ATI PN 112 Exam 3 Urinary/Male/Female Reproduction 12/25

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Free ATI PN 112 Exam 3 Urinary/Male/Female Reproduction 12/25 Questions

1.

A nurse is reinforcing discharge teaching with a client who had a total abdominal hysterectomy and a vaginal repair. Which of the following statements by the client indicates a need for further teaching?

  • "I should increase my intake of protein and vitamin C."

  • "I will take a tub bath instead of a shower."

  • "Once I am able to resume sexual activity, I can use a water-based lubricant if I experience discomfort."

  • "I will no longer have menstrual periods."

Explanation

Explanation

After a total abdominal hysterectomy and vaginal repair, clients should avoid tub baths, swimming pools, and hot tubs until cleared by the provider to reduce the risk of infection. Showering is recommended because it allows gentle cleaning without submerging the surgical site. The other statements reflect correct understanding: protein and vitamin C support healing, water-based lubricants can reduce discomfort during sexual activity, and the client will no longer have menstrual periods after a total hysterectomy.

2.

A nurse is collecting data from a client who has AIDS. The nurse notes that the client has multiple, widespread purplish-brown skin lesions. The nurse should suspect that the client has developed which of the following types of skin lesions?

  • Actinic keratosis

  • Basal cell carcinoma

  • Actinic dermatitis

  • Kaposi's sarcoma

Explanation

Explanation
Kaposi's sarcoma is a vascular malignancy commonly associated with AIDS and appears as purplish, brown, or red lesions on the skin or mucous membranes. These lesions result from abnormal growth of blood vessels and can occur on the skin, gastrointestinal tract, or respiratory system. Their widespread distribution in an immunocompromised client strongly suggests Kaposi's sarcoma. The other options involve sun damage or localized skin cancers and do not present with this characteristic coloration or association with AIDS.
3.

A nurse is assisting with the admission of several clients.

Plan of Care

Admission Day 1

0900:

Collect data from clients. Observe for physical signs such as shakiness, moist or cool hands, needle track marks, hyperactivity, and poor hygiene. Behavioral signs may include a poor attention span, forgetfulness, irritability, poor job performance, losing a job, poor performance at

school, possession of drugs and drug paraphernalia, and drug seeking behaviors.

Based on data, prioritize hypothesis regarding clients' risks, needs, and manifestations of disease processes.

1200:

Plan care for clients and generate solutions to identified problems. Consider the client's preferences, wishes, and needs along with any spiritual, ethical, or cultural preferences when creating an unbiased plan, which is individualized to the specific client.

Implement the plan of care and take actions to utilize identified nursing interventions to meet client needs.

Day 2:

Evaluate client outcomes and determine if plan of care needs to be altered or modified.


A charge nurse is assisting a newly licensed nurse with the admission of two clients. The charge nurse is discussing the nursing process with the newly licensed nurse. Which of the following information should the nurse include? Select all that apply.

  • Planning should be initiated upon admission

  • Recognizing cues occurs during the evaluation process.

  • Prioritizing hypothesis allows the nurse to determine immediate care needs

  • Nursing interventions require a prescription prior to taking action

  • Determining the client's knowledge regarding relapse prevention is part of data collection.

Explanation

Explanation

A. Planning should be initiated upon admission
Planning begins early in the nursing process, often during or immediately after admission, to ensure that interventions are timely and responsive to the client’s immediate needs. Early planning allows the nurse to address priority problems efficiently.

C. Prioritizing hypothesis allows the nurse to determine immediate care needs
By analyzing data and prioritizing hypotheses, the nurse identifies which problems require urgent attention, ensuring that care focuses on the client’s most critical needs first. This step guides effective and safe interventions.

E. Determining the client's knowledge regarding relapse prevention is part of data collection
Assessing the client’s understanding of relapse prevention is a component of the assessment phase, which involves gathering both subjective and objective information to identify risks, strengths, and educational needs. This information informs individualized care planning.

4.

A nurse is caring for a client who has HIV.

Physical Examination

1000:

Reports flu-like symptoms of headache, body aches, sore throat, low-

grade fever, shortness of breath, productive cough

Swollen lymph nodes

Dry skin with rash

Weight loss of 6.8 kg (15 lb) over past 3 months with report of diarrhea and anorexia, difficulty eating due to oral ulcers

Diagnostic Results

1200:

Chest x-ray:

Areas of increased density and white infiltrates to lower right lobe

indicative of pneumonia

1600:

Hemoglobin: 11 g/dL (12 to 16 g/dL)

Hematocrit: 36% (37% to 47%)

Platelet count: 155,000/mm3 (150,000 to 400,000/mm3)

WBC count: 4,500/mm2 (5,000 to 10,000/mm2

CD4 cell count 400 cells/mm3 (600 to 1500 Cenorstt 7

Sputum culture: pneumocystis jirovecii


The client is at risk for developing —------ and —------------------

  • tuberculosis

  • sepsis

  • malnutrition

  • hemorrhage

Explanation

Explanation

C. Malnutrition
The client demonstrates significant weight loss, anorexia, diarrhea, and difficulty eating due to oral ulcers, all of which contribute to inadequate nutritional intake. Malnutrition is a common complication in clients with HIV, as it weakens the immune system and reduces the body’s ability to fight infections. Nutritional support and monitoring are essential to maintain health and improve outcomes.

A. Tuberculosis
Clients with HIV are immunocompromised, making them more susceptible to opportunistic infections, including tuberculosis. The presence of chronic symptoms such as cough, weight loss, and low-grade fever increases the risk for TB. Early screening, diagnosis, and treatment are crucial to prevent disease progression and transmission.

