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ATI PN comprehensive predictor latest version 2025.docx, Exams of Nursing

University of Illinois - Urbana-ChampaignNursing

ATI PN comprehensive predictor latest version 2025.docx

Typology: Exams

2024/2025

Uploaded on 06/06/2025

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ATI PN comprehensive predictor latest
version 2025/2026.
What can be delegated to Assistive personnel (AP)? - ANSWER- ADLs - bathing -
grooming - dressing - ambulating - feeding (w/o swallow precautions) - positioning - bed
making - specimen collection - I&O - VS (stable clients
A nurse on a med surge unit has recieved change of shift report and will care for 4
clients. Which of the following clients needs will the nurse assign to an AP?
A. Feeding a client who was admitted 24 hours ago with aspiration pneumonia
B. Reinforcing teaching with a client who is learning to walk with a quad cane
C. Reapplying a condom catheter for a client who has urinary incontinence
D. Applying a sterile dressing to a pressure ulcer - ANSWERC
A nurse is delegating the ambulation of a client who had knee arthroplasty 5 days ago
to an AP. Which of the following info should the nurse share with the AP?
Select all:
A. the roommate is up independently
B. The client ambulates with his slippers on over his antiembolic stockings
C. The client uses a front wheeled walker when ambulating
D. The client had pain meds 30 minutes ago
E. The client is allergic to codeine
F. the client ate 50 % of his breakfast this morning - ANSWERB
C
D
An RN is making assignments for client care to an LPN at the beginning of the shift.
Which of the following assignments should the LPN question?
A. Assisting a client who is 24 hr postop to use an incentive spirometer
B. Collecting a clean catch urine specimen from a client who was admitted on the
previous shift
C. providing nasopharyngeal suctioning for a client who has pneumonia
D. Replacing the cartridge and tubing on a PCA pump - ANSWERD
A nurse is preparing an inservice program about delegation. Which of the following
elements should she identify when presenting the 5 rights of delegation. Select all:
A. Right client
B. Right supervision/evaluation
C. Right direction/communication
D. Right time
E. Right circumstances - ANSWERB
C
E
A nurse manager of a med surge unit is assigning care responsibilities for the oncoming
shift. A client is waiting transfer back to the unit from the PACU following thoracic
surgery. To which staff member should the nurse assign the client?
A. Charge nurse
B. RN
C. LVN
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ATI PN comprehensive predictor latest

version 2025/2026.

What can be delegated to Assistive personnel (AP)? - ANSWER- ADLs - bathing - grooming - dressing - ambulating - feeding (w/o swallow precautions) - positioning - bed making - specimen collection - I&O - VS (stable clients A nurse on a med surge unit has recieved change of shift report and will care for 4 clients. Which of the following clients needs will the nurse assign to an AP? A. Feeding a client who was admitted 24 hours ago with aspiration pneumonia B. Reinforcing teaching with a client who is learning to walk with a quad cane C. Reapplying a condom catheter for a client who has urinary incontinence D. Applying a sterile dressing to a pressure ulcer - ANSWERC A nurse is delegating the ambulation of a client who had knee arthroplasty 5 days ago to an AP. Which of the following info should the nurse share with the AP? Select all: A. the roommate is up independently B. The client ambulates with his slippers on over his antiembolic stockings C. The client uses a front wheeled walker when ambulating D. The client had pain meds 30 minutes ago E. The client is allergic to codeine F. the client ate 50 % of his breakfast this morning - ANSWERB C D An RN is making assignments for client care to an LPN at the beginning of the shift. Which of the following assignments should the LPN question? A. Assisting a client who is 24 hr postop to use an incentive spirometer B. Collecting a clean catch urine specimen from a client who was admitted on the previous shift C. providing nasopharyngeal suctioning for a client who has pneumonia D. Replacing the cartridge and tubing on a PCA pump - ANSWERD A nurse is preparing an inservice program about delegation. Which of the following elements should she identify when presenting the 5 rights of delegation. Select all: A. Right client B. Right supervision/evaluation C. Right direction/communication D. Right time E. Right circumstances - ANSWERB C E A nurse manager of a med surge unit is assigning care responsibilities for the oncoming shift. A client is waiting transfer back to the unit from the PACU following thoracic surgery. To which staff member should the nurse assign the client? A. Charge nurse B. RN C. LVN

