ATI Level 3 practice PDF

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ATI Concept based level 3 practice...

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A nurse is planning medication teaching for a client who has ED. Which of the following medications should the nurse plan to include in the teaching? A. Hydrochlorothiazide B.Finasteride C.Sildenafil D.Carbidopa/levodopa A. Hydrochlorothiazide Hydrochlorothiazide is a thiazide diuretic prescribed to treat hypertension. B.Finasteride Finasteride is a 5-alpha reductase inhibitor medication, which is prescribed to treat benign prostatic hypertrophy, as well as alopecia. C.Sildenafil (CORRECT) The nurse should identify that sildenafil is a PDE5 inhibitor, which is prescribed as an oral firstline treatment for erectile dysfunction. D.Carbidopa/levodopa Carbidopa/levodopa is a dopaminergic medication, which is prescribed to treat Parkinson's disease. Set confidence level:

5 2 A nurse is caring for a client who has gestational hypertension and is experiencing postpartum hemorrhage. Which of the following medications should the nurse anticipate? A.Dinoprostone B.Misoprostol C.Methylergonovine D.Carboprost A.Dinoprostone This medication is contraindicated for clients who have hypertension. B.Misoprostol (CORRECT) The nurse should anticipate administering misoprostol or oxytocin to the client who has gestational hypertension and is experiencing a postpartum hemorrhage. C.Methylergonovine This medication is contraindicated for clients who have hypertension. D.Carboprost This medication is contraindicated for clients who have hypertension.

2 3 A nurse is assessing a 7 month old infant who is experiencing developmental delays. Which of the following findings should the nurse expect? A.Makes eye contact with staff members B.Plays with blocks in the crib C.Restricts attention to large objects D.Momentarily sits erect A.Makes eye contact with staff members The nurse should expect a 7-month-old infant to make eye contact with staff members. However, a 7-month-old infant who is experiencing developmental delays will not display this socialization skills. B.Plays with blocks in the crib The nurse should expect a 7-month-old infant to play with blocks in the crib. However, a 7month-old infant who is experiencing developmental delays will not display this fine motor skill.

C.Restricts attention to large objects (CORRECT) The nurse should expect a 7-month-old infant to begin to focus on very small objects. However, a 7-month-old infant who restricts attention to large objects is displaying a sensory developmental delay. D.Momentarily sits erect The nurse should expect a 7-month-old infant to momentarily sit erect. However, a 7-month-old infant who is experiencing developmental delays will not display this gross motor skill. 3 4 A nurse is caring for a client who is being seen for infertility and has a new prescription for clomiphene citrate. Which of the following manifestations should the nurse include in the teaching as a common adverse effect of the medication? A."You might have chills while taking the medication." B."You might experience drooling while taking the medication." C."You might have breast tenderness while taking the medication." D."You might experience an increase in urination while taking the medication." A."You might have chills while taking the medication." The client might experience hot flashes while taking clomiphene citrate. B."You might experience drooling while taking the medication."

The client might have a dry mouth while taking clomiphene citrate. C."You might have breast tenderness while taking the medication." (CORRECT) Breast tenderness is a common adverse effect of the medication. D."You might experience an increase in urination while taking the medication." Increased urine output is an adverse effect of furosemide, rather than clomiphene citrate. 3 5 A nurse is discussing palliative care with the family of a client who is terminally ill. Which of the following information should the nurse include? A.Palliative care begins once life-saving treatments have been stopped. B.Palliative care includes a variety of therapies. C.Palliative care requires the client to sign a DNR. D.Palliative care must be provided in the home setting. A.Palliative care begins once life-saving treatments have been stopped. A client is eligible to participate in hospice care when curative or life-saving treatments, such as chemotherapy, have been stopped. Palliative care is available to a client throughout her illness, regardless of the treatment regimen. B.Palliative care includes a variety of therapies. (CORRECT) Along with medical treatments, palliative care includes a holistic approach using a variety of therapies to improve the client's level of comfort. Therapies such as yoga, meditation, and pet therapy enhance the client's quality of life. C.Palliative care requires the client to sign a DNR. Palliative care does not require a client to sign a DNR. Curative treatments can continue simultaneously with palliative care. D.Palliative care must be provided in the home setting. Palliative care is offered in both home and inpatient settings. -6 A nurse is caring for a client who is experiencing hypovolemic shock due to postpartum hemorrhage. After notifying the provider, which of the following actions should the nurse take next? A.Massage the client's fundus.

