ATI PN COMPREHENSIVE EXIT EXAM

ATI PN COMPREHENSIVE EXIT EXAM Determine if the AP has completed the assignment. 6. A client is scheduled for an outpatient colonoscopy+ which of the following actions is a nursing responsibility in the informed consent process? Verify that there is a signed and witnesses consent form in the client's chart. 7. A nurse smells alcohol on the breath of an assistive personnel CAP) during report. Which of the following actions should the nurse take? Report the situation to the nurse manager. 8. A nurse from a medical-surgical unit is floating to a postpartum unit. Which of the following clients is an appropriate assignment for the nurse to accept? A client who had a cesarean delivery 24hr ago. 9. A nurse in a provider's office is collecting data from a parent of an infant who is being screened for cystic fibrosis. Which of the following supports a diagnosis of cystic fibrosis? Frothy stools. 10. When caring for an assigned group of clients, the nurse should wear gloves when Performing oral hygiene. 11. A nurse is preparing a client for surgery. The client tells the nurse that he is concerned about the safety of a large sum of money in his wallet. Which of the following actions is appropriate for the nurse to take? Contact security personnel to place the money in the facility safe. 12. A nurse is caring for a client who is receiving heparin. Which of the following is the appropriate route of administration? Subcutaneously. 13. A nurse is reinforcing teaching about car seat safety to the parents of a newborn, The nurse should instruct the parents to place the car seat in a? Rear-facing position in the back seat. DownDlooawdneldoabdye: desbmy:eKraalydyah15| 7k7am| easnmdeearablidgaa1el5@ DDiissttrriibbuuttiioon oof tthhiis ddooccuummeennt iis iilllleeggaall 14. A nurse is caring for a client and recognizes the client's rights to confidentiality have been breached in which of the following situations? A hospital risk manager includes information from a client's medical record in 15. A nurse is caring for a client who had a femoral-popliteal bypass graft 2 days ago. When monitoring peripheral pulses, the nurse is unable to locate a pulse on the affected leg. Which of the following actions should the nurse take? Notify the charge nurse of the finding. 16. A nurse is caring for a full-term newborn who was circumcised 6 hours ago, which of the following findings indicates that the newborn is experiencing pain? Furrowed Brow 17. A nurse is reinforcing teaching with a client about organ donation. Which of the following client statements indicated a need for further teaching? "My doctor should decide if my organs will be donated." DownDlooawdneldoabdye: desbmy:eKraalydyah15| 7k7am| easnmdeearablidgaa1el5@ DDiissttrriibbuuttiioon oof tthhiis ddooccuummeennt iis iilllleeggaall 18. A Client who is prescribed metoprolol (Lopressor) for hypertension tells the nurse, "I don't want to take this medication because it makes me tired all the time." Which of the following is the appropriate response? "Let's talk with your doctor about other options." 19. A nurse is preparing to administer an IM injection to a client. To reduce the risk of needle stick injury, the nurse should? Dispose of the used needle immediately in a puncture-proof sharps container. 20. A Nurse is contributing to the discharge plan for a client following surgery. Which of the following findings indicate the need for an interdisciplinary care conference? The client requires assistance to pay for dressing supplies. 21. A client who is 24 hour postoperative suddenly develops chest pain, dyspnea, anxiety, diaphoresis, and cough. Which of the following actions should the nurse take first? Elevate the head of the client's bed. DownDlooawdneldoabdye: desbmy:eKraalydyah15| 7k7am| easnmdeearablidgaa1el5@ DDiissttrriibbuuttiioon oof tthhiis ddooccuummeennt iis iilllleeggaall 22. A nurse is caring for a 17-year old client who is admitted for an emergency appendectomy. Which of the following is an appropriate action by the nurse in obtaining informed consent? Obtain verbal consent from the client while waiting for the parents to arrive. b. Witness the signature of the client's parent when he arrives. c. Have the client's older sibling give consent if a parent is not available. d. Delay the procedure if the provider cannot contact the parents. 23. A nurse has delegated care to an assistive personnel. At the end of the shift, the Ap asks the nurse to enter data for her because the AP has forgotten her password and needs to leave, Which of the following actions should the nurse take? Tell the AP to contact the IT department for charting assistance 24. A nurse is reinforcing discharge teaching to a client following a gastrectomy, to prevent dumping syndrome, which of the following foods should the nurse instruct the client to avoid? Ice Cream 25. A nurse is caring for a client admitted with shortness of breath who will be undergoing arterial blood gas testing, which of the following client statements DownDlooawdneldoabdye: desbmy:eKraalydyah15| 7k7am| easnmdeearablidgaa1el5@ DDiissttrriibbuuttiioon oof tthhiis ddooccuummeennt iis iilllleeggaall indicated an understanding of the purpose of drawing arterial blood gases? "This will indicate how much acid is building up in my blood." 26. A nurse manager is seeking ways to increase cost-effectiveness on the unit. In which of the following client care situations should the nurse manager intervene? Nurse discards a bottle of sterile saline after it has been open for 24 hours 27. A nurse is collecting data from a client who reports recent weight loss and a Chronic cough that is now producing blood-streaked sputum. For which of the following should the nurse expect the client to have diagnostic testing? A. Lung Cancer B. Emphysema. 