D. AP - ANSWERB

What is the study of conduct and character? - ANSWEREthics What are the values and beliefs that guide behavior and decision making? - ANSWERMorals What is the right to make ones own personal decisions, even tho those decisions might not be in the persons best interest - ANSWERAutonomy What are positive actions to help others - ANSWERBeneficience What is an agreement to keep promises - ANSWERFidelity What is fairness in care delivery and use of resources - ANSWERJustice What is avoidance of harm or injury - ANSWERNon-maleficence A nurse is caring for a client who decides not to have surgery despite significant blockages in his coronary arteries. The nurse understands that this clients choice is an example of what principles? A. Fidelity B. Autonomy C. Justice D. Nonmalificience - ANSWERA A nurse offers pain meds to a client who is postop prior to ambulation. The nurse understands that this aspect of care delivery is an example of which of the following ethical principles? A. Fidelity B. Autonomy C. Justice D. Beneficience - ANSWERD A nurse is instructing a group of nursing students about the responsibilities involved with organ donation and procurement. When the nurse explains that all clients waiting for a kidney transplant have to meet the same qualifications, the students should understand that this aspect of care delivery is an example of which ethical principle A. Fidelity B. Autonomy C. Justice D. Nonmaleficence - ANSWERC A nurse questions a med prescription as too extreme and light of the clients advanced age and unstable status. The nurse understands that this action is an example of which ethical principle A. Fidelity B. Autonomy C. Justice D. Nonmalificence - ANSWERD Which of the following situations can be identified as an ethical dilemma? A. A nurse on a med surge unit demonstrates signs of chemical impairment B. A nurse over hears another nurse telling an older adult client that if he doesnt stay in bed she will restrain him C. A family has conflicting feelings about the initiation of enteral tube feedings of their father who is terminally ill

Fill in the blank:

