ICU to The time of the client's last dose of pain medication
the medical floor. The client was recently weaned from
mechanical ventilation following a pneumonectomy.
which of the following information should the nurse
include in the change of shift report?
a nurse is assessing an infant who has hydrocephalus irritability when being held - increased intracranial pressure
and is 6 hr postoperative following placement of a
ventriculoperitoneal VP shunt. Which of the following
findings should the nurse report to the provider?