ATI Study Quiz

A nurse is teaching about a low-cholesterol diet to a client who had a myocardial infarction. Which of the following meal selections by the client indicates an understanding of the teaching? A. Chicken breast and corn on the cob B. Shrimp and rice C. Cheese omelet and turkey bacon D. Liver and onions

A. Chicken breast and corn on the cob

A nurse is reviewing the laboratory findings of a client who has protein-calorie malnutrition. Which of the following findings should the nurse expect? A. Decreased albumin B Elevated hemoglobin C. Elevated lymphocytes D. Decreased cortisol

A. Decreased albumin A decrease in the albumin level can be an indication of a long-term protein depletion. Other potential conditions that result in decreased albumin levels include burns, wound drainage, and impaired hepatic function.

A nurse is assessing a client who has heart failure and is taking daily furosemide. The client's apical pulse is weak and irregular. The nurse should identify these findings as manifestations of which of the following electrolyte imbalances? A. Hypokalemia B. Hypophosphatemia C. Hypercalcemia D. Hypermagnesemia

A. Hypokalemia Furosemide can cause the loss of potassium, sodium, calcium and magnesium. Manifestations of hypokalemia can include shallow respirations, muscle weakness, lethargy, and ectopic heartbeats.

A nurse is teaching a client with heart disease about a low cholersterol diet. Which of the following client statements indicates the teaching was effective? A. "I should remove the skin from poultry before eating it." B. "I will eat seafood once per week." C. "I should use margarine when preparing meals." D. "I can use whole milk in my oatmeal."

A. I should remove the skin from poultry before eating it. The nurse should identify the client understands the teaching when he states he will remove the skin from poultry before eating, as the skin contains the greatest amount of fat.

A nurse is caring for a client who is receiving mechanical ventilation and develops acute respiratory distress. Which of the following actions should the nurse take first? A. Initiate bag-valve-mask ventilation B. Provide the client with a communication board. C. Obtain a blood sample for ABG analysis D. Document the ventilator settings

A. Initiate bag-valve-mask ventilation The nurse should apply the ABC priority setting framework.

A nurse is teaching a client who has coronary artery disease the difference between angina pectoris and myocardial infarction. Which of the following manisfestations should the nurse identify as indications of MI? (Select all that apply) A. Nausea and vomiting B. Diaphoresis and dizziness C. Chest and left arm pain that subsides with rest D. Anxiety and feelings of doom E. Bounding pulse and bradypnea

A. Nausea and vomiting B. Diaphoresis and dizziness D. Anxiety and feelings of doom Theses are all common manisfestations of MI.

What are common manifestations of peripheral arterial disease? A. Ankle swelling B. Absent pedal pulses C. Hair loss D. Skin atrophy

All except for ankle swelling. Absent pedal pulses and hair loss of the affected extremity is seen in PAD.

A nurse is completing teaching with a client who has heart failure and is prescribed a 2g sodium diet. Which of the following statements by the client undicates an understanding of the teaching? A. "I should use salt sparingly while cooking." B. "I can have yogurt as a dessert." C. "I should use baking soda when I bake." D. "I should use canned vegetables instead of frozen."

B. "I can have yogurt as a dessert." The client understands the teaching when he selects yogurt as a dessert. Yogurt is low in fat and sodium and is a good source of calcium and protein.

A nurse is assessing a client who has peripheral vasular disease and a venous ulcer on the right ankle. Which of the following findings should the nurse expect in the client's affected extremity? A. Absent pedal pulses B. Ankle swelling C. Hair loss D. Skin atrophy

B. Ankle swelling The nurse should identify that swelling of the ankle is a manifestation of venous insufficiency due to poor venous return. Other manisfestations can include brown pigmentations and cellulitis.

A nurse is caring for a client who is experiencing acute opiod toxicity. Which of the following actions should the nurse identify as the priority? A. Insert a large-bore IV catheter B. Ensure an adequate airway C. Obtain an accurate medication history D. Prepare to administer an antagonist

B. Ensure an adequate airway Teh first action the nurse should take when using the ABC approach is to ensure the client's airway is adequate, as respiratory depression is a manifestation of opiod toxicity.

