ATI Predictor exam Questions with 100% Verified Answers A nurse is caring for a client who was admitted for acute alcohol delirium withdrawal 2 days ago. Which of the following findings is associated with this diagnosis? A. Increased appetite B. El

A nurse is caring for a client who was admitted for acute alcohol delirium withdrawal 2 days ago. Which of the following findings is associated with this diagnosis? A. Increased appetite B. Elevated Temperature C. Bradycardia D. Drowsiness corrrect answer- Elevated Temperature Rationale: The content of this question emphasizes the concept of client-centered care through identifying findings associated with a client's diagnosis. Client-centered care focuses on the client and emphasizes the client's cultural, ethnic, and social values. The identification of expected and unexpected findings associated with a client's diagnosis assists the nurse to distinguish possible unrelated complications the client might be experiencing, which indicates the need for further investigation. The specific focus on the client enhances the provision of safe, quality nursing care. An elevated temperature is a finding associated with acute alcohol delirium. A nurse working in a hospice facility is talking to a client's son who is distressed because his mother cries frequently and says she wants to die. Which of the following responses by the nurse is appropriate? A. "I know this must be difficult, but your mother will calm down soon." B. "Lets discuss some strategies you can use when this happens again." C. Individuals near death are ready to let go toward the end." D. "Have you determined why she is crying and saying she is ready to die?" corrrect answer- " Let's discuss some strategies you can use when this happens again." Rationale: This response by the nurse offers to provide information, which can reduce anxiety and enhance decision making. This response creates a safe environment, fosters trust and respect, and is appropriate. A nurse is caring for a client who had cerebrovascular accident 2 days ago. Which of the following is the first sign of increased intracranial pressure (ICP)? A. pupil dilation B. Ataxia C. Lethargy D Bradycardia corrrect answer- Lethargy rationale: Lethargy occurs when pressure is placed on the reticular activating system within the brainstem. Along with other indicators of a change in level of consciousness, such as restlessness, irritability, and disorientation. Lethargy is the first sign of increased ICP. A nurse working in a provider's office is reinforcing teaching with a client who is 14 weeks of gestation. The nurse should instruct the client to immediately notify the provider if she experiences which of the following? A. facial edema b. urinary frequency c. acid indigestion d. breast leakage corrrect answer- Facial edema rationale: facial edema is an indication of pregnancy-induced hypertension and should be reported immediately to the provider. A nurse is caring for a client who is receiving parenteral nutrition through a nontunneled central venous catheter and reports hearing a gurgling sound on the side of the catheter. The nurse suspects the catheter has migrated to the jugular vein. Which of the following actions should the nurse take first? A. Notify the provider B. Obtain a chest x-ray C. Flush the catheter. D. Stop the infusion. corrrect answer- Stop the infusion Rationale: This prevents further damage to vessel and minimizes any additional harm to the client A nurse is reinforcing teaching with a caregiver who has aphasia. The nurse should include which of the following communication strategies in the teaching? A. Cue the client by providing picture cards that portray common needs. B. Increase the volume of the voice when speaking to a client. C. Encourage the client to limit hand gestures when communicating. D. Vary the use of phrases and terminology in discussions. corrrect answer- Cue the client by providing picture cards that portray common needs. Rationale: Using picture cards enhances communication. The nurse should include this communication strategy in the teaching. A nurse is caring for a client who has a urinary tract infection and is prescribed ciprofloxacin (Cipro). The client exhibits urticaria and angioedema following administration of the medication. Which of the following is the first action the nurse should take? A. Administer epinephrine (Adrenaline) B. Elevate the lower extremities C. Determine respiratory status D. Apply oxygen via non