ATI CUSTOM: AH2- FA25- Exam 3
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Free ATI CUSTOM: AH2- FA25- Exam 3 Questions
A nurse is caring for a client with a spinal cord tumor. Which of the following are cues that may indicate spinal cord compression syndrome? (Select All that Apply.)
- A. Bladder or bowel dysfunction
- B. Muscle spasms and tremors
- C. Progressive weakness or numbness in the limbs
- D. Severe back pain
- E. Visual disturbances
- F. Fever and chills
Explanation
Explanation of Correct Answers
A. Bladder or bowel dysfunction
Loss of bladder or bowel control is a classic sign of spinal cord compression. It results from disruption of nerve signals controlling sphincter function. This finding is often one of the earliest red flags of neurological involvement requiring urgent intervention to prevent permanent paralysis.
C. Progressive weakness or numbness in the limbs
Compression of the spinal cord interferes with motor and sensory pathways, causing gradual weakness, numbness, or loss of coordination. These symptoms often start in the lower extremities and progress upward, depending on the level of compression. Early recognition is vital for timely decompression therapy.
D. Severe back pain
Persistent or worsening back pain, often described as deep, aching, or radiating, is the most common presenting symptom of spinal cord compression. The pain may worsen when lying down, coughing, or sneezing due to increased pressure on the spinal nerves.
The nurse is providing care for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and is critically ill. Which of the following lab findings requires immediate intervention?
- A. Serum potassium 5.0 mEq/L
- B. Blood urea nitrogen (BUN) 24 mg/dL
- C. Serum calcium 8.0 mg/dL
- D. Serum sodium 125 mEq/L
Explanation
A serum sodium level of 125 mEq/L indicates significant hyponatremia, a hallmark of SIADH. This condition results from excessive antidiuretic hormone secretion, causing water retention and dilutional hyponatremia. Severe hyponatremia can lead to cerebral edema, seizures, confusion, and potentially coma. Immediate interventions include fluid restriction, hypertonic saline administration (in severe cases), and close neurological monitoring to prevent further complications and stabilize serum sodium safely.
A nurse is caring for a client who recently started treatment for Stage I Hodgkin’s lymphoma and describes the following to the nurse: “My arms and hands feel so tight and heavy. I can’t put my ring on and I’m having trouble doing everyday things around the house because my fingers won’t move normally.” The nurse should understand that the client is experiencing which of the following complications associated with cancer and cancer treatments?
- A. Peripheral neuropathy
- B. Lymphedema
- C. Fatigue
- D. Mucositis
Explanation
Lymphedema is a common complication of lymph node removal or radiation therapy, often seen in clients treated for Hodgkin’s lymphoma, breast cancer, or other cancers involving lymphatic structures. It results from impaired lymphatic drainage, leading to accumulation of lymph fluid in the interstitial tissues. This causes swelling, tightness, heaviness, and decreased mobility in the affected limb. Management includes elevating the arm, performing range-of-motion exercises, using compression garments, and avoiding blood draws or BP measurements on the affected side.
A nurse is caring for a client with ascites caused by liver failure. Which of the following should the nurse report for immediate follow-up?
- A. Jaundice
- B. Dyspnea
- C. Increased abdominal girth
- D. Irregular menses
Explanation
Dyspnea (difficulty breathing) in a client with ascites requires immediate follow-up because it may indicate respiratory compromise caused by excessive abdominal fluid pressing upward on the diaphragm. This increased intra-abdominal pressure restricts lung expansion, leading to decreased oxygenation and potential respiratory distress. The nurse should promptly assess oxygen saturation, position the client in high Fowler’s position, and notify the healthcare provider. Paracentesis or diuretic therapy may be required to relieve pressure and improve breathing.
A nurse is reviewing the laboratory data of a client who has acute pancreatitis. The nurse should expect to find an elevation of which of the following values?
- A. Magnesium
- B. Calcium
- C. Amylase
- D. RBC count
Explanation
In acute pancreatitis, pancreatic enzymes such as amylase and lipase leak into the bloodstream due to inflammation and autodigestion of the pancreas. Elevated serum amylase is one of the hallmark diagnostic findings, typically rising within hours of symptom onset and remaining elevated for several days. High amylase levels reflect pancreatic injury and help confirm the diagnosis alongside elevated lipase, which is more specific to the pancreas.
A nurse is reviewing laboratory findings for four clients. Which of the following clients has manifestations of acute kidney injury?