  1. _______ is used by interdisciplinary team to make health care decisions about clients with multiple problems. 2. ________, which may take place at team meetings, allows the achievement of results that the participants would be incapable of accomplishing if working alone. - ANSWER1 & 2 = collaboration What is the nurse's contribution to an interdisciplinary team? - ANSWER- knowledge of nursing care & its management
  • a holistic understanding of the client, her/his healthcare needs & healthcare systems. A four-month-old infant is admitted to the pediatric intensive care unit with a temperature of 105°F (40.5 °C). The infant is irritable, and the nurse observes nuchal rigidity. Which assessment finding would indicate an increase in intracranial pressure?
  1. Positive Babinski.
  2. High-pitched cry.
  3. Bulging posterior fontanelle.
  4. Pinpoint pupils. - ANSWER A client is receiving total parenteral nutrition (TPN). To determine the client's tolerance of this treatment, the nurse should assess for which of the following?
  5. A significant increase in pulse rate.
  6. A decrease in diastolic blood pressure.
  7. Temperature in excess of 98.6°F (37°C).
  8. Urine output of at least 30 cc per hour. - ANSWER The client is exhibiting symptoms of myxedema. The nursing assessment should reveal
  9. increased pulse rate.
  10. decreased temperature.
  11. fine tremors.
  12. increased radioactive iodine uptake level. - ANSWER A nonstress test is scheduled for a client at 34-weeks gestation who developed hypertension, periorbital edema, and proteinuria. Which of the following nursing actions should be included in the care plan in order to BEST prepare the client for the diagnostic test?
  13. Start an intravenous line for an oxytocin infusion.
  14. Obtain a signed consent prior to the procedure.
  15. Instruct client to push a button when she feels fetal movement.
  16. Attach a spiral electrode to the fetal head. - ANSWER Which of the following nursing interventions is MOST important for a 45-year-old woman with rheumatoid arthritis?
  17. Provide support to flexed joints with pillows and pads.
  18. Position her on her abdomen several times a day.
  19. Massage the inflamed joints with creams and oils.
  20. Assist her with heat application and ROM exercises. - ANSWER The nurse is caring for a young adult admitted to the hospital with a severe head injury. The nurse should position the patient
  21. with his neck in a midline position and the head of the bed elevated 30°.
  1. side-lying with his head extended and the bed flat.
  2. in high Fowler's position with his head maintained in a neutral position.
  3. in semi-Fowler's position with his head turned to the side. - ANSWER The nurse is teaching a 40-year-old man diagnosed with a lower motor neuron disorder to perform intermittent self-catheterization at home. The nurse should instruct the client to
  4. use a new sterile catheter each time he performs a catheterization.
  5. perform the Valsalva maneuver(holding breath and bearing down) before doing the catheterization.
  6. perform the catheterization procedure every 8 hours.
  7. limit his fluid intake to reduce the number of times a catheterization is needed. - ANSWER A client is being discharged with sublingual nitroglycerin (Nitrostat). The client should be cautioned by the nurse to
  8. take the medication five minutes after the pain has started.
  9. stop taking the medication if a stinging sensation is absent.
  10. take the medication on an empty stomach.
  11. avoid abrupt changes in posture. - ANSWER A 38-year-old woman is returned to her room after a subtotal thyroidectomy for treatment of hyperthyroidism. Which of the following, if found by the nurse at the patient's bedside, is nonessential?
  12. Potassium chloride for IV administration.
  13. Calcium gluconate for IV administration.
  14. Tracheostomy set-up.
  15. Suction equipment. - ANSWER A nurse recognizes that an initial positive outcome of treatment for a victim of sexual abuse by one parent would be that the client
  16. acknowledges willing participation in an incestuous relationship.
  17. reestablishes a trusting relationship with his/her other parent.
  18. verbalizes that s/he is not responsible for the sexual abuse.
  19. describes feelings of anxiety when speaking about sexual abuse. - ANSWER An adolescent client is ordered to take tetracycline HCL (Achromycin) 250 mg PO bid. Which of the following instructions should be given to this client by the nurse?
  20. "Take the medication on a full stomach, or with a glass of milk."
  21. "Wear sunscreen and a hat when outdoors."
  22. "Continue taking the medication until you feel better."
  23. "Avoid the use of soaps or detergents for two weeks." - ANSWER After a client develops left-sided hemiparesis from a cerebral vascular accident (CVA), there is a decrease in muscle tone. Which of the following nursing diagnoses would be a priority to include in his care plan?
  24. Alteration in mobility related to paralysis.
  25. Alteration in skin integrity related to decrease in tissue oxygenation.
  26. Alteration in skin integrity related to immobility.
  27. Alteration in communication related to decrease in thought processes - ANSWER A client has a history of oliguria, hypertension, and peripheral edema.

that the medication is appropriate if the client displays which of the following symptoms?

