ATI practice assessment A+/questions with correct answers verified 100%/recommended download

ATI practice assessment A+/questions with correct answers verified 100%/recommended download ATI practice assessment A+/questions with correct answers verified 100%/recommended download A nurse is suctioning the endotracheal tube of a client who is on a ventilator. The client's heart rate increases from 86/min to 110/min and becomes irregular. Which of the following actions should the nurse take? A. Obtain a cardiology consult. B. Suction the client less frequently. C. Administer an antidysrhythmic medication. D. Perform pre-oxygenation prior to suctioning. - correct answers-D. Perform pre-oxygenation prior to suctioning Suctioning should be performed on the endotracheal tube of a client who is mechanically ventilated to remove accumulated secretions from the airways. Possible complications of the procedure include hypoxemia, manifested by tachycardia and arrhythmia, and tissue injury.. In preparation for suctioning, and to prevent hypoxemia, the client should be pre-oxygenated using a manual resuscitator bag set at 100% oxygen. A nurse is monitoring a client who was admitted with a severe burn injury and is receiving IV fluid resuscitation therapy. The nurse should identify a decrease in which of the following findings as an indication of adequate fluid replacement? A. BP B. Heart rate C. Urine output D. Weight - correct answers-B. Heart rate When a client's circulating fluid volume is low, the heart rate increases to maintain adequate blood pressure. Therefore, the nurse should identify a decrease in heart rate as in indication of adequate fluid replacement. A nurse is caring for a client who has a cardiopulmonary arrest. The nurse anticipates the emergency response team will administer which of the following medications if the client's restored rhythm is symptomatic bradycardia? A. Epinephrine B. Magnesium C. Atropine D. Sodium bicarbonate - correct answers-C. Atropine The team administers atropine during CPR if the client has symptomatic bradycardia, or is hemodynamically unstable. - The team administers epinephrine during CPR to clients who have systole or pulseless electrical activity. - The team administers magnesium during CPR for clients who have torsade de pointes, which is a specific type of ventricular tachycardia. - The team administers sodium bicarbonate to correct metabolic acidosis that does not improve with CPR. A nurse is assessing a group of clients for hospice services. The nurse should recommend hospice care for which of the following clients? A. A client who has diabetes mellitus and is having difficulty self-administering insulin because of poor eye sight B. A client who has terminal cancer and needs assistance with pain management C. A client who is recovering from a stroke and needs someone to provide care while his spouse is at work D. A client who has dementia and needs help with activities of daily living - correct answers-B. A client who has terminal cancer and needs assistance with pain management A client who has a terminal disease and who is deemed to have less than 6 months to live is eligible for hospice services. Hospice care provides the client with physical and psychological support, which includes management of symptoms, such as pain and dyspnea. A nurse is assessing a client who has chronic kidney disease for fluid volume increase. Which of the following provides a reliable measure of fluid retention? A. Daily weight B. Sodium level C. Tissue turgor D. Intake and output - correct answers-A. Daily weight Obtaining a client's daily weight and comparing it to previous weights is a reliable method for measuring a client's fluid volume over time. A nurse is caring for an older adult client who has left-sided heart failure. Which of the following assessment findings should the nurse expect? A. Frothy sputum B. Dependent edema C. Nocturnal polyuria D. Jugular distention - correct answers-A. Frothy sputum Left-sided heart failure reduces cardiac output and raises pulmonary venous pressure. Manifestations include hacking cough, frothy sputum, wheezing, fatigue, and weakness. All the other options are signs of right-sided heart failure. A nurse is assessing a client who has asthma. Which of the following areas should the nurse evaluate as the most reliable indicator of central cyanosis? A. Oral mucosa B. Conjunctivae C. Ear lobes D. Soles of the feet - correct answers-A. Oral mucosa According to evidence-based practice, the nurse should first monitor the client's tongue and lips for manifestations of central cyanosis because cyanosis is most evident in areas with minimal pigmentation. A nurse is completing discharge planning for a client who has bacterial endocarditis. The client will need to receive 12 weeks of antibiotic therapy. Which of the following venous access devices should the nurse identify as appropriate for the client? A. Short peripheral catheter B. Implanted infusion port C. Peripherally inserted central catheter D. Arteriovenous fistula - correct answers-C. Peripherally inserted central catheter A peripherally inserted central catheter (PICC) line is the venous access device commonly used when the client needs extended, but not permanent, intravenous access. The PICC line may remain in place for weeks or months. PICC lines can also be used to draw blood samples without the need for additional venipunctures. A nurse is caring for a client who is HIV positive and is one day postoperative following an appendectomy. The nurse should wear a gown as personal protective equipment when taking which of the following actions? A. Talking to the client at the bedside B. Administering an intermittent IV bolus medication C. Completing a dressing change D. Administering an IM injection - correct answers-C. Completing a dressing change Standard precautions require personal protective equipment when there is a risk of contact with body fluids. A dressing change does present a risk for coming into contact with body fluids. A nurse is teaching a client about the seven warning signs of cancer. Which of the following signs should the nurse include as manifestations of cancer? (Select all that apply.) A. A nonhealing sore B. Bloating C. Change in bowel pattern D. Change in moles E. Nagging cough - correct answers-A, C, D, E A nurse is reviewing the medical records of four clients who have an acid-base imbalance. The nurse should recognize that which of the following clients is at risk for metabolic acidosis? A. A client who has diarrhea B. A client who is vomiting C. A client who is taking a thiazide diuretic D. A client who has salicylate intoxication - correct answers-A. A client who has diarrhea - Diarrhea can cause metabolic acidosis due to the loss of bicarbonate. - Vomiting can cause metabolic alkalosis due to acid loss. Thiazide diuretics can cause metabolic alkalosis due to excretion of acid. Salicylate intoxication can cause respiratory alkalosis due to carbon dioxide loss from tachypnea.