- A. Hemoglobin 16 g/dL
- B. Serum creatinine 6 mg/dL
- C. Serum potassium 4.5 mEq/L
- D. BUN 15 mg/dL
Explanation
A serum creatinine level of 6 mg/dL is markedly elevated and indicates acute kidney injury (AKI). Creatinine is a waste product filtered by the kidneys, and when renal function declines, creatinine accumulates in the blood. This rise reflects impaired glomerular filtration and decreased excretion capability. Clients with AKI often exhibit oliguria, fluid retention, and electrolyte imbalances such as hyperkalemia. Prompt treatment focuses on identifying and reversing the underlying cause while preventing further renal damage.
A nurse cares for a client receiving chemotherapy. Which of the following are appropriate actions when handling bodily fluids from a client receiving chemotherapy? (Select All that Apply.)
- A. Respiratory protection should be worn if there is risk for inhalation exposure when cleaning bodily fluid spills
- B. Soiled linens should be kept separated and not combined with other client’s linens
- C. Pour fluids down the sink with running water
- D. Wear gloves and other appropriate personal protective equipment (PPE) when handling the fluids
- E. Flush the fluids down the toilet
- F. Dispose of the fluids in regular trash bins
Explanation
Explanation of Correct Answers
A. Respiratory protection should be worn if there is risk for inhalation exposure when cleaning bodily fluid spills
Chemotherapy drugs and their metabolites can become aerosolized during spill cleanup. Using respiratory protection, such as a mask or respirator, prevents inhalation exposure to these hazardous substances. This is part of safe handling precautions to minimize occupational risk.
B. Soiled linens should be kept separated and not combined with other client’s linens
Linens contaminated with chemotherapy agents or body fluids should be isolated in clearly labeled, leak-proof bags. This prevents cross-contamination and protects laundry staff and other patients from accidental exposure.
D. Wear gloves and other appropriate personal protective equipment (PPE) when handling the fluids
Gloves, gowns, and face shields should always be used when handling chemotherapy or contaminated body fluids. Chemotherapy can be excreted through urine, feces, vomit, and sweat for up to 48 hours after administration, requiring strict PPE use for safe handling.
E. Flush the fluids down the toilet
Bodily fluids from clients receiving chemotherapy may be safely flushed down the toilet if proper precautions are followed. The nurse should ensure the lid is closed before flushing to prevent splashing or aerosolization, and double flushing is recommended to ensure complete disposal.
A nurse is caring for a client who has end-stage liver disease and a recent diagnosis of thrombocytopenia. Which of the following statements provides the best recommendation to prevent complications of bleeding?
- A. Use a floss pick instead of the floss string to floss in between the teeth.
- B. Apply an ice pack over a bleeding wound.
- C. Only use a soft-bristle toothbrush.
- D. Wear sleeveless or short-sleeved shirts and shorts to better visualize any skin issues.
Explanation
Clients with thrombocytopenia have a significantly increased risk for bleeding because of low platelet counts, which impair clot formation. Using a soft-bristle toothbrush helps maintain oral hygiene while minimizing the risk of gum trauma and bleeding. The nurse should also instruct the client to avoid flossing, using toothpicks, or performing aggressive oral care, as even minor abrasions can lead to prolonged bleeding in thrombocytopenic patients.
A nurse is providing care for several clients who have type 1 diabetes mellitus. Which of the following clients is most at risk for developing diabetic ketoacidosis (DKA)?
- A. A client who is awaiting cataract surgery
- B. A client who is being evaluated for a breast lump
- C. A client who is receiving IV antibiotics for a urinary tract infection
- D. A client with a history of Grave’s disease
Explanation
Infection is the most common precipitating factor for diabetic ketoacidosis (DKA) in clients with type 1 diabetes. During infection, the body releases stress hormones such as cortisol and catecholamines, which increase glucose production and reduce insulin effectiveness. This leads to hyperglycemia, fat breakdown, and ketone production, resulting in metabolic acidosis. A client with a urinary tract infection who is receiving IV antibiotics is therefore at the highest risk for developing DKA, especially if insulin doses are missed or poorly absorbed due to illness.
A nurse is teaching a client who has chronic kidney failure about planning a low-protein diet. The client states, "Why do I have to be concerned about protein?" Which of the following responses should the nurse make?
- A. "A low-protein diet reduces the risk for edema."
- B. "A low-protein diet will increase the nitrogenous wastes in the blood."
- C. "A low-protein diet reduces the risk for uremia."
- D. "A low-protein diet will reduce the risk for hyperkalemia."
Explanation
In chronic kidney failure, the kidneys lose their ability to effectively excrete urea and other nitrogenous wastes produced from protein metabolism. Consuming excessive protein increases the production of these waste products, which accumulate in the bloodstream and lead to uremia—manifested by nausea, vomiting, fatigue, and confusion. A low-protein diet helps decrease urea production, reducing symptoms and slowing progression of kidney damage, while maintaining adequate nutrition through high-biological-value proteins such as eggs and milk.
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