B.Insert an indwelling urinary catheter. C.Elevate the client's right hip on a pillow. D.Administer oxygen via nonrebreather face mask at 10 L/min. A.Massage the client's fundus. (CORRECT) The greatest risk to the client is hemorrhage. Therefore, the next action the nurse should take is to massage the client's fundus to expel clots and promote contractions. B.Insert an indwelling urinary catheter. The nurse should insert an indwelling urinary catheter to monitor perfusion of the kidneys. However, this is not the next action the nurse should take. C.Elevate the client's right hip on a pillow. The nurse should elevate the client's right hip to enhance perfusion. However, this is not the next action the nurse should take. D.Administer oxygen via nonrebreather face mask at 10 L/min. The nurse should administer oxygen at 10 L/min to enhance perfusion. However, this is not the next action the nurse should take. -7 A nurse in a provider’s office is performing office a skin assessment on a client who reports concern about lesions on her back. Which of the following images should the nurse identify as having the characteristics of melanoma? A.The nurse should identify this image as having the characteristics of melanoma. This form of skin cancer is characterized by an irregularly shaped lesion that contains a combination of colors such as red, black, blue-black, and brown. The nurse should perform a complete skin assessment because melanoma can occur anywhere on the client's body, especially where the client has nevi or birthmarks.

B.The nurse should identify this image as having the characteristics of squamous cell carcinoma. This form of skin cancer is characterized by a nodular lesion that is firm to palpation. The lesion has an ulcerated center and is covered by a crust. Squamous cell carcinoma is most commonly found on sun-exposed areas of the skin.

C.The nurse should identify this image as having the characteristics of basal cell carcinoma. This form of skin cancer is characterized by a papular lesion that has rolled borders and a crater in the center. Basal cell carcinoma is most commonly found on sun-exposed areas of the skin.

D.The nurse should identify this image as having the characteristics of psoriasis. This autoimmune disorder is not cancerous and is characterized by thick reddened areas covered with scales that have a silver-white color. Psoriasis is commonly found on the elbows, knees, and scalp. (CORRECT) A.The nurse should identify this image as having the characteristics of melanoma. This form of skin cancer is characterized by an irregularly shaped lesion that contains a combination of colors such as red, black, blue-black, and brown. The nurse should perform a complete skin assessment because melanoma can occur anywhere on the client's body, especially where the client has nevi or birthmarks.

B.The nurse should identify this image as having the characteristics of squamous cell carcinoma. This form of skin cancer is characterized by a nodular lesion that is firm to palpation. The lesion has an ulcerated center and is covered by a crust. Squamous cell carcinoma is most commonly found on sun-exposed areas of the skin.

C.The nurse should identify this image as having the characteristics of basal cell carcinoma. This form of skin cancer is characterized by a papular lesion that has rolled borders and a crater in the center. Basal cell carcinoma is most commonly found on sun-exposed areas of the skin.

D.The nurse should identify this image as having the characteristics of psoriasis. This autoimmune disorder is not cancerous and is characterized by thick reddened areas covered with scales that have a silver-white color. Psoriasis is commonly found on the elbows, knees, and scalp. -8 A nurse is assessing a client who is at 24 weeks of gestation. Which of the following findings should the nurse identify as an indication of gestational hypertension? A.Protein in the urine B.Visual disturbances C.Systolic blood pressure 132 mm Hg D.Diastolic blood pressure 98 mm Hg A.Protein in the urine Protein in the urine is a manifestation of preeclampsia. Preeclampsia is a complication that can follow uncontrolled gestational hypertension. B.Visual disturbances