5.

A nurse is collecting data for a middle-aged client who has pyelonephritis. Which of the following findings should the nurse expect?

  • Weight gain

  • Confusion

  • Flank pain

  • Hypotension

Explanation

Explanation

Flank pain is a common and expected finding in pyelonephritis because the infection involves the kidneys, causing inflammation and irritation of the renal tissue. The pain is typically located in the lower back or flank area and may be accompanied by fever, chills, and urinary symptoms such as dysuria or frequency. Recognizing flank pain helps the nurse identify the site and severity of the infection and guides timely interventions such as administering prescribed antibiotics and monitoring for complications.

6.

A nurse is assessing an older adult client who has a urinary tract infection (UTI). Which of the following findings should the nurse identify as unique for this age group?

  • Urinary retention

  • Incontinence

  • Confusion

  • Low back pain

Explanation

Explanation

In older adults, UTIs often present with atypical symptoms such as acute confusion or delirium rather than the classic signs of dysuria, frequency, or urgency. Cognitive changes occur due to systemic infection affecting the central nervous system, making confusion a key early indicator of UTI in this age group. Recognizing this age-specific manifestation is critical for timely diagnosis and treatment, preventing complications such as sepsis or worsening functional decline. Other symptoms like urinary retention, incontinence, or low back pain can occur in UTIs across age groups.

7.

A nurse is reviewing the laboratory reports for a client who has chronic kidney disease. Which of the following laboratory reports should the nurse expect to find?

  • BUN 35 mg/dL, serum creatinine 8 mg/dL

  • BUN 11 mg/dL, serum creatinine 10 mg/dL

  • BUN 10 mg/dL, serum creatinine 0.3 mg/dL

  • BUN 45 mg/dL, serum creatinine 1.0 mg/dL

Explanation

Explanation

In chronic kidney disease, the kidneys’ ability to filter waste is impaired, leading to elevated blood urea nitrogen (BUN) and serum creatinine levels. A BUN of 35 mg/dL and creatinine of 8 mg/dL reflect significant accumulation of nitrogenous waste products, which is typical in advanced kidney disease. Monitoring these values is essential for assessing the progression of CKD, guiding fluid and electrolyte management, and determining the need for interventions such as dialysis.

8.

A nurse is reinforcing breast self-examination (BSE) teaching with a client who is menopausal. Which of the following statements by the client indicate an understanding of the teaching? (Select all that apply.)

  • "I can stand in the shower to perform the examination."

  • "I will make sure to feel for changes in my underarm area."

  • "It is important to press my breasts firmly to detect any lumps."

  • "I will use my fingertips to check my breasts."

  • "Since I no longer have periods, I can do the exam at any time of the month."

Explanation

Explanation

A. "I can stand in the shower to perform the examination."
Performing BSE in the shower is practical and effective because the wet, soapy skin allows the fingers to glide smoothly over breast tissue. This makes it easier to detect subtle changes, such as small lumps, thickening, or unusual texture, without missing areas due to friction or dryness.

B. "I will make sure to feel for changes in my underarm area."
Breast tissue extends into the axillary (underarm) region, so checking this area is crucial. Lumps, swelling, or tenderness can appear in the axilla, and early detection of changes in this region can be key for identifying abnormalities such as lymph node enlargement or extension of breast tissue changes.

D. "I will use my fingertips to check my breasts."
Using the pads of the three middle fingertips rather than the entire hand enhances tactile sensitivity. The fingertips allow the client to apply varying pressure to assess superficial, intermediate, and deeper tissue layers, helping identify lumps or irregularities that might otherwise go unnoticed.

E. "Since I no longer have periods, I can do the exam at any time of the month."
For menopausal clients, there is no need to coordinate BSE with the menstrual cycle, unlike premenopausal women whose breasts may be more tender or dense at certain times. Performing BSE consistently at any convenient day of the month ensures regular monitoring and improves early detection of changes.

9.

A nurse is providing medication teaching about sildenafil to a client who has erectile dysfunction. Which of the following statements is the nurse's highest priority?

  • "This medication does not prevent sexually transmitted infections."

  • "Take the medication before you plan to engage in sexual intercourse."

  • "This medication can cause a headache."

  • "If you have an erection for more than four hours, seek emergency treatment."

Explanation

Explanation

The highest priority teaching point for sildenafil is the risk of priapism, a prolonged and painful erection lasting more than four hours, which is a medical emergency. Untreated priapism can cause permanent tissue damage and erectile dysfunction. While other information—such as timing of the medication, potential side effects, and STI prevention—is important, preventing serious complications that could lead to permanent harm takes precedence in client education.

10.

A nurse is reinforcing discharge teaching with a client about how to care for a newly created ileal conduit. Which of the following instructions should the nurse include in the teaching?

  • Trim the opening of the ostomy seal to be 1/2 in. wider than the stoma

  • Apply lotion to the peristomal skin when changing the ostomy pouch

  • Empty the ostomy pouch when it is 2/3 full

  • Change the ostomy pouch daily

Explanation

Explanation

Clients with an ileal conduit should empty the ostomy pouch when it is about two-thirds full to prevent leakage, reduce pressure on the seal, and maintain skin integrity. Overfilling can cause the pouch to detach or urine to leak onto the peristomal skin, increasing the risk of irritation and infection. Proper emptying ensures hygiene, comfort, and effective appliance management, supporting the client’s independence in ostomy care.

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