ATI Custom NUR 2711 Test 2
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Free ATI Custom NUR 2711 Test 2 Questions
A nurse is caring for an adolescent client who has a history of depression and suicidal ideation. Which of the following client statements should the nurse identify as requiring further intervention?
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"I have not used drugs in 6 weeks."
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"I have been participating in my local YMCA after-school dance program again."
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"I don't have anyone I can talk to about my problems."
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"I think that I missed two math tutoring classes last week, but I can still catch up."
Explanation
Correct Answer: (C) "I don't have anyone I can talk to about my problems."
Social isolation and lack of a support system are major risk factors for suicide in adolescents with a history of depression and suicidal ideation. This statement indicates the client feels disconnected and without support, which requires immediate further intervention to reduce the risk of self-harm.
Why the other options are incorrect:
A. "I have not used drugs in 6 weeks." This is a positive statement indicating progress and improved coping, not a cause for concern or further intervention.
B. "I have been participating in my local YMCA after-school dance program again." Re-engaging in social activities and hobbies is a positive sign of recovery and improved mental health, not a warning sign.
D. "I think that I missed two math tutoring classes last week, but I can still catch up." While missing classes may warrant monitoring, the client demonstrates a positive and hopeful attitude by acknowledging she can still catch up, which is not an immediate concern.
A nurse is planning care for a 65-year-old female client who is 1 day postoperative following a left total hip arthroplasty.
Diagnostic Results (0900): WBC 11,500/mm³ (5,000 to 10,000/mm³) Hgb 13 g/dL (12 to 16 g/dL) Hct 40% (37% to 47%) Potassium 4.2 mEq/L (3.5 to 5 mEq/L) Sodium 139 mEq/L (136 to 145 mEq/L) Platelet count 250,000/mm³ (150,000 to 400,000/mm³)
Diagnostic Results (1700): WBC 8,500/mm³ (5,000 to 10,000/mm³) Hgb 13 g/dL (12 to 16 g/dL) Hct 40% (37% to 47%) Potassium 4.2 mEq/L (3.5 to 5 mEq/L) Sodium 139 mEq/L (136 to 145 mEq/L) Platelet count 250,000/mm³ (150,000 to 400,000/mm³)
Which of the following findings indicates that the client's condition is improving?
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The client's level of orientation.
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The client's oxygen saturation.
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The client's blood pressure.
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The amount of sleep the client had overnight.
Explanation
Correct Answer: (A) The client's level of orientation.
The WBC count decreased from 11,500/mm³ at 0900, which was above the normal range, to 8,500/mm³ at 1700, which is now within the normal range of 5,000 to 10,000/mm³. This trend indicates that an inflammatory or infectious process that may have been contributing to the client's delirium is resolving. Since delirium is directly linked to underlying physiological disturbances, improvement in the precipitating cause would be reflected in an improving level of orientation. The level of orientation is the most clinically relevant indicator of improvement in a client being managed for acute delirium.
Why Other Options are Incorrect:
B. The client's oxygen saturation. The oxygen saturation was documented at 95% on room air at 0715 and remains stable. While maintaining adequate oxygenation is important, there is no documented change in oxygen saturation between the two time points that would specifically indicate overall clinical improvement in this client's delirium.
C. The client's blood pressure. The blood pressure was recorded at 140/86 mm Hg at 0715 and no subsequent blood pressure readings are provided in the 0900 or 1700 diagnostic results. There is insufficient data to identify blood pressure as a finding that demonstrates improvement in this client's condition.
D. The amount of sleep the client had overnight. While adequate sleep is beneficial and sleep deprivation can worsen delirium, there is no documentation in the provided clinical information regarding the client's sleep patterns. This finding cannot be identified as an indicator of improvement based on the available data.
Additional Nurses' Notes (Day 8, 1000): Upon entering the room, client is sitting in bed finishing breakfast. They ate 75% of the meal but stated that it was difficult to swallow some of the items because their throat felt scratchy and painful. Client states that they slept 7 hr overnight. The client is engaged in conversation and is making eye contact. States that they are hearing voices less often than before being admitted. During assessment, the client's skin is warm to the touch. They report the presence of body aches and chills since waking up. Last BM yesterday.
Nurses' Notes (Day 12, 0800): Client pacing back and forth, mumbling in their room. Client returns to bed and sits down when nurse enters the room, is alert and oriented. Reports that they showered this morning before breakfast. Looks at the floor during conversation. Reports that they are able to eat a regular diet. Last BM on day 7 of admission. Upon auscultation, bowel sounds hypoactive.
