ATI- RN Concept-Based Assessment Level 2 & 3
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Free ATI- RN Concept-Based Assessment Level 2 & 3 Questions
A nurse in an emergency department is assessing a client following an acute ischemic stroke. Which of the following actions should the nurse take first?
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Check the strength of the client’s affected side.
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Observe the client’s ability to communicate.
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Determine if the client is incontinent of urine.
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Evaluate the client’s swallowing capability.
Explanation
The Correct Answer is:
D. Evaluate the client’s swallowing capability.
Detailed Explanation:
After an acute ischemic stroke, the priority nursing action is to assess the client’s ability to swallow before offering food, fluids, or oral medications. Stroke can cause dysphagia due to impaired cranial nerve function, increasing the risk of aspiration, airway obstruction, and pneumonia.
Once swallowing safety is established, the nurse can proceed with a focused neurological assessment, including motor strength, speech, sensation, and reflexes. Observing communication abilities and assessing for incontinence are also important but occur after ensuring airway protection and preventing aspiration.
This prioritization follows the ABCs of care (Airway, Breathing, Circulation)—airway safety through swallow evaluation always comes first in acute stroke management.
A nurse is admitting a client who has acute pyelonephritis. Which of the following assessment findings should the nurse expect? (Select all that apply.)
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Tachypnea
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Hypothermia
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Bradycardia
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Flank pain
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Nausea
Explanation
The Correct Answers are:
A. Tachypnea, D. Flank pain, and E. Nausea.
Detailed Explanation:
A. Tachypnea
Clients with acute pyelonephritis often experience tachypnea due to fever and pain. The infection and associated inflammation can cause increased metabolic demand and shallow, rapid breathing.
D. Flank pain
Flank pain is a hallmark sign of pyelonephritis, resulting from inflammation and stretching of the renal capsule. The pain is typically located in the back or sides and may radiate toward the abdomen or groin.
E. Nausea
Nausea and vomiting are common due to systemic infection and inflammation affecting the gastrointestinal tract.
A charge nurse is teaching a group of newly licensed nurses about postpartum complications. Which of the following conditions should the nurse include as a risk factor for the development of postpartum hemorrhage?
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Oligohydramnios
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Fetal intrauterine growth restriction
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Prolonged labor
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Primigravida
Explanation
The Correct Answer is:
C. Prolonged labor.
Detailed Explanation:
Prolonged labor is a significant risk factor for postpartum hemorrhage (PPH) because the uterus becomes fatigued from extended contractions, which can impair its ability to contract effectively after delivery. Ineffective uterine contraction, or uterine atony, is the leading cause of PPH. A uterus that fails to contract properly cannot compress the open blood vessels at the placental site, resulting in excessive bleeding. Oligohydramnios and fetal growth restriction are not associated with hemorrhage risk, and primigravida (first pregnancy) does not inherently increase PPH risk.
A nurse in an in-patient psychiatric facility is conducting an admission assessment for a client who has major depressive disorder. Which of the following findings should the nurse identify as a risk factor for attempting suicide?
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Female gender
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Mid-socioeconomic status
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Aged 37 years old
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Religious affiliation
Explanation
The Correct Answer is:
A. Female gender.
Detailed Explanation:
While men are more likely to die by suicide, women are more likely to attempt suicide, making female gender a recognized risk factor for suicide attempts. Women often use less lethal methods and are more likely to have underlying mood disorders, such as major depressive disorder, which increases risk. Mid-socioeconomic status and religious affiliation are generally protective factors, as social and faith-based support can reduce suