ATI PN 112 Final Exam 12/25
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Free ATI PN 112 Final Exam 12/25 Questions
A nurse is caring for a client who has borderline personality disorder (BPD).
Medication Administration Record
Naltrexone 50mg PO once daily
Fluoxetine 20mg PO every morning
Diagnostic Results
Hepatitis Viral Study (HAA) positive (expected reference range: negative)
Sodium 131 mEq/L (expected reference range 136 to 145 mEq/L
Calcium 9.5 mg/dL (expected reference range 9 to 10.5 mg/dL)
BUN 11 mg/dL (expected reference range 10 to 20 mg/dL)
FBS 82 mg/dL (expected reference range 74 to 106 mg/dL)
Hct 44% (expected reference range 37% to 52%)
Hgb 14 g/dL (expected reference range 12 to 18 g/dL)
Medical History
Client has been hospitalized three times within the past 12 months. Client shows marked emotional lability and difficulty controlling impulses. Client admits to having multiple sexual partners and denies use of condoms. History of total abdominal hysterectomy 10 years ago. Client also acknowledges spending a lot of money lately and is not sure how to pay for current bills. Client admits to using self-mutilating behaviors (cutting) in the past to soothe them when feeling anxious - no evidence of recent self-mutilation. Client has recently suffered the loss of their remaining living parent and has increased the use of alcohol and recreational intravenous drugs to numb the pain.
Nurses' Notes
Skin warm and dry. Sclera bloodshot. Client is unsteady on their feet, restless and tense. Admits to drinking "a lot of whiskey" within last 24 hrs. Presence of alcohol noted on breath. Asking for "my nerve" pill. Evidence of old healed scratches/cuts noted on arms and legs. Client has several
tattoos on back, arms, and lower abdomen. States, "I don't have any money to pay for this!" When asked about living family members, states, "everyone is dead, life stinks."
The nurse completed a review of the client's electronic health record. Which of the following client findings require immediate follow-up by the nurse? (Select all that apply.)
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Hepatitis Viral Study (HAA) results
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BUN level
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Frequency of hospitalizations
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Financial status
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Increased use of mood-altering substances
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Sexual behaviors
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Sodium level
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Loss of parent
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I. Hgb level
Explanation
Explanation
Explanation of Correct Answers:A. Hepatitis Viral Study (HAA) results
A positive hepatitis viral study requires immediate follow-up because it indicates an active or prior viral hepatitis infection. This is especially concerning given the client’s intravenous drug use, which increases the risk of transmission and liver injury. Prompt follow-up is needed for infection control, further diagnostic evaluation, patient education, and coordination of appropriate medical treatment.
E. Increased use of mood-altering substances
The client’s increased use of alcohol and intravenous drugs requires immediate follow-up due to the high risk of overdose, withdrawal, impaired judgment, and worsening mental health symptoms. Substance use also increases the risk of self-harm, unsafe behaviors, and medical complications. Early intervention is essential to ensure safety and initiate appropriate substance-use treatment and monitoring.
F. Sexual behaviors
The client’s report of multiple sexual partners without condom use requires immediate follow-up because it places the client at high risk for sexually transmitted infections, including HIV and hepatitis. This concern is heightened by the positive hepatitis study and substance use. The nurse must address risk reduction, screening, and education to prevent further health complications.
G. Sodium level
The sodium level of 131 mEq/L indicates hyponatremia, which can lead to neurological symptoms such as confusion, seizures, and altered mental status if it worsens. Given the client’s psychiatric condition, substance use, and current instability, this abnormal value requires prompt assessment and intervention to prevent complications.
H. Loss of parent
The recent loss of the client’s remaining living parent requires immediate follow-up due to its significant emotional impact. In a client with borderline personality disorder, grief can intensify impulsivity, substance use, emotional instability, and suicidal risk. The nurse must assess coping, safety, and the need for emotional and mental health support.
Correct Answer Is:
A. Hepatitis Viral Study (HAA) resultsE. Increased use of mood-altering substances
F. Sexual behaviors
G. Sodium level
H. Loss of parent
A nurse is caring for a client who was admitted with major burns to the head, neck, and chest. Which of the following complications should the nurse identify as the greatest risk to the client?
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Fluid imbalance
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Hypothermia
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Hyponatremia
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Airway obstruction
Explanation
Explanation
Burns involving the head, neck, and chest place the client at the highest risk for airway obstruction due to edema, inhalation injury, and tissue swelling. Airway compromise can develop rapidly and is life-threatening if not recognized and managed immediately. Using ABC priorities, airway protection takes precedence over fluid imbalance, electrolyte disturbances, or hypothermia, which are serious but secondary to maintaining a patent airway.Correct Answer Is:
D. Airway obstructionA nurse is preparing a client for magnetic resonance imaging (MRI). Which of the following statements should the nurse include when reinforcing teaching?
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“You’ll have to remove metal objects such as watches and body jewelry.”
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“Unlike an x-ray, the MRI allows you to move around a bit.”
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“Your exposure to radiation will be minimal.”
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“You will not be able to talk to the technician during the procedure.”