  1. Agitation and decreased level of consciousness.
  2. Lethargy and decreased respiratory rate.
  3. Restlessness and increased heart rate.
  4. Hostility and increased blood pressure. - ANSWER A 59-year-old woman with bipolar disorder is receiving haloperidol (Haldol) 2 mg PO tid. She tells the nurse, "Milk is coming out of my breasts." Which of the following responses by the nurse is BEST?
  5. "You are seeing things that aren't real."
  6. "Why don't we go make some fudge."
  7. "You are experiencing a side effect of Haldol."
  8. "I'll contact your physician to change your medication." - ANSWER The physician orders ranitidine hydrochloride (Zantac) 150 mg PO qd for a client. The nurse should advise the client the BEST time to take this medication is
  9. before breakfast.
  10. with dinner.
  11. with food.
  12. at hs. - ANSWER . If a client develops cor pulmonale (right-sided heart failure), the nurse would expect to observe
  13. increasing respiratory difficulty seen with exertion.
  14. cough productive of a large amount of thick, yellow mucus.
  15. peripheral edema and anorexia.
  16. twitching of extremities. - ANSWER The nurse is performing triage on a group of clients in the emergency department. Which of the following clients should the nurse see FIRST?
  17. A 12-year-old oozing blood from a laceration of the left thumb due to cut on a rusty metal can.
  18. A 19-year-old with a fever of 103.8°F (39.8°C) who is able to identify her sister but not the place and time.
  19. A 49-year-old with a compound fracture of the right leg who is complaining of severe pain.
  20. A 65-year-old with a flushed face, dry mucous membranes, and a blood sugar of 470 mg/dL. - ANSWER The nurse in the outpatient clinic teaches a client with a sprained right ankle to walk with a cane. What behavior, if demonstrated by the client, would indicate that teaching was effective?
  21. The client advances the cane 18 inches in front of her foot with each step.
  22. The client holds the cane in her left hand.
  23. The client advances her right leg, then her left leg, and then the cane.
  24. The client holds the cane with her elbow flexed 60°. - ANSWER A client returns to his room following a myelogram. The nursing care plan should include which of the following?
  1. Encourage oral fluid intake.
  2. Maintain the prone position for 12 hours.
  3. Encourage the client to ambulate after the procedure.
  4. Evaluate the client's distal pulses on the affected side. - ANSWER The nurse is caring for a patient following an appendectomy. The patient takes a deep breath, coughs, and then winces in pain. Which of the following statements, if made by the nurse to the patient, is BEST?
  5. "Take three deep breaths, hold your incision, and then cough."
  6. "That was good. Do that again and soon it won't hurt as much."
  7. "It won't hurt as much if you hold your incision when you cough."
  8. "Take another deep breath, hold it, and then cough deeply - ANSWER A young woman is transferred to a psychiatric crisis unit with a diagnosis of a dissociative disorder. The nurse knows which of the following comments by the client is MOST indicative of this disorder?
  9. "I keep having recurring nightmares."
  10. "I have a headache and my stomach has bothered me for a week."
  11. "I always check the door locks three times before I leave home."
  12. "I don't know who I am and I don't know where I live." - ANSWER A 23-year-old man is admitted with a subdural hematoma and cerebral edema after a motorcycle accident. Which of the following symptoms should the nurse expect to see INITIALLY?
  13. Unequal and dilated pupils.
  14. Decerebrate posturing.
  15. Grand mal seizures.
  16. Decreased level of consciousness. - ANSWER . The nursing team includes two RNs, one LPN/LVN, and one nursing assistant. The nurse should consider the assignments appropriate if the nursing assistant is assigned to care for
  17. a client with Alzheimer's requiring assistance with feeding.
  18. a client with osteoporosis complaining of burning on urination.
  19. a client with scleroderma receiving a tube feeding.
  20. a client with cancer who has Cheyne-Stokes respirations. - ANSWER An elderly client is returned to her room after an open reduction and internal fixation of the left femoral head after a fracture. It is MOST important for the nursing care plan to include that the client
  21. eat a high-protein, low-residue diet.
  22. lie on her unoperated side.
  23. exercise her arms and legs.
  24. cough and deep breathe. - ANSWER Which of the following is a correctly stated nursing diagnosis for a client with abruptio placentae?
  25. Infection related to obstetrical trauma.
  26. Potential for fetal injury related to abruptio placentae.
  27. Potential alteration in tissue perfusion related to depletion of fibrinogen.
  28. Fluid volume deficit related to bleeding. - ANSWER An 8-year-old client is returned to the recovery room after a
  1. The staff uses standard precautions. - ANSWER When using restraints for an agitated/aggressive patient, which of the following statements should NOT influence the nurse's actions during this intervention?
  2. The restraints/seclusion policies set forth by the institution.
  3. The patient's competence.
  4. The patient's voluntary/involuntary status.
  5. The patient's nursing care plan. - ANSWER The nurse is caring for an 80-year-old client with Parkinson's disease. Which of the following nursing goals is MOST realistic and appropriate in planning care for this client?
  6. Return the client to usual activities of daily living.
  7. Maintain optimal function within the client's limitations.
  8. Prepare the client for a peaceful and dignified death.
  9. Arrest progression of the disease process in the client. - ANSWER A client with a peptic ulcer had a partial gastrectomy and vagotomy (Billroth I). In planning the discharge teaching, the client should be cautioned by the nurse about which of the following?
  10. Sit up for at least 30 minutes after eating.
  11. Avoid fluids between meals.
  12. Increase the intake of high-carbohydrate foods.
  13. Avoid eating large meals that are high in simple sugars and liquids. - ANSWER A nurse is caring for a 37-year-old woman with metastatic ovarian cancer admitted for nausea and vomiting. The physician orders total parenteral nutrition (TPN), a nutritional consult, and diet recall. Which of the following is the BEST indication that the patient's nutritional status has improved after 4 days?
  14. The patient eats most of the food served to her.
  15. The patient has gained 1 pound since admission.
  16. The patient's albumin level is 4.0mg/dL.
  17. The patient's hemoglobin is 8.5g/dL. - ANSWER A 23-year-old woman at 32-weeks gestation is seen in the outpatient clinic. Which of the following findings, if assessed by the nurse, would indicate a possible complication?
  18. The client's urine test is positive for glucose and acetone.
  19. The client has 1+ pedal edema in both feet at the end of the day.
  20. The client complains of an increase in vaginal discharge.
  21. The client says she feels pressure against her diaphragm when the baby moves. - ANSWER After abdominal surgery, a client has a nasogastric tube attached to low suctioning. The client becomes nauseated, and the nurse observes a decrease in the flow of gastric secretions. Which of the following nursing interventions would be MOST appropriate?
  22. Irrigate the nasogastric tube with distilled water.
  23. Aspirate the gastric contents with a syringe.
  24. Administer an antiemetic medicine.
  1. Insert a new nasogastric tube. - ANSWER After sustaining a closed head injury and numerous lacerations and abrasions to the face and neck, a five-year-old child is admitted to the emergency room. The client is unconscious and has minimal response to noxious stimuli. Which of the following assessments, if observed by the nurse three hours after admission, should be reported to the physician?
  2. The client has slight edema of the eyelids.
  3. There is clear fluid draining from the client's right ear.
  4. There is some bleeding from the child's lacerations.
  5. The client withdraws in response to painful stimuli. - ANSWER The nurse is caring for a manic client in the seclusion room, and it is time for lunch. It is MOST appropriate for the nurse to take which of the following actions?
  6. Take the client to the dining room with 1:1 supervision.
  7. Inform the client he may go to the dining room when he controls his behavior.
  8. Hold the meal until the client is able to come out of seclusion.
  9. Serve the meal to the client in the seclusion room. - ANSWER A client is given morphine 6 mg IV push for postoperative pain. Following administration of this drug, the nurse observes the following: pulse 68, respirations 8, BP 100/68, client sleeping quietly. Which of the following nursing actions is MOST appropriate?
  10. Allow the client to sleep undisturbed.
  11. Administer oxygen via facemask or nasal prongs.
  12. Administer naloxone (Narcan).
  13. Place epinephrine 1:1,000 at the bedside. - ANSWER What type of infectious diseases are required to be reported to the health department? - ANSWER- severe cases of Staphylococcus aureus infections including methicillin- resistant Staphylococcus aureus (MRSA) What is the process of taking a telephone order from a provider? - ANSWERPatient name, drug, dose, route, frequency read back for accuracy A nurse is caring for a client who has tuberculosis. Which of the following actions should the nurse take? SATA a) Place the client in a negative pressure room b) wear gloves when assisting the client with oral care c) limit each visitor to 2 hr increments d) wear a surgical mask when providing care e) Use antimicrobial sanitizer for hand hygiene - ANSWERA B E A charge nurse is discussing the responsibility of nurses carig for clients who have C. difficile. Which of the following information should the nurse include in the teaching? a) Assign the client to a room with a negative air-flow system b) Use alcohol-based hand sanitizer when leaving the clients room

