ATI- RN Concept-Based Assessment Level 2 & 3 with NGN
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Free ATI- RN Concept-Based Assessment Level 2 & 3 with NGN Questions
A nurse in a long-term care facility is admitting a client who has multiple sclerosis. Which of the following findings is the priority for the nurse to address?
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Decreased problem-solving ability.
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Increased nystagmus.
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Increased confusion.
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Decreased hearing acuity.
Explanation
The Correct Answer is:
C. Increased confusion.
Detailed Explanation:
For a client with multiple sclerosis, increased confusion is the priority finding because it can indicate hypoxia, infection, or an adverse medication effect, all of which require immediate intervention to prevent deterioration. While other findings like nystagmus, decreased problem-solving ability, and hearing loss are common or expected in MS due to demyelination, acute confusion suggests a potentially reversible or life-threatening complication. The nurse should promptly assess vital signs, oxygenation, and infection indicators to determine the underlying cause and intervene accordingly.
A nurse is creating a plan of care for a newly admitted adolescent client who has sickle cell anemia and is experiencing a vasoocclusive crisis. Which of the following interventions should the nurse include?
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Administer aspirin every 4 hr.
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Administer allopurinol once daily.
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Decrease the client's oral fluid intake.
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Apply a warm compress to the client's affected joints
Explanation
The Correct Answer is:
D. Apply a warm compress to the client's affected joints.
Detailed Explanation:
During a vasoocclusive crisis, sickled red blood cells obstruct blood flow, causing severe pain and tissue ischemia. Applying warm compresses helps promote vasodilation, improve circulation, and relieve discomfort in affected joints. Cold therapy is avoided because it causes vasoconstriction, worsening the crisis. Adequate hydration (not restriction) is critical to reduce blood viscosity and prevent further sickling. Aspirin increases bleeding risk and is not recommended; allopurinol is used for gout, not sickle cell disease. Thus, warm compresses are the appropriate supportive intervention.
A newly licensed nurse is experiencing bullying from another staff nurse. Which of the following actions should the newly licensed nurse take?
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File a transfer request to be assigned to a different unit.
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Discuss the matter with the facility's quality improvement team.
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Introduce a no-tolerance policy for incivility at the next unit meeting.
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Calmly address the coworker's behavior as soon as it occurs.
Explanation
The Correct Answer is:
D. Calmly address the coworker’s behavior as soon as it occurs.
Detailed Explanation:
The most appropriate and professional response to bullying is to address the behavior directly and immediately in a calm, assertive manner. This approach demonstrates self-advocacy, professionalism, and adherence to the American Nurses Association (ANA) Code of Ethics, which emphasizes maintaining respect and civility in the workplace. By confronting the coworker privately and respectfully, the nurse sets clear boundaries and discourages future incidents.
If the bullying persists after addressing it, the nurse should escalate the issue to a supervisor or human resources for formal resolution. Avoiding or transferring from the situation does not resolve the underlying problem, and implementing policies is a managerial responsibility. Early, confident communication helps foster a healthy work environment and supports a culture of mutual respect.
A nurse is providing teaching about varenicline to a client who is in a smoking cessation program. Which of the following statements should the nurse make?
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"Take this medication for the full course of 30 days and do not repeat the course."
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"This medication can cause drowsiness."
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"Do not eat grapefruit while taking this medication."
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"Plan to start taking this medication 1 week before you stop smoking."
Explanation
The Correct Answer is:
D. "Plan to start taking this medication 1 week before you stop smoking."
Detailed Explanation:
Varenicline (Chantix) is a partial nicotine receptor agonist that helps reduce nicotine cravings and withdrawal symptoms by partially stimulating nicotine receptors in the brain while blocking nicotine’s pleasurable effects. The client should begin taking varenicline 1 week before their planned quit date so that steady-state medication levels are achieved by the time they stop smoking.
The typical course lasts 12 weeks and may be extended if additional support is needed. Clients should be instructed to take the medication after eating and with a full glass of water to minimize nausea, a common side effect. Other possible effects include insomnia, vivid dreams, mood changes, and suicidal ideation—so ongoing assessment for behavioral changes is essential.
Grapefruit restrictions and short 30-day courses do not apply to varenicline therapy, and while mild sleep disturbance can occur, drowsiness is not a typical effect.
A nurse in an emergency department is assessing a client who has gastroenteritis with dehydration and reports vomiting for the last 3 days. Which of the following manifestations should the nurse expect?
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Hypertension
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Tachycardia
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Peripheral edema
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Polyuria
Explanation
The Correct Answer is:
B. Tachycardia.
Detailed Explanation:
Dehydration caused by prolonged vomiting leads to a decrease in circulating blood volume, triggering a compensatory response by the body. The heart rate increases (tachycardia) in an attempt to maintain adequate cardiac output and tissue perfusion. Additional signs of dehydration can include hypotension, dry mucous membranes, poor skin turgor, and decreased urine output. Monitoring vital signs and fluid status is essential to prevent hypovolemic shock and restore fluid balance.