Explanation
Explanation
MRI uses a powerful magnetic field, so all metal objects must be removed to prevent injury and avoid interference with image quality. Clients must remain still during the procedure, and MRI does not use ionizing radiation. Communication with the technician is maintained throughout the scan via an intercom system, making the other statements incorrect.Correct Answer Is:
A. “You’ll have to remove metal objects such as watches and body jewelry.”The nurse is caring for a client who has a bowel obstruction and a new prescription for the insertion of a nasogastric tube. Which of the following interventions should the nurse take when inserting the nasogastric tube?
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Instruct the client to place his chin to his chest and swallow.
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Withdraw the tube if the client gags during insertion.
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Place the client in a supine position.
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Measure the tube for insertion from the tip of the nose to the umbilicus.
Explanation
Explanation
Having the client flex the neck by placing the chin to the chest and swallowing during insertion helps close the airway and opens the esophagus, making passage of the nasogastric tube easier and safer. Swallowing facilitates advancement of the tube into the esophagus and reduces the risk of tracheal placement. Gagging alone is expected, the client should be upright, and tube measurement should be nose–earlobe–xiphoid, not to the umbilicus.Correct Answer Is:
A. Instruct the client to place his chin to his chest and swallow.A nurse is preparing to administer scheduled immunizations to a 5-year-old child. Which of the following vaccines should the nurse plan to administer?
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Haemophilus influenza type b (Hib)
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Hepatitis B (Hep B)
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Varicella (VAR)
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Meningococcal (MCV4)
Explanation
Explanation
The varicella vaccine is routinely administered in two doses, with the first dose given at 12–15 months and the second (booster) dose given at 4–6 years of age. A 5-year-old child is within the recommended age range for the second varicella immunization. Hib and Hepatitis B vaccines are typically completed during infancy, and the meningococcal vaccine (MCV4) is routinely given starting at 11–12 years of age, unless specific risk factors are present.Correct Answer Is:
C. Varicella (VAR)A nurse is caring for a client who has obsessive compulsive disorder (OCD) and is constantly picking up after others and cleaning in the day room. The nurse should recognize the client’s actions as which of the following?
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Manipulating and controlling others’ behavior.
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Focusing attention on useful tasks.
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Decreasing anxiety to a tolerable level.
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Limiting the amount of time available for interaction with others.
Explanation
Explanation
Clients with OCD perform compulsive behaviors, such as excessive cleaning, to relieve the intense anxiety caused by obsessive thoughts. These actions temporarily reduce distress and help the client feel a sense of control. Although the behaviors may appear purposeful or helpful, their primary function is anxiety reduction rather than productivity, manipulation, or avoidance of social interaction.Correct Answer Is:
C. Decreasing anxiety to a tolerable level.The nurse is caring for a client who has a pneumothorax and a water-seal chest tube drainage system to suction. Which of the following actions should the nurse take?
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Empty the collection container every shift.
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Maintain the drainage container below the level of the client’s chest.
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Add tap water as needed to the suction control chamber.
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Clamp the chest tubes if it becomes disconnected.
Explanation
Explanation
The chest tube drainage system must be kept below the level of the client’s chest to promote gravity drainage and prevent backflow of air or fluid into the pleural space. This positioning helps maintain negative pressure within the system, which is essential for lung re-expansion in a client with pneumothorax. The container is not emptied routinely, only sterile water is used in chambers, and chest tubes should not be clamped if disconnected.Correct Answer Is:
B. Maintain the drainage container below the level of the client’s chest.A nurse is preparing to count the controlled substances in the secure cabinet. Which of the following actions should the nurse take?
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Verify that the amounts of each medication she counts match the amounts on the inventory record.
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Set aside any controlled substances the nurse plans to give during her shift.
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Discard any partial doses she finds in the cabinet in the sharps container.
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Co-sign any notations of wasting controlled substances on the previous shift.
Explanation
Explanation
Controlled substances require strict accountability to prevent diversion and medication errors. When counting controlled medications, the nurse must compare the physical count with the inventory record to ensure accuracy. Any discrepancies must be reported immediately according to facility policy. The nurse should never remove medications in advance, discard doses independently, or co-sign wasting that did not occur in their presence.Correct Answer Is:
A. Verify that the amounts of each medication she counts match the amounts on the inventory record.A nurse overhears another nurse being harassed by a staff member. Which of the following actions by the nurse is an appropriate way to handle this situation?
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Avoid interacting with the staff member.
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Ask the charge nurse for a new client assignment.
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Report the incident to a manager.
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Tell the staff member that they may lose their job for harassment.
Explanation
Explanation
Workplace harassment is a serious issue that must be addressed through appropriate organizational channels. Reporting the incident to a manager or supervisor ensures the behavior is documented and investigated according to facility policy, promoting a safe and respectful work environment. Avoiding the staff member or changing assignments does not address the behavior, and threatening job loss is inappropriate and outside the nurse’s role.Correct Answer Is:
C. Report the incident to a manager.A nurse is assisting in the plan of care for a client who has a suspected myocardial infarction. Which of the following medication should the nurse plan to administer first?
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Oxygen
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Aspirin
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Morphine
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Nitroglycerin
Explanation
Explanation
Aspirin is administered first in suspected myocardial infarction because it inhibits platelet aggregation and helps prevent further clot formation in the coronary arteries. Early administration reduces mortality by limiting the progression of the thrombus. Oxygen is given only if the client is hypoxic, morphine is used for pain unrelieved by other measures, and nitroglycerin is administered after aspirin to improve coronary blood flow and relieve chest pain.Correct Answer Is:
B. AspirinHow to Order
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