ATI Testing level 2 Proctored Exam Complete
Questions with 100% Correct Answers Verified Latest
Update
A nurse is planning care for a client who has renal calculi. Which of the following
interventions should the nurse include to promote elimination of the calculi?
Maintain bedrest until calculi are expelled.
Withhold thiazide diuretics.
Encourage intake of at least 3 L of fluid each day.
Collect all urine for 24 hr in a collection container. - ans -Encourage intake of at
least 3 L of fluid each day.
A nurse is assessing a client for manifestations of grief after having a colostomy
for removal of colon cancer. Which of the following findings indicates to the nurse
that the client has accepted the loss?
Becomes angry when it is time to perform colostomy care
Touches the colostomy stoma when the bag is changed
Looks away as the nurse empties the colostomy bag
Tells others that it will be nice to have a normal bowel movement again - ans -
Touches the colostomy stoma when the bag is changed
The client touching the colostomy stoma when the bag is changed should indicate
to the nurse that the client is accepting and coping with the alteration of body
image and has gone through the stages of grief.
A nurse is assessing a school-age child who has appendicitis with possible
perforation. Which of the following findings should the nurse identify as a
manifestation of peritonitis?
,Abdominal distention
Bradycardia
Hyperactive bowel sounds
Slow, deep breathing - ans -Abdominal distention
The nurse should identify that peritonitis is an inflammation of the lining of the
abdominal wall. This inflammation, along with the ileus that develops, causes
abdominal distention; therefore, the nurse should identify this as a manifestation
of peritonitis.
A nurse is reviewing the medical record of a client who has a peptic ulcer. Which
of the following findings is a priority to report to the provider?
Melena stools
Hemoglobin 7.6 mg/dL
Weight gain of 1.4 kg (3 lb) in 2 weeks
Dyspepsia during the day - ans -Hemoglobin 7.6 mg/dL
When using the urgent vs. nonurgent approach to client care, the nurse should
determine that the priority finding to report to the provider is the hemoglobin
below the expected reference range, which in an indication of a peptic ulcer that
is chronically bleeding.
A nurse in an emergency department is assessing a client who has hyperthermia.
Which of the following findings should the nurse identify as an indication that the
client has heat exhaustion?
Hallucinations
Vomiting
,Bradycardia
Seizures - ans -Vomiting
The nurse should identify that heat exhaustion is usually the result of excess
sweating, leading to dehydration. Manifestations include nausea, vomiting,
headache, dizziness, fainting, and a temperature typically between 38.3º C and
38.9º C (101º F and 102º F).
A nurse is providing teaching to a client who is experiencing malabsorption
related to lactose intolerance. Which of the following foods should the nurse
recommend to the client as the best nondairy source of calcium?
Ground beef
Collard greens
Cauliflower
Walnuts - ans -Collard greens
The nurse should determine that collard greens are the best food source to
recommend because 1 cup contains 268 mg of calcium per serving.
A nurse is planning care for a client who is postoperative and has developed left
lower leg deep-vein thrombosis. Which of the following interventions should the
nurse include in the plan of care?
Initiate complete bed rest.
Massage the left lower leg three times a day.
Make sure the client's legs are elevated while in bed.
Apply cold compresses to the left lower leg every 2 hr. - ans -Make sure the
client's legs are elevated while in bed.
, The nurse should ensure the client elevates her legs in bed and wears antiembolic
stockings to help prevent venous insufficiency.
A nurse is assessing a client who is 1 day postoperative following open ileostomy
placement to treat an inflammatory bowel disorder. Which of the following
findings is the priority for the nurse to report to the provider?
The stool is a dark green liquid with a small amount of blood.
The ileostomy output is 1,000 mL for the past 24 hr.
The stoma is purple in color.
The output from the NG tube has decreased over the past 24 hr. - ans -The stoma
is purple in color.
When using the urgent vs. nonurgent approach to client care, the nurse should
determine that the priority finding to report to the provider is the color of the
stoma. Stomas should be pink to bright red in color and shiny. A stoma that is pale
bluish, dark red-purplish, or black in color is not receiving adequate blood supply.
A nurse is developing a plan of care for a preschooler who has heart failure.
Which of the following interventions should the nurse include in the plan?
Assess and record the child's blood pressure every 6 to 8 hr.
Weigh the child once each week using the same scale.
Place the child in a supine position for a minimum of 4 hr each day.
Offer small, frequent meals based on the child's endurance level. - ans -Offer
small, frequent meals based on the child's endurance level.
The nurse should offer small, frequent meals based on the child's endurance
level. The child requires an increase in caloric intake, but often has a low energy
level. The nurse should choose times for meals when the child is most rested, and
make sure those meals are high in calories.