A nurse is providing teaching to the parents of a child who has cerebral palsy and a new prescription for baclofen. The nurse should instruct the parents to monitor the child for which of the following adverse effects of the medication?
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Hirsutism
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Tachycardia
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Constipation
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Rhinorrhea
Explanation
Correct Answer:
C. Constipation
Explanation of Correct Answer
Constipation is a common adverse effect of baclofen, a centrally acting skeletal muscle relaxant used to reduce muscle spasticity in clients with cerebral palsy. Baclofen acts on the central nervous system, which can slow intestinal motility, leading to constipation. Parents should be advised to encourage a high-fiber diet, adequate fluid intake, and physical activity as tolerated to minimize this effect.
Additionally, baclofen can cause other CNS effects such as drowsiness, weakness, and fatigue, but constipation is one of the key side effects that requires consistent monitoring in pediatric clients.
A home health nurse is teaching a parent about diet recommendations for a toddler who has Down syndrome and failure to thrive. Which of the following statements should indicate to the nurse that the parent understands the teaching?
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"I should continue to feed my child when he pushes food out with his tongue."
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"I will offer my child apple juice instead of milk."
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"I will provide his favorite food as a reward for good behavior."
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"I should increase my child's vitamin A intake by feeding him raw carrot slices."
Explanation
The Correct Answer is:
A. "I should continue to feed my child when he pushes food out with his tongue."
Detailed Explanation:
Children with Down syndrome often have tongue thrust, a reflex that causes them to push food out of their mouths. This does not mean they are refusing food. The parent should gently continue feeding to help the child learn to coordinate tongue and swallowing movements. Persistent, calm feeding promotes adequate nutrition and supports developmental progress. Other options may pose choking hazards or fail to meet the toddler’s nutritional needs.
A nurse is teaching the parents of a school-age child who has sickle cell anemia with splenomegaly about management of the disorder. Which of the following statements should the nurse make?
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"Flushing of the skin is an indication that a sickling crisis is imminent."
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"Your child should stay home from school for 2 weeks."
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"Notify your child's provider if your child experiences chest pain."
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"Your child should not receive live-virus vaccines."
Explanation
The Correct Answer is:
C. "Notify your child's provider if your child experiences chest pain."
Detailed Explanation:
Chest pain in a child with sickle cell anemia may indicate acute chest syndrome, a life-threatening complication caused by sickled cells blocking pulmonary vessels, leading to hypoxia and respiratory distress. This requires immediate medical attention.
Flushing of the skin is not associated with a sickling crisis—pallor, jaundice, or pain are more typical signs. Children with sickle cell anemia should attend school as tolerated and maintain normal routines. They should receive all recommended vaccines, including live-virus vaccines, since they are more prone to infections, especially due to splenic dysfunction from splenomegaly or splenic infarction. Thus, prompt reporting of chest pain is essential for early intervention and prevention of severe complications.
A nurse is teaching a group of clients who have anorexia nervosa about cognitive-behavioral therapy. Which of the following client statements indicates an understanding of the teaching?
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"I will consider the negative effects of my eating disorder."
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"I will get to attend a unit activity if I eat all of my meal."
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"I will imagine a peaceful scene when I feel anxious about food."
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"I will identify distorted thoughts about my body image."
Explanation
Correct Answer:
D. "I will identify distorted thoughts about my body image."
Explanation of Correct Answer
Cognitive-behavioral therapy (CBT) focuses on helping clients recognize and correct distorted thinking patterns that contribute to maladaptive behaviors. In anorexia nervosa, this includes challenging negative self-perceptions about weight, body shape, and eating habits. By identifying and reframing irrational beliefs, the client learns to replace them with healthier, more realistic thoughts that support recovery and self-acceptance.
A nurse in an emergency department is assessing a client who has experienced a right hemispheric stroke. Which of the following findings should the nurse expect?
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Aphasia
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Depression
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Slow, cautious behavior
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Loss of depth perception
Explanation
The Correct Answer is:
D. Loss of depth perception.
Detailed Explanation:
A right hemispheric stroke affects the brain’s spatial-perceptual and visual awareness centers, leading to loss of depth perception, impulsivity, poor judgment, and left-sided hemiplegia or neglect. Clients often exhibit overconfidence and lack of awareness of their deficits, increasing their risk for injury. In contrast, aphasia, depression, and slow, cautious behavior are more characteristic of left hemispheric strokes, which primarily affect language and analytical functions. Therefore, loss of depth perception is the expected finding in a client with a right hemispheric stroke.
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