A nurse is caring for a client who needs a 24-hr urine collection initiated. Which of the following client statements indicates an understanding of the procedure? a) "I had a bowel movement, but I was able to save the urine" b) "I have a specimen in the bathroom from about 30 minutes ago" c) "I flushed what I urinated at 7 am and have saved the rest since" d) "I drink a lot, so I will fill up the bottle and complete the test quickly" - ANSWERC A nurse is caring for a client who has an NG tube that is to be irrigated every 8 hr. Which of the following should be used to irrigate the tube in order to maintain fluid and electrolyte balance? a) tap water b) sterile water c) 0.9% sodium chloride d) 0.45% sodium chloride - ANSWERC A nurse is reinforcing teaching regarding the use of a cane to a client who has left-leg weakness. Which of the following should the nurse include in the teaching? a) use the cane on the weak side of the body b) advance the cane and the atrong leg simultaneously c) maintain two points of support on the floor d) advance the cane 30 to 45 cm (12-18 in) with each step - ANSWERC Which of the following should indicate to a nurse the need to suction a client's tracheostomy? a) irritability b) hypotension c) flushing d) bradycardia - ANSWERA A nurse is caring for a client who has a prescription for wound irrigation. Which of the following actions should the nurse take? a) wear sterile gloves when removing the old dressing b) warm the irrigation solution to 40.5C (105F) c) cleanse the wound from the center outwards d) use a 20 mL syringe to irrigate the wound - ANSWERC A nurse is providing teaching about a clear liquid diet. Which of the following should the nurse instruct the client to avoid? a) lemon-lime sports drinks b) ginger ale c) black coffee d) orange sherbet - ANSWERD A nurse is caring for a client who is having difficulty voiding following the removal in an indwelling urinary catheter. Which of the following interventions should the nurse take?