Questions with 100% Correct Answers Verified Latest
Update
A nurse is planning care for a client who has renal calculi. Which of the following
interventions should the nurse include to promote elimination of the calculi?
Maintain bedrest until calculi are expelled.
Withhold thiazide diuretics.
Encourage intake of at least 3 L of fluid each day.
Collect all urine for 24 hr in a collection container. - ans -Encourage intake of at
least 3 L of fluid each day.
A nurse is assessing a client for manifestations of grief after having a colostomy
for removal of colon cancer. Which of the following findings indicates to the nurse
that the client has accepted the loss?
Becomes angry when it is time to perform colostomy care
Touches the colostomy stoma when the bag is changed
Looks away as the nurse empties the colostomy bag
Tells others that it will be nice to have a normal bowel movement again - ans -
Touches the colostomy stoma when the bag is changed
The client touching the colostomy stoma when the bag is changed should indicate
to the nurse that the client is accepting and coping with the alteration of body
image and has gone through the stages of grief.
A nurse is assessing a school-age child who has appendicitis with possible
perforation. Which of the following findings should the nurse identify as a
manifestation of peritonitis?
,Abdominal distention
Bradycardia
Hyperactive bowel sounds
Slow, deep breathing - ans -Abdominal distention
The nurse should identify that peritonitis is an inflammation of the lining of the
abdominal wall. This inflammation, along with the ileus that develops, causes
abdominal distention; therefore, the nurse should identify this as a manifestation
of peritonitis.
A nurse is reviewing the medical record of a client who has a peptic ulcer. Which
of the following findings is a priority to report to the provider?
Melena stools
Hemoglobin 7.6 mg/dL
Weight gain of 1.4 kg (3 lb) in 2 weeks
Dyspepsia during the day - ans -Hemoglobin 7.6 mg/dL
When using the urgent vs. nonurgent approach to client care, the nurse should
determine that the priority finding to report to the provider is the hemoglobin
below the expected reference range, which in an indication of a peptic ulcer that
is chronically bleeding.
A nurse in an emergency department is assessing a client who has hyperthermia.
Which of the following findings should the nurse identify as an indication that the
client has heat exhaustion?
Hallucinations
Vomiting
,Bradycardia
Seizures - ans -Vomiting
The nurse should identify that heat exhaustion is usually the result of excess
sweating, leading to dehydration. Manifestations include nausea, vomiting,
headache, dizziness, fainting, and a temperature typically between 38.3º C and
38.9º C (101º F and 102º F).
A nurse is providing teaching to a client who is experiencing malabsorption
related to lactose intolerance. Which of the following foods should the nurse
recommend to the client as the best nondairy source of calcium?
Ground beef
Collard greens
Cauliflower
Walnuts - ans -Collard greens
The nurse should determine that collard greens are the best food source to
recommend because 1 cup contains 268 mg of calcium per serving.
A nurse is planning care for a client who is postoperative and has developed left
lower leg deep-vein thrombosis. Which of the following interventions should the
nurse include in the plan of care?
Initiate complete bed rest.
Massage the left lower leg three times a day.
Make sure the client's legs are elevated while in bed.
Apply cold compresses to the left lower leg every 2 hr. - ans -Make sure the
client's legs are elevated while in bed.
, The nurse should ensure the client elevates her legs in bed and wears antiembolic
stockings to help prevent venous insufficiency.
A nurse is assessing a client who is 1 day postoperative following open ileostomy
placement to treat an inflammatory bowel disorder. Which of the following
findings is the priority for the nurse to report to the provider?
The stool is a dark green liquid with a small amount of blood.
The ileostomy output is 1,000 mL for the past 24 hr.
The stoma is purple in color.
The output from the NG tube has decreased over the past 24 hr. - ans -The stoma
is purple in color.
When using the urgent vs. nonurgent approach to client care, the nurse should
determine that the priority finding to report to the provider is the color of the
stoma. Stomas should be pink to bright red in color and shiny. A stoma that is pale
bluish, dark red-purplish, or black in color is not receiving adequate blood supply.
A nurse is developing a plan of care for a preschooler who has heart failure.
Which of the following interventions should the nurse include in the plan?
Assess and record the child's blood pressure every 6 to 8 hr.
Weigh the child once each week using the same scale.
Place the child in a supine position for a minimum of 4 hr each day.
Offer small, frequent meals based on the child's endurance level. - ans -Offer
small, frequent meals based on the child's endurance level.
The nurse should offer small, frequent meals based on the child's endurance
level. The child requires an increase in caloric intake, but often has a low energy
level. The nurse should choose times for meals when the child is most rested, and
make sure those meals are high in calories.