Vital Signs (Day 12, 0800): Temperature 37.4° C (99.4° F) Heart rate 95/min Respiratory rate 18/min Blood pressure 90/70 mm Hg Oxygen saturation 97% on room air
Diagnostic Results: Day 8, 0800: WBC 3,500/mm³ (5,000 to 10,000/mm³), Platelet count 280,000/mm³ (150,000 to 400,000/mm³) Day 12, 0800: WBC 5,200/mm³ (5,000 to 10,000/mm³), Platelet count 320,000/mm³ (150,000 to 400,000/mm³)
Stimulus 6 of 6: Which of the following findings indicate the client's treatment plan is effective? (Select all that apply.)
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Temperature 37.4° C (99.4° F)
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Blood pressure 90/70 mm Hg
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Client returns to bed and sits down when nurse enters the room, is alert and oriented
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Reports that they showered this morning before breakfast
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Looks at the floor during conversation
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Reports that they are able to eat a regular diet
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Last BM on day 7 of admission, bowel sounds hypoactive
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WBC 5,200/mm³ (5,000 to 10,000/mm³)
Explanation
Correct Answer Is:
(C) Client returns to bed and sits down when nurse enters the room, is alert and oriented, (D) Reports that they showered this morning before breakfast, (F) Reports that they are able to eat a regular diet, (H) WBC 5,200/mm³ (5,000 to 10,000/mm³) The client's WBC count has risen from a critically low 3,500/mm³ on day 8, indicating resolving neutropenia and reduced risk of clozapine-induced agranulocytosis, an effective response to monitoring and intervention. The client being alert, oriented, and redirectable, along with independently showering and resuming a regular diet, reflects improved self-care, cognition, and appetite compared to the disorganized, paranoid presentation and swallowing difficulty noted earlier in treatment.
Why the other options are incorrect:
A. Temperature 37.4° C (99.4° F) remains slightly elevated and does not clearly indicate resolution of the earlier fever/infection concern. B. Blood pressure 90/70 mm Hg is on the low end and may reflect an adverse effect of clozapine (orthostatic hypotension) rather than treatment effectiveness. E. Looks at the floor during conversation suggests continued poor eye contact, which does not indicate improvement. G. Last BM on day 7 of admission with hypoactive bowel sounds indicates significant constipation, a serious adverse effect of clozapine that requires follow-up rather than a sign of effective treatment.
A community health nurse is creating a presentation about mood disorders for a local support group. The nurse should include which of the following as a risk factor for suicide?
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Exercising caution in behavior
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Financial stability
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Loss of a job
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Engaging in extracurricular activities
Explanation
Job loss represents a significant life stressor and loss of identity, financial security, and daily structure, all of which are recognized risk factors that can increase a person's vulnerability to suicidal ideation.
Why the other options are incorrect:
A. Exercising caution in behavior reflects a protective factor rather than a risk factor for suicide. B. Financial stability is a protective factor that reduces stress and risk, rather than increasing it. D. Engaging in extracurricular activities reflects social connectedness and engagement, which serves as a protective factor against suicide.
Which of the following characteristics would a nurse expect to find in an adolescent who has ADHD?
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Taking multiple attempts in completing verbal sentences
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Expressing difficulties in reading assignments at school
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Manifestations of a schizophrenia spectrum related disorder
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Manifestations of an anxiety related disorder
Explanation
Correct Answer: (A) Taking multiple attempts in completing verbal sentences Adolescents with ADHD often exhibit impulsivity and difficulty organizing their thoughts, which can result in disorganized speech, interrupted or restarted sentences, and multiple attempts to complete a verbal thought clearly.
Why the other options are incorrect:
B. Expressing difficulties in reading assignments at school is more characteristic of a specific learning disorder, such as dyslexia, rather than a core feature of ADHD itself. C. Manifestations of a schizophrenia spectrum related disorder involve symptoms such as hallucinations or delusions, which are not characteristic of ADHD. D. Manifestations of an anxiety related disorder involve excessive worry or fear responses, which are a separate diagnostic category from ADHD.
A nurse in an acute care mental health facility is preparing to administer morning medication for a client who has been taking lithium for 2 weeks and has a current lithium level of 1.0 mEq/L. Which of the following actions should the nurse take?
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Administer the morning dose of lithium.
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Prepare for gastric lavage due to an extremely elevated lithium level.
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Hold the medication and assess for early manifestations of toxicity.
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Check the client's medication record to assess whether the client has been refusing her lithium.
Explanation
The therapeutic range for lithium is 0.6 to 1.2 mEq/L for maintenance therapy. A level of 1.0 mEq/L falls well within this therapeutic range, meaning it is safe and appropriate to administer the morning dose as prescribed. No intervention or dose adjustment is necessary.