A nurse is caring for a client who has severely elevated blood pressure. Which of the following findings should the nurse identify as a manifestation of hypertension? A. Vertigo B. Epistaxis C. Exophtalmos D. Spondylolisthesis

B. Epistaxis A nosebleed is a manisfestation of elevated blood pressure. Hypertension is often asymptomatic, but when it is severely elevated it can also cause headaches, dizziness, facial flushing and fainting.

A nurse is providing instructions about pursed-lip breathing for a client who has COPD with emphysema. This breathing technique accomplishes which of the following? A. Increases oxygen intake B. Promotes cardion dioxide elimination C. Uses the intercostal muscles D. Strengthens the diaphragm

B. Promotes carbon dioxide elimination A client with COPD with emphysema should use pursed lip breathing when experiencing dyspnea. This slows the pace of breathing, making each breath more effective. Pursed lip breathing releases trapped air in the lungs and prolongs exhalation in order to slow the breathing rate. This improved pattern moves carbon dioxide out of the lungs more efficiently.

The nurse is caring for an older adult client who has COPD with pneumonia. The nurse should watch the client for which of the following acid-base imbalances? A. Respiratory alkalosis B. Respiratory acidosis C. Metabolic alkalosis D. Metabolic acidosis

B. Respiratory acidosis Respiratory acidosis is a common complication of COPD. This complication occurs because clients who have COPD are unable to exhale carbon dioxide due to a loss of elastic recoil in the lungs.

A nurse is caring for a client who reports calf pain. What is the first action the nurse should take? A. Notify the provider B. Elevate the affected extremity C. Check the affected extremity for warmth and redness D. Prepare to administer unfractionated heparin

C. Check the affected extremity for warmth and redness The first action the nurse hsould take using the nursing process is to assess the client's calf for swelling, redness, and warmth. These findings can indicate a DVT.

A nurse is caring for an adult male client who is undergoing screening tests for atherosclerosis. Which of the following laboratory findings should the nurse identify as an increased risk for this disorder? A. Cholesterol level 195 mg/dL B. Elevated HDL levels C. Elevated LDL levels D. Triglyceride level 135 mg

C. Elevated LDL levels. An elevated LDL level increases a client's risk of atherosclerosis. The client's desirable LDL level is <100 mg/dL.

A nurse is teaching a client about dietary modifications to control blood pressure. Which of the following food choices should the nurse identify as an indication that the client understands the instructions? A. Onion soup and salad B. Vegetarian wrap with potato chips C. Grilled chicken salad with fresh tomatoes. D. Chicken bouillon and crackers.

C. Grilled chicken salad with fresh tomatoes

A nurse is preparing to assist a provider with an ABG withdrawal from a clients radial artery for ABG measurement. Which of the following actions should the nurse plan to take? A. Hyperventilate the client with 100% oxygen prior to obtaining the specimen. B. Apply ice to the site after obtaining the specimen. C. Perform an Allen's test prior to obtaining the specimen. D. Release the pressure applied to the puncture site 1 min after the needle is withdrawn.

C. Perform an Allen's test prior to obtaining the specimen. The nurse should always ensure that circulation to the hand is adequate from the ulnar artery in case the radial artery is injured from the blood draw. The most common site for withdrawal of arterial blood gases is the radial artery.

A nurse is assessing a client who has an abdominal aortic aneurysm. Which of the following findings indicates that the AAA is expanding? A. Increased BP and decreased pulse rate B. Jugular vein distention and peripheral edema. C. Report of sudden, severe back pain D. Report of retrosternal chest pain radiating to the left arm.

C. Report of sudden, severe back pain. An aortic aneurysm is a weak spot in the wall of the aorta that allows the aorta to expand and increase in diameter. Sudden and increasing abdominal and back pain indicates that the aneurysm is extending downward and pressing on the lumbar sacral nerves.