Visual disturbances are a manifestation of preeclampsia. Preeclampsia is a complication that can follow uncontrolled gestational hypertension. C.Systolic blood pressure 132 mm Hg For a client who has gestational hypertension, the nurse should expect a systolic blood pressure greater than 140 mm Hg. D.Diastolic blood pressure 98 mm Hg (CORRECT) Gestational hypertension is characterized by a systolic blood pressure greater than 140 mm Hg or a diastolic blood pressure greater than 90 mm Hg in a client who is at or past 20 weeks of gestation. To diagnose gestational hypertension, the nurse should record the increased levels on two occasions that are 4 hr apart. -9 A nurse in a mental health facility is caring for a client who has anorexia nervosa. Which of the following actions should the nurse take to help the client manage this eating disorder? (select all that apply) Have the client establish a weight gain goal of 1.81 kg (4 lb) per week Offer the client fried foods to increase caloric intake Limit the client's intake of caffeine Suggest high-fiber food choices to the client Use increments of 100 calories when advancing the client's dietary intake Have the client establish a weight gain goal of 1.81 kg (4 lb) per week is incorrect. The nurse should help the client establish a reasonable weight gain goal, such as 0.45 to 1.36 kg (1 to 3 lb) per week. Offer the client fried foods to increase caloric intake is incorrect. The client should avoid eating fried foods because they can lead to gastrointestinal intolerance. Limit the client's intake of caffeine is correct. The nurse should limit the client's intake of caffeine because it works as a diuretic and can cause excess stimulation. Suggest high-fiber food choices to the client is correct. The client should consume high-fiber foods to decrease the risk of constipation. Use increments of 100 calories when advancing the client's dietary intake is correct. The client's dietary intake should be increased gradually to avoid overwhelming the client. Increasing the client's dietary intake by increments of 100 to 200 calories is a reasonable strategy --

10 A school nurse is observing a preschooler who has autism spectrum disorder. Which of the following behavioral characteristics should the nurse expect the child to exhibit? A.Imaginative B.Extroverted C.Ritualistic D.Adaptable A.Imaginative A child who has ASD has difficulty with imaginative activities. The child is likely to demonstrate reduced initiation of interactions with others and repetitive, rigid play. B.Extroverted A child who has mild ASD has difficulty with social relationships. A child who has severe ASD is likely to show no interest in peers and might lack the ability to communicate with others. C.Ritualistic (CORRECT) The nurse should expect a child who has ASD to demonstrate compulsive ritualistic or repetitive movements, such as hand-clapping or, in some cases, self-mutilation movements such as banging or hitting his head. D.Adaptable A child who has ASD demonstrates rigid behaviors, insists on repetition, and is inflexible regarding routines. -11 A nurse is caring for a newborn who has a congenital heart defect and is postoperative following a cardiac catheterization. Which of the following actions should the nurse take? A.Administer an IV of lactated Ringer's. B.Assess vital signs once every 30 min. C.Remove the pressure dressing 2 hr after the procedure. D.Monitor the color of the affected extremity. A.Administer an IV of lactated Ringer's. The nurse should administer an IV fluid containing dextrose because newborns are at an increased risk for hypoglycemia. B.Assess vital signs once every 30 min. The nurse should assess the newborn's vital signs as frequently as every 15 min. The nurse should focus on the heart rate and ensure it is auscultated for 1 full min to detect bradycardia or dysrhythmias. C.Remove the pressure dressing 2 hr after the procedure. The nurse should remove the pressure dressing the day after the catheterization.

D.Monitor the color of the affected extremity. (CORRECT) The nurse should assess the color and temperature of the affected extremity because blanching or coolness can indicate an arterial obstruction. Additionally, the nurse should palpate the pulses with special attention to pulses below the catheterization site. The nurse should palpate for symmetry and equality -12 A nurse is discussing family planning with a client who wants to use a diaphragm for conception. Which of the following statements should the nurse include in the teaching? A."You should be refitted for your diaphragm after a 20 percent weight fluctuation." B."You should inspect your diaphragm once each month. C."You should get an exam by your provider every 2 years to check the fit of your diaphragm." D."You do not have to use a spermicide with the diaphragm." A."You should be refitted for your diaphragm after a 20 percent weight fluctuation." (CORRECT) The nurse should instruct the client to be refitted for a diaphragm after a 20% weight fluctuation, after a pregnancy, and after abdominal or pelvic surgery. B."You should inspect your diaphragm once each month. The nurse should instruct the client to inspect the diaphragm prior to each use. C."You should get an exam by your provider every 2 years to check the fit of your diaphragm." The nurse should instruct the client to get an annual examination by a provider to check the fit of the diaphragm. D."You do not have to use a spermicide with the diaphragm." The nurse should instruct the client to use a spermicide with the diaphragm to increase the effectiveness of pregnancy prevention. -13 A nurse is assessing a client who is at 34 weeks of gestation and is experiencing severe uterine pain. Which of the following findings should the nurse report to the provider? A.Increased fundal height since admission (CORRECT) An increased fundal height since admission indicates placental abruption with concealed bleeding. Therefore, the nurse should report this finding to the provider. B.Biophysical profile score of 8 This is an expected finding that indicates the fetus is at low risk for asphyxia.