a) assess for bladder distention after 6 hr b) encourage the client to use a bed pan in the supine position c) restrict the clients intake of oral fluids d) pour warm water over the clients perineum - ANSWERD When caring for the client diagnosed with delirium, which condition is the most important for the nurse to investigate?

  1. Cancer of any kind.
  2. Impaired hearing.
  3. Prescription drug intoxication.
  4. Heart failure. - ANSWER Which of the following is essential when caring for a client who is experiencing delirium?
  5. Controlling behavioral symptoms with low-dose psychotropics.
  6. Identifying the underlying causative condition or illness. 3. Manipulating the environment to increase orientation.
  7. Decreasing or discontinuing all previously prescribed medications. - ANSWER Which of the following is a realistic short-term goal to be accomplished in 2 to 3 days for a client with delirium?
  8. Explain the experience of having delirium.
  9. Resume a normal sleep-wake cycle.
  10. Regain orientation to time and place.
  11. Establish normal bowel and bladder function. - ANSWER A client diagnosed with dementia wanders the halls of the locked nursing unit during the day. To ensure the client's safety while walking in the halls, the nurse should do which of the following?
  12. Administer PRN haloperidol (Haldol) to decrease the need to walk.
  13. Assess the client's gait for steadiness.
  14. Restrain the client in a geriatric chair.
  15. Administer PRN lorazepam (Ativan) to provide sedation. - ANSWER During a home visit to an elderly client with mild dementia, the client's daughter reports that she has one major problem with her mother. She says, "She sleeps most of the day and is up most of the night. I can't get a decent night's sleep anymore." Which suggestions should the nurse make to the daughter? Select all that apply.
  16. Ask the client's physician for a strong sleep medicine. 2. Establish a set routine for rising, hygiene, meals, short rest periods, and bedtime.
  17. Engage the client in simple, brief exercises or a short walk when she gets drowsy during the day.
  18. Promote relaxation before bedtime with a warm bath or relaxing music.
  19. Have the daughter encourage the use of caffeinated beverages during the day to keep her mother awake. - ANSWER 3 4 The physician orders risperidone (Risperdal) for a client with Alzheimer's disease. The nurse anticipates administering this medication to help decrease which of the following behaviors?
  20. Sleep disturbances.
  21. Concomitant depression.

with the appropriate instruction. ____ Passive smoking ____ Carbon monoxide poisoning ____ Food poisoning A. Have water heaters inspected on an annual basis. B. Cook all meat at an appropriate temperature. C. Avoid enclosed areas with others who may be smoking. - ANSWERC A B When performing nasotracheal suctioning what technique should be used? - ANSWERSterile asepsis bc the trachea is considered sterile and prevents infections A nurse educator is presenting a module on basic first aid for newly licensed home health nurses. The nurse educator evaluates the teaching as effective when the newly licensed nurse states the client who has heat stroke will have which of the following? A. Hypotension B. Bradycardia C. Clammy skin D. Bradypnea - ANSWERA What do you do when a client has a seizure - ANSWER- lower to bed/floor