A nurse is caring for a client who is extremely anxious and is hyperventilating. The clients ABG results are: pH 7.5, PaCO2 27mmHg, and HCO3 25mEq/L. The nurse should identify that the client has which of the following acid-base imbalances? A. Respiratory acidosis B. Metabolic acidosis C. Respiratory alkalosis D. Metabolic alkalosis

C. Respiratory alkalosis Because of rapid breathing, the client is echaling excessive amounts of carbon dioxide. This loss of carbon dioxide decreases the hydrogen ion level of the blood, which causes the pH to increase and results in respiratory alkalosis.

A nurse is preparing an inservice presentation about assessing clients who are having an acute MI. What is the most common assessment finding with acute MI? A. Dyspnea B. Pain in the shoulder and left arm C. Substernal chest pain D. Palpitations

C. Substernal chest pain Evidence-based practice indicates that the most common manifestations of acute MI is substernal chest pain that does not subside with rest or nitroglycerin. Therefore, nurses should make pain management with morphine a priority to reduce myocardial oxygen demand and increase oxygenation.

A client who just learned that he has variant angina asks the nurse how this type of angina compares with stable angina. Which of the following replies should the nurse make? A. Exertion often brings on pain. B. Variant angina occurs randomly at various times. C. Variant angina can cause changes on your electrocardiogram. D. Reducing your cholerterol can help you experience less pain.

C. Variant angina can cause changes on your electrocardiogram. Variant angia causes ECG changes that reflect coronary artery spasms, which results in less oxygen supplying the myocardium.

A nurse is assessing a client who has right-sided heart failure. Which of the following should the nurse expect? A. Decreased capillary refill B. Dyspnea C. Orthopnea D. Dependant edema

D. Dependent edema Blood return from the venous system to the right atrium is impaired by a weakened right heart. The subsequent systemic venous backup leads to the development of dependent edema.

A nurse is reviewing laboratory values for an adult client who has sickle cell anemia and a history of receiving blood transfusions. For which of the following complications should the nurse monitor? A. Hypokalemia B. Lead poisoning C. Hypercalcemia D. Iron toxicity

D. Iron toxicity A client who has received several blood transfusions is at risk of hemosiderosis, which is the excess storage of iron in the body. Excessive iron can come from overuse of supplements or from receiving frequent blood transfusions as in sickle cell anemia.

A nurse is planning care for a client who is postoperative following a hip arthroplasty. In the client's medical record, the nurse notes a history of COPD. Which of the following oxygen-delivery methods should the nurse plan to use for this client? A. Simple face mask B. Nonrebreather mask C. Bag-valve-mask deice D. Nasal cannula

D. Nasal cannula A nasal cannula delivers precise concentrations of oxygen, therefore, it is an appropriate device for a client who has COPD and requires a precise percentage of inspired oxygen.

A nurse is caring for a client who has COPD and is experiencing shortness of breath. Which of the following actions should the nurse perform first? A. Monitor the client's arterial blood gas results. B. Instruct the client to perform controlled coughing. C. Teach the client how to use pursed-lip breathing. D. Place the client in an upright position.

D. Place the client in an upright position. Using the ABC approach, the nurse should place the client in an upright position to facilitate chest expansion and proper diaphragmatic contraction. Positionign the client uright will also assist with mobilizing secretions that might be impeding airflow.

A nurse is caring for a client who is receiving IV ampicillin and develops urticaria and dyspnea. Which of the following actions should the nurse take first? A. Elevate the clients feet and legs B. Administer epinephrine C. Infuse 0.9% sodium chloride D. Stop the medicaiton infusion

D. Stop the medication infusion The greatest risk to this client is an allergic reaction that can progress to anaphylaxis. The nurse should stop the infusion immediately to halt further exposure of the client to the allergen.

A nurse is reviewing the progress notes for a client who has heart failure. The provider noted some improvement in the client's cardiac output. The nurse should understand that cardiac output reflects which of the following physiologic parameters? A. The percentage of blood the ventricles pump during each beat B. The amount of blood the left ventricle pumps during each beat C. The amount of blood in the left ventricle at the end of diastole. D. The heart rate times the stroke volume.

D. The heart rate times the stroke volume. Cardiac output is the product of the client's heart rate and stroke volume (the amount of blood the left ventricle pumps with each contraction). In systolic heart failure, the heart cannot pump enough oxygenated blood into the circulation, causing cardiac output to decrease.