C.Client reports eight fetal movements in 1 hr This is an expected finding at 34 weeks of gestation. A count of less than three movements in 1 hr requires further evaluation and a nonstress test. D.Client's cervical length is 30 mm A cervical length of 30 mm is an expected finding. A length of less than 25 mm is an indication of cervical insufficiency and should be reported to the provider. -14 A nurse is providing teaching to a client who has epilepsy and is starting to take carbamazepine. The nurse should instruct the client to monitor for which of the following manifestations as an adverse effect of this medication? A.Increased fundal height since admission B.Biophysical profile score of 8 C.Client reports eight fetal movements in 1 hr D.Client's cervical length is 30 mm A.Weight loss The nurse should instruct the client to monitor for the adverse effect of weight gain while taking carbamazepine. B.Urinary frequency The nurse should instruct the client to monitor for the adverse effect of urinary hesitancy or retention while taking carbamazepine. C.Blurred vision (CORRECT) The nurse should instruct the client to monitor for the adverse effect of blurred vision or double vision while taking carbamazepine and report the occurrence of these findings to the provider. D.Insomnia The nurse should instruct the client to monitor for the adverse effect of drowsiness or sedation while taking carbamazepine. -15 A nurse is an acute care mental health unit is caring for a newly admitted client who has OCD. The client is repeatedly washing her hands. Which of the following actions should the nurse take? A.Physically prevent the client from repeating compulsive acts.

B.Teach the client to use thought-stopping techniques. C.Allow the client to choose from a list of alternative activities. D.Administer diphenhydramine IV to the client. A.Physically prevent the client from repeating compulsive acts. The nurse should not physically prevent the client from repeating compulsive acts, because this could greatly increase anxiety. At the beginning of treatment, the nurse should allow the client time for compulsive acts and should gradually limit that time as therapy continues by replacing rituals with other behaviors. B.Teach the client to use thought-stopping techniques. (CORRECT) Thought stopping, where the client is taught to stop herself from performing compulsions, can interrupt impulsive actions. Other activities that accomplish this include physical activity and relaxation techniques. C.Allow the client to choose from a list of alternative activities. The nurse should provide the client with a structured schedule of activities to prevent increasing anxiety. D.Administer diphenhydramine IV to the client. Diphenhydramine is an anticholinergic medication given for allergy symptoms and itching. Medications used for a client who has obsessive-compulsive disorder include anxiolytics and SSRI antidepressants -16 A nurse is assessing a client who has acute pyelonephritis. The nurse should identify which of the following findings as an indication of inflammation? A.Increased BUN B.Redness on the right flank C.Decreased C-reactive protein D.Urinary retention A.Increased BUN An increased BUN can indicate dehydration and renal failure, but it is not an indication of inflammation. B.Redness on the right flank (CORRECT) The nurse should assess the client's flanks and gently palpate the costovertebral angle. Findings including redness, enlargement, asymmetry, or edema can indicate inflammation. C.Decreased C-reactive protein An increase in the C-reactive protein would indicate inflammation. The nurse should also

monitor the client's erythrocyte sedimentation rate to note the presence of inflammation. D.Urinary retention Urinary retention is a manifestation of an enlarged prostate or an obstruction in the urinary tract. Urinary frequency, urgency, or burning with urination are manifestations of acute pyelonephritis -17 A nurse is assessing a 12 month old infant who has down syndrome. Which of the following manifestations should the nurse expect? A.Long, thin neck B.Decreased muscle tone C.Large ears with thick cartilage D.Early tooth eruptions A.Long, thin neck The nurse should expect an infant who has Down syndrome to exhibit a short, broad neck. B.Decreased muscle tone (CORRECT) Decreased muscle tone is an expected assessment finding in a 12-month-old infant who has Down syndrome. The nurse should expect the infant to exhibit hypotonia as well as hyperflexibility. C.Large ears with thick cartilage The nurse should expect an infant who has Down syndrome to exhibit small...