  • protect head, move nearby furniture, provide privacy, - - put on side with head flexed slightly forward, and loosen clothing to prevent injury -in event of seizure, stay with client and call for help -admin meds as ordered -note duration of seizure and sequence and type of movement seclusion and restraints - ANSWER-must be ordered -should be ordered for the shortest duration necessary and only if less restrictive measures are not sufficient -a client may voluntarily request temp seclusion -restraints can be physical or chemical -if used, frequency of client assessments in regards to food, fluid, comfort, and safety should be performed and documented every 15-30 min What position is good to use for a patient who is at high risk for a pressure ulcer - ANSWER30 degree lateral position is recommended for clients at risk for pressure ulcers health promotion (injury prevention-suffocation): infant (birth-1 yr) - ANSWER-avoid plastic bags -keep balloons out of reach -ensure crib mattress fits snugly -ensure crib slats are no more than 6 cm (2.4 in) apart -remove crib mobiles and gyms by 4-5 months -do not use pillows in crib -place infant on back for sleep -keep toys with small parts out of reach -remove drawstrings from jackets and other clothing

hypotension is classified with a reading below normal; - ANSWERsystolic < 90 mm Hg; can be a result of fluid depletion, heart failure, or vasodilation What temperature should pork be cooked at - ANSWER160 degrees What is the safest way to thaw out frozen foods - ANSWERIn the refrigerator What are the precautions for vancomycin resistant enterococcus - ANSWERStandard precautions including hand washing and gloving should be followed What does a newborns poop look like - ANSWERIf your baby is exclusively breastfed, her poop will be yellow or slightly green and have a mushy or creamy consistency What is appropriate for an adolescent in the hospital? - ANSWERPuzzles and books What is the proper nutrition during pregnancy - ANSWER- Folic acid is important for pregnancy, as it can help to prevent birth defects known as neural tube defects, including spina bifida

  • green leafy vegetables and brown rice What should be avoided during pregnancy - ANSWERDo not take vitamin A supplements, or any supplements containing vitamin A (retinol), as too much could harm your baby What is the most appropriate method for contraception for an adolescent - ANSWERIUD or implant If a patient has anorexia nervosa and works out constantly - ANSWERAllow them to workout and continue their regimen What medications can be taken to help with smoking cessation - ANSWERBupropion hydrochloride is a medicine for depression, but it also helps people quit smoking. Brand names include Zyban®, Wellbutrin®, Wellbutrin SR® and Wellbutrin XL® but this medication is also available as a generic. Varenicline (chantix) What are the five stages of grief - ANSWERdenial anger bargaining depression acceptance discrete and applies the letting go of an object or person before the loss as in the case of terminal illness individuals have the opportunity to greet before the actual loss - ANSWERanticipatory grief involves difficult progression through the expected stages of the grieving process grief work is prolonged and manifestations more severe client may develop suicidal ideation, intense feelings of guilt and lowered self-esteem somatic complaints persist for an extended period of time - ANSWERdysfunctional grief Signs for meningococcemia - ANSWERVomiting, febrile, petechial rash (unstable) Levothyroxine effects - ANSWERUsed to restore client's metabolic rate
  • Toxic effects = heat intolerance, Tachycardia, Weight loss, Hypertension Multiple Sclerosis Patient - ANSWERMitoxantrone SE's Mitoxantrone IV every 3 months (chemo drug)
  • Report Sore Throat (greatest risk for client is severe infection due to myelosuppression from mitoxantrone)
  • Vomiting = causes dehydration

