ATI Dynamic Quiz: Comprehensive Final
A nurse is providing preoperative teaching for a client who will undergo laser-assisted in situ keratomileusis (LASIK) surgery. Which of the following information should the nurse include? A. "you might need glasses after the surgery' B. "you may drive home after the procedure" C. "continue to wear your contact lenses until the day of surgery" D. "expect complete healing and clear vision in about a week"
A. "you might need glasses after the surgery' LASIK is a type of refractive laser eye surgery ophthalmologists perform to correct myopia, hyperopia, and astigmatism, which are common causes of nearsightedness. However, overcorrection or undercorrection of refractive errors is possible, so some clients will need prescription eyeglasses despite having had LASIK surgery.
A nurse is teaching a client who has extensive deep partial- and full-thisckness burns and requires a topical antimicrobial medication. The nurse should explain to the client that the goal of this medication therapy is to reduce which of the following outcomes? A. Bacterial growth B. Scarring C. Skin graft size D. Pain
A. Bacterial growth Topical antimicrobial medications (particularly broad-spectrum antimicrobials) help prevent bacteria from entering the body when a client has an impairment of the protective covering of the skin, as with burns. It creates a protective barrier, along with the dressing, between bacteria and the exposed body tissues. This therapy helps prevent infection.
A nurse participating in a community health fair is providing information to a client who has a BP of 150/90 mmHg during a blood pressure screening. Which of the following actions should the nurse take? A. give the client a written record of his BP ro bring to their provider B. encourage the client to go to the nearest emergency department C. instruct the client to follow up with a provider within 6 months D. explain to the client that he is not at risk unless he has manifestations of hypertension
A. give the client a written record of his BP ro bring to their provider When a client has an elevated reading at a hypertension screening, the nurse should encourage him to see his provider for further evaluation within 2 months. To help facilitate this process, the nurse should give him a written record of the BP at the screening to share with his provider.
A nurse is admitting a client who has manifestations that suggest tuberculosis. Which of the following actions is the nurse's priority? A. initiate airborne precautions B. administer antimicrobial therapy C. tell the client that his infection will be communicable D. teach the client about manifestations of tuberculosis
A. initiate airborne precautions Clients who have or might have tuberculosis require airborne isolation precautions immediately because of the highly communicable nature of the infection. Airborne precautions prevent transmission of pathogens that remain infectious in the air, including Mycobacterium tuberculosis, the bacterium that causes tuberculosis.
A nurse is caring for a client who has chronic phantom limb pain following an above-knee amputation. Which of the following medication prescriptions should the nurse verify with the provider? A. meperidine B. amitriptyline C. gabapentin D. propranolol
A. meperidine Opioids are more effective for residual limb pain rather than phantom limb pain. Additionally, meperidine is not recommended for chronic pain because using it long-term can cause accumulation of a toxic metabolite.
A nurse is providing teaching to the parents of a child who has strabismus. Which of the following instructions should the nurse include to prevent the development of amblyopia? A. patch the unaffected eye B. administer mydriatic eye drops daily C. obtain prescription eyeglasses D. administer antihistamines
A. patch the unaffected eye Amblyopia is a disorder of the eye in which unilateral central blindness occurs as a result of another problem, such as strabismus. With strabismus, muscle weakness allows one eye to wander so that the child cannot focus on an object with both eyes at the same time. This confusion causes the brain to ignore the signals from the weak eye in favor of the strong one. This will result in central blindness if the child does not receive treatment by 6 years of age. To strengthen the weak eye muscles, the parents should patch the unaffected eye.
A nurse is providing discharge teaching to a client who has had a transient ischemic attack (TIA). Which of the following instructions should the nurse include? A. reduce dietary sodium B. decrease dietary potassium C. restrict intake of insoluble fiber D. limit. alcohol intake to 3 or fewer servings per day
A. reduce dietary sodium A temporary disturbance of the blood supply to the brain causes TIAs, which are brief alterations in neurologic function. The most common causes are atherosclerotic plaque in the carotid arteries and hypertension; therefore, the client should limit sodium intake to help control hypertension and prevent future TIAs.