28. A nurse is caring for an older adult client with a decreased level of consciousness. Which of the following is an appropriate intervention related to the client's mouth care? Uses a sponge toothette to cleanse the inside of the mouth. DownDlooawdneldoabdye: desbmy:eKraalydyah15| 7k7am| easnmdeearablidgaa1el5@ DDiissttrriibbuuttiioon oof tthhiis ddooccuummeennt iis iilllleeggaall 29. A nurse in a long-term care facility nuts that the assistive personnel lack knowledge of blood glucose monitoring, The nurse should bring this observation to the attention of which of the following personnel? Charge Nurse. 30. A nurse is reinforcing discharge teaching for a client admitted with an acute myocardial infarction, which of the following activities is appropriate for the client to participate in during the first two weeks following discharge? Walking. 31. A nurse is providing anticipatory guidance to the parent of a 6-year old child, which of the following statements by the parent indicated an understanding of appropriate safety precautions for the child? "I will encourage my child to wear a bicycle helmet whenever bike riding." 32. A nurse is collecting data from a client who presents to the clinic reporting vomiting. Which of the following findings indicate that the client is experiencing a fluid volume deficit? DownDlooawdneldoabdye: desbmy:eKraalydyah15| 7k7am| easnmdeearablidgaa1el5@ DDiissttrriibbuuttiioon oof tthhiis ddooccuummeennt iis iilllleeggaall Orthostatic hypotension. 33. A nurse is reinforcing teaching for a client undergoing radiation therapy to the neck. Which of the following should the nurse include? Avoid exposing the neck to the cold 34. A nurse is caring for a client who is receiving warfarin (Coumadin) for deep vein thrombosis. The nurse observed that the client's INR is 3.8.Which of the following actions should the nurse take? Withhold the ordered dose of the medication 35. A nurse is reinforcing teaching with the parents of a 4-month-old infant during a home visit. Which of the following findings in the infant's room indicates a need for further teaching? The infant is lying in the crib with a stuffed animal 36. A nurse is caring for a client who has hepatitis B, When caring for the client, which of the following actions places the nurse at highest risk for acquiring hepatitis B? Performing oral hygiene DownDlooawdneldoabdye: desbmy:eKraalydyah15| 7k7am| easnmdeearablidgaa1el5@ DDiissttrriibbuuttiioon oof tthhiis ddooccuummeennt iis iilllleeggaall 37. A nurse is reinforcing discharged teaching with the family of a client who has dependent personality disorder. Which of the following instructions should the nurse include in the teachings? Assume responsibility for making the clients decisions 38. A nurse is reinforcing teaching with school staff about streptococcal infection of the pharynx, the nurse should instruct the staff that the period of contagion for children who have this infection is which of the following? From onset of symptoms until 24hrs of antibiotic therapy. 39. A nurse is caring for a client who is 2 days postoperative following a partial bowel resection_ The client reports that the "felt something pop" when he sneezed, The nurse observes an evisceration, After calling for assistance, which of the following actions should the nurse take first? Cover the wound with sterile saline-soaked gauze DownDlooawdneldoabdye: desbmy:eKraalydyah15| 7k7am| easnmdeearablidgaa1el5@ DDiissttrriibbuuttiioon oof tthhiis ddooccuummeennt iis iilllleeggaall 40. A nurse is caring for a client who is in balanced skeletal traction for a leg fracture. Which of the following should the nurse expect to be included in the care plan? Increase counter traction every 24 hr. d. Inspect the ropes, knots, and pulleys every 8 hrs 41. A nurse is using contact precautions while caring for a toddler. Which of the following actions should the nurse take? Use a designated stethoscope for the toddler 42. A client's daughter calls the nurse requesting information about her mother's condition, the client's chart does not specify that information can be released to the daughter, which of the following is an appropriate response by the nurse? "You will need to contact your mother directly about her condition." 43. A nurse is reviewing the immunization records of a 9 year old child during a routine physical exam, which of the following should indicate to the nurse the child is not current with the minimum required immunization? DownDlooawdneldoabdye: desbmy:eKraalydyah15| 7k7am| easnmdeearablidgaa1el5@ DDiissttrriibbuuttiioon oof tthhiis ddooccuummeennt iis iilllleeggaall One MMR vaccine. 44. A nurse is reinforcing teaching with a new mother on facility security measure, which of the following statements by the mother indicates that the teaching was effective? "I will have an identification band that matches the one my baby wears." 45. A nurse is reinforcing teaching with a client who is at 10 weeks gestation and has a medical history of mild hypertension. The nurse should remind the client to call the clinic if she? Develops edema of the ankles. 46. A nurse is caring for a client who has been placed in restraints. Which of the following is appropriate? Monitor the client's skin integrity on a regular schedule. 47. A nurse is working on a mental health unit is reviewing policies for client seclusion. For which of the following is seclusion appropriate? Aggressive behavior DownDlooawdneldoabdye: desbmy:eKraalydyah15| 7k7am| easnmdeearablidgaa1el5@ DDiissttrriibbuuttiioon oof tthhiis ddooccuummeennt iis iilllleeggaall