What comorbidities may be observed with a patient who is bipolar? - ANSWERSubstance use disorder (experiences more rapid cycling), anxiety disorders, eating disorders, ADHD. What therapy will be useful for patients with bipolar? - ANSWERElectroconvulsive therapy for the patient who is suicidal or rapid cycling who HAS taken Lithium and has proven ineffective. Used to subdue manic behavior. What kind of medications are indicated for abstinence maintenance of alcohol? - ANSWERDisulfiram (Antabuse), Naltrexone (Vivitrol), Acamprosate (Campral) Teaching points for naltrexone (Vivitrol)? - ANSWERTake with meals to supress GI distress. Monthly IM injections should be suggested for patients who have difficulty to adhering to the medication regimen. A nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to: a) restrict fluid intake to 1 qt (1,000 ml)/day. b) drink liquids only between meals. c) don't drink liquids 2 hours before meals. d) drink liquids only with meals. - ANSWERB A patient who has undergone colostomy surgery is experiencing constipation. Which of the following interventions should a nurse consider for such a patient? a) Instruct the patient to keep a record of food intake b) Instruct the patient to avoid prune or apple juice c) Suggest fluid intake of at least 2 L per day d) Assist the patient regarding the correct diet or to minimize food intake - ANSWERC A client is admitted with a diagnosis of acute appendicitis. When assessing the abdomen, the nurse would expect to find rebound tenderness at which location? a) Left lower quadrant b) Left upper quadrant c) Right upper quadrant d) Right lower quadrant - ANSWERD Which outcome indicates effective client teaching to prevent constipation? a) The client reports engaging in a regular exercise regimen. b) The client limits water intake to three glasses per day. c) The client verbalizes consumption of low-fiber foods. d) The client maintains a sedentary lifestyle. - ANSWERA Patients diagnosed with esophageal varices are at risk for hemorrhagic shock. Which of the following is a sign of potential hypovolemia? a) Hypotension b) Bradycardia c) Warm moist skin d) Polyuria - ANSWERA The nurse is assessing a client with a bleeding gastric ulcer. When examining the client's stool, which of the following characteristics would the nurse be most likely to find? a) Green color and texture b) Black and tarry appearance c) Clay-like quality

d) Bright red blood in stool - ANSWERB After teaching a group of students about the various organs of the upper gastrointestinal tract and possible disorders, the instructor determines that the teaching was successful when the students identify which of the following structures as possibly being affected? a) Large intestine b) Ileum c) Stomach d) Liver - ANSWERC A nurse is caring for a client with active upper GI bleeding. What is the appropriate diet for this client during the first 24 hours after admission? a) Skim milk b) Nothing by mouth c) Regular diet d) Clear liquids - ANSWERB Bladder retraining for the treatment of urge incontinence: - ANSWER• Use timed voidings to increase intervals between voidings/decrease voiding frequency.

  • Perform pelvic floor (Kegel) exercises.
  • Perform relaxation techniques.
  • Offer undergarments while the client is retraining.
  • Teach the client not to ignore the urge to void.
  • Provide positive reinforcement as client maintains continence.
  • Eliminate or decrease caffeine drinks.
  • Take diuretics in the morning. what are normal creatinine levels? what are normal BUN levels? - ANSWER0.8-1.4 mg/dL 8-25 mg/dL What are total serum protein values (normals) - ANSWER6-8 g/dL Describe pre-albumin - ANSWERthis is the best tool for evaluating nutrition. it has a half-life of 2 days which is much shorter than albumin so it is much more accurate. (albumin's half-life is 2-3 weeks) what is normal pre-albumin values? what are normal serum levels of magnesium? what is a normal potassium serum level? - ANSWER17-40 mg/dL 1.5-2.5 mEq/L (less than 1.5 is considered hypomagnesemia) 3.5-5.0 mEq/L (less than 3.5 is considered hypokalemia) what are good sources of folic acid? - ANSWERExcellent sources of folate include romaine lettuce, spinach, asparagus, turnip greens, mustard greens, calf's liver, parsley, collard greens, broccoli, cauliflower, beets, chicken liver and lentils. Sources of potassium - ANSWERbeans, spinach, potatoes, dried apricots, acorn squash, yogurt, salmon, avocados, mushrooms and bananas what is important about the diet of someone taking ACE inhibitors? - ANSWERcan result in high potassium levels. Limit potassium intake (beans, spinach, potatoes, dried apricots, acorn squash, yogurt, salmon, avocados, mushrooms and bananas) Taking Coumadin. Which foods should the client limit? - ANSWERFoods containing Vitamin K. Dark leafy greens (spinach), brussel sprouts, broccoli, asparagus, cabbage, pickels, prunes