Why the other options are incorrect:
B. Prepare for gastric lavage due to an extremely elevated lithium level. A level of 1.0 mEq/L is not extremely elevated. Gastric lavage would only be considered in severe lithium toxicity, which occurs at levels above 2.0 mEq/L.
C. Hold the medication and assess for early manifestations of toxicity. Holding the medication is unnecessary as the level is within the therapeutic range. Toxicity is generally not a concern until levels exceed 1.5 mEq/L.
D. Check the client's medication record to assess whether the client has been refusing her lithium. There is no indication of non-compliance. The lithium level is therapeutic, suggesting the client has been taking her medication as prescribed.
A nurse is teaching the family of a client who has a new diagnosis of borderline personality disorder about the disorder. Which of the following information should be the nurse's priority?
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Information about insurance coverage
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Medication compliance
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Resources for group therapy in the community
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Awareness of potential for self-harm
Explanation
Using the safety priority framework, clients with borderline personality disorder are at significant risk for self-harming behaviors, so educating the family about this risk and the warning signs is the priority to ensure the client's immediate safety.
Why the other options are incorrect:
A. Information about insurance coverage is a practical consideration but does not take priority over safety education. B. Medication compliance is an important aspect of ongoing treatment but is secondary to ensuring the family understands the risk of self-harm. C. Resources for group therapy in the community support long-term treatment but are not the priority compared to immediate safety awareness.
A nurse is providing education about somatic symptom disorder to a client's family. Which of the following pieces of information should the nurse include in the education?
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"There are limited effective treatment options for this disorder."
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"Somatic symptom disorder is characterized by suicidal ideations or thoughts of death."
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"Individuals may intentionally make up the symptoms they are experiencing."
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"Individuals with somatic symptom disorder experience real physical effects, but these manifestations are due to emotional causes rather than physical ones."
Explanation
Correct Answer: (D) "Individuals with somatic symptom disorder experience real physical effects, but these manifestations are due to emotional causes rather than physical ones." Somatic symptom disorder involves genuine physical symptoms that cause real distress and impairment, but these symptoms stem from underlying psychological or emotional factors rather than an identifiable medical cause. This distinction is important for families to understand so they can offer appropriate support.
Why the other options are incorrect:
A. "There are limited effective treatment options for this disorder." This is inaccurate, as therapies such as cognitive behavioral therapy and regular follow-up with a primary provider are effective in managing this disorder.
B. "Somatic symptom disorder is characterized by suicidal ideations or thoughts of death." Suicidal ideation is not a defining characteristic of somatic symptom disorder.
C. "Individuals may intentionally make up the symptoms they are experiencing." This is incorrect and describes factitious disorder or malingering, not somatic symptom disorder, in which the symptoms are not intentionally produced.
A nurse observes a client's spouse sitting alone in the waiting room crying. When approached, the spouse says, "I am really concerned about my husband." Which of the following is a therapeutic nursing response?
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"Crying helps us let things out and we feel better."
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"Your husband is making really good progress."
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"Did your husband say something to upset you?"
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"Tell me what is concerning you."
Explanation
Correct Answer: (D) "Tell me what is concerning you." This response uses therapeutic communication by inviting the spouse to openly express their specific concerns, demonstrating active listening and allowing the nurse to better understand and address the spouse's emotional needs.
Why the other options are incorrect:
A. "Crying helps us let things out and we feel better." offers a generalized statement rather than exploring the spouse's specific concerns. B. "Your husband is making really good progress." dismisses the spouse's expressed worry by redirecting to reassurance rather than addressing their feelings. C. "Did your husband say something to upset you?" makes an assumption about the cause of the spouse's distress rather than allowing them to share their own concerns openly.
A nurse is caring for a client with a mood disorder. Bipolar 1 is characterized by which of the following?
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Mania and depression
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Anxiety and depression
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Split personality
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Mania and anxiety
Explanation
Bipolar 1 disorder is characterized by the presence of at least one full manic episode, which may be preceded or followed by hypomanic or major depressive episodes. The manic episodes in Bipolar 1 are severe enough to cause significant impairment in functioning and may require hospitalization.
Why the other options are incorrect:
B. Anxiety and depression Anxiety and depression together describe a different presentation more consistent with an anxiety disorder or mixed anxiety-depressive disorder, not Bipolar 1.
C. Split personality Split personality refers to dissociative identity disorder, which is an entirely separate and unrelated psychiatric condition to bipolar disorder.
D. Mania and anxiety While anxiety can occur alongside bipolar disorder, it is not the defining characteristic. Bipolar 1 is specifically defined by the presence of mania and depressive episodes, not mania and anxiety.
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