ATI Concept-Based Assessment Online Practice A Level 2 Questions and Answers

ATI Concept-Based Assessment Online Practice A Level 2 Questions and Answers A hospice nurse is caring for a preschooler who has a terminal illness. One of the child's parents tells the nurse that it is too difficult to cope any longer and has decided to move out of the house. Which of the following responses should the nurse make? A: "Let's talk about a few ways you have dealt with stress in the past." Rationale: This statement by the nurse combines two therapeutic responses, active listening and focusing. Used together, these techniques facilitate communication by letting the parent know one's feelings are heard and taken seriously, which conveys acceptance and respect. Therefore, the parent feels the nurse validates the concerns and becomes comfortable asking the nurse sensitive questions about the child. A nurse is teaching a client ways to prevent osteoporotic fractures due to osteoporosis. Which of the following information should the nurse include in the teaching? A: "Maintain bone health by eating fruits, vegetables, and protein." Rationale: The nurse should instruct the client that the best way to maintain bone health and bone remodeling is by eating fruits, vegetables, and protein. A nurse is teaching a client who has hypothyroidism about taking levothyroxine. Which of the following statements should the nurse make? B: "This medication causes adverse effects if the dosage is too high or too low." Rationale: The nurse should instruct the client that levothyroxine, in the right dosage, does not typically cause adverse effects. If the dosage is too low, the manifestations of hypothyroidism will recur. If the dosage is too high, the manifestations of hyperthyroidism will occur. A nurse in an emergency department is assessing a preschooler who has severe dehydration as a result of gastroenteritis and is receiving isotonic IV fluids. Which of the following findings should the nurse identify as an indication that the treatment is effective? D: Brisk skin turgor Rationale: The nurse should expect the child to have brisk skin turgor if fluid replacement therapy is effective. A nurse is caring for a client who has left hemiparesis following a stroke. Which of the following actions should the nurse take? B: Encourage the client to use wide-grip utensils when eating with the right hand. Rationale: The nurse should encourage the client who has hemiparesis to use wide-grip utensils when eating with the right hand, which can accommodate a weak grasp and encourage independence in eating. A nurse is teaching about herbal supplements with a group of newly licensed nurses. Which of the following herbal supplements should the nurse include in the teaching for treating hyperlipidemia? D: Garlic Rationale: The nurse should include that garlic can help improve cholesterol levels, which then helps to reduce the buildup of plaque in the arteries. For some clients, it can also help lower blood pressure A nurse is admitting a client who has an acute bacterial wound infection and a temperature of 39.8° C (103.6° F). Which of the following actions should the nurse take? D: Set the temperature of the client's room to 22.2° C (72°). Rationale: The nurse should set the temperature of the client's room at 21° C to 27° C (70° F to 80° F). This promotes a reduction in the client's fever without causing shivering. By combining nonpharmacological interventions with antipyretics, the nurse can reduce the client's fever. A nurse is planning care for a client who had surgery for osteomyelitis from a past musculoskeletal trauma to the lower leg. Which of the following interventions should the nurse include in the plan of care? C: Check for paresthesia of the affected leg. Rationale: The nurse should include in the interventions to check for paresthesia, such as a tingling sensation of the leg and foot, which can indicate manifestations of neurovascular compromise or compartment syndrome. A nurse is assessing the eyes and ears of a 2-year-old toddler at a well-child visit. Which of the following findings should the nurse report to the provider? B: Presence of strabismus Rationale: The nurse should recognize that the presence of strabismus, or crossing of the eyes, should disappear by 4 months of age. If this is not corrected by 4 to 6 years of age, it can lead to amblyopia; therefore, the nurse should report this finding to the provider. A nurse is teaching a client who has atherosclerosis about self-care. Which of the following instructions should the nurse include in the teaching? C: Increase fiber intake to at least 30 g per day. Rationale: The nurse should instruct the client to increase daily fiber intake to at least 30 g. Fiber assists in the elimination of lipids and minimizes the development of atherosclerosis. A nurse is assessing a client who has as an ulcer due to peripheral vascular disease. Which of the following findings should the nurse identify as an indication that the client has a venous ulcer rather than an arterial ulcer? B: Discoloration and edema of the right ankle Rationale: The nurse should identify that manifestations of peripheral venous disease include discoloration and edema of the ankle, resulting from venous hypertension. A nurse is providing discharge teaching to a client who is postoperative following a transurethral resection of the prostate (TURP) for treatment of benign prostatic hyperplasia. Which of the following instructions should the nurse include in the teaching? D: "Perform Kegel exercises several times throughout the day." Rationale: The nurse should instruct the client on the performance of Kegel exercises, or tightening and then relaxing the urinary sphincter, to assist the client in regaining urinary control and eliminate dribbling or the leakage of urine. The nurse should encourage the client to perform these exercises several times each day. A nurse is assessing a client who has left-sided heart failure. Which of the following findings should the nurse expect? (Select all the apply.) A: Nocturia C: Dyspnea D: Hacking cough Rationale: Left-sided heart failure causes oliguria during the day and nocturia during sleeping hours, pulmonary manifestations, such as dyspnea, orthopnea, crackles, and wheezes, and a hacking cough that worsens at night and eventually produces frothy sputum. A nurse is assessing a client who is 1 hour postoperative following a transurethral resection of the prostate (TURP) for treatment of benign prostatic hyperplasia. For which of the following assessment findings should the nurse notify the provider? C: The catheter tubing has multiple red clots. Rationale: The nurse should identify that the presence of multiple red clots in the catheter tubing or drainage that is ketchup-like are manifestations of postoperative bleeding. The nurse should notify the provider and provide hand irrigation of the bladder per provider prescription. A nurse is teaching a client who has gastroesophageal reflux disease about ways to prevent reflux. Which of the following information should the nurse include in the teaching?