Results of enzyme-linked immunosorbent assay (ELISA) testing for an 18-month-old infant who has pneumocystis carinii pneumonia indicate that she is HIV positive. When planning care, the nurse should consider which of the following factors? A. the infant's mother is most likely HIV positive B. the infant's ELISA test result is probably a false positive for HIV C. antiretroviral medications are inappropriate for infants and children who have HIV D. HIV-positive status is a contraindication for MMR immunizations
A. the infant's mother is most likely HIV positive Transmission of HIV from a woman to her infant can occur during pregnancy, delivery, or through breastfeeding. Though it is possible for the infant to acquire HIV from sexual abuse, mother-to-child transmission accounts for the majority of HIV/AIDS cases in infants.
A nurse is caring for a group of clients in a long-term care facility. one of the clients is walking in the hallway and bumping into walls and does not. respond to his name. Which of the following actions should the nurse take first? A. offer the client a nutritious snack B. accompany the client back to his room C. reorient the client to his surroundings D. administer a PRN anti-anxiety medication
B. accompany the client back to his room the nurse should first escort the client back to his room to protect him from injury due to wandering
A nurse is providing teaching to a client who has a new prescription for sertraline. The client asks the nurse if he should continue to take St. John's wort for depression. Which of the following instructions should the nurse give to the client? A. take the medication & herbal supplement together B. stop taking the herbal supplement while taking the medication C. take the herbal supplement & the medication at least 2 hours apart D. take an antacid with both the herbal supplement & the medication
B. stop taking the herbal supplement while taking the medication Taking the antidepressant sertraline and the herbal supplement St. John's wort together puts the client at risk for serotonin syndrome.
A nurse in the emergency department is reviewing ;ab results for several children who have manifestations of influenza. Which of the following children should the nurse report to the provider immediately? A. a school aged child whose urine specific gravity is 1.035 B. a toddler whos bUN is 25 mg/dL and whose creatinine is 0.5 mg/dL C. an infant whose WBC is 24,000/mm3 D. an adolescent whose beta human chorionic gonadotropin is positive
C. an infant whose WBC is 24,000/mm3 hen there are several risks to client safety, the one posing the greatest threat is the highest priority. The nurse should use Maslow's Hierarchy of Needs, the ABC priority-setting framework, or nursing knowledge to identify which risk poses the greatest threat to the client. This WBC count is high and indicates infection and possibly sepsis, which poses the greatest risk to the client. The provider must initiate blood, urine, and spinal fluid cultures and begin antimicrobial therapy.
A nurse in the emergency department is caring for a client who reports pain in her left leg following a motor-vehicle crash. The nurse notes that herr left leg has bruising, swelling, and displacement of bones. Which of the following actions should the nurse take first? A. obtain an x-ray of the injured leg B. apply ice packs to the affected area C. check neurovascular status distal to the injury D. elevate the affected leg on two pillows
C. check neurovascular status distal to the injury The greatest risk to this client is impaired circulation to the limb from trauma and the resulting edema; therefore, the first action is to check the circulation, sensation, and movement distal to the level of the injury. If the nurse notes a weak or absent pulse distal to the injury, the limb's circulation is compromised, and immediate action is critical.
A nurse is assessing a 66-year old client during a routine physical examination at her first clinic visit and does not have her medical records. When the nurse asks if she has received the pneumococcal immunization, the client replies, "I am not sure, but it has been at least 5 years since ive had any immunizations." Which of the following responses should the nurse make? A. "Just in case you had the immunization before, we can't give you another one." B. "You'll need a series of three injections." C. "This immunization is unsafe for people over the age of 65 years old." D. "Let's go ahead with giving you this immunization."
D. "Let's go ahead with giving you this immunization." The CDCP recommends this immunization for people who are 65 years old and older. If the client did receive this immunization more than 5 years ago, the nurse should administer another one because the client is over 65.
a nurse is caring for an infant who has a cleft palate. The parents ask the nurse how long they should wait before he should have corrective surgery. The nurse should explain that the parents should wait no longer than 6-12 months to prevent which of the following outcomes? A. repeated ear infections B. nutritional deficits C. immune system deficits D. difficulty with language acquisition
D. difficulty with language acquisition Infants who have a cleft palate can have difficulty acquiring language because they need to use the palate for vocalizing sounds. With the cleft in the palate, these infants could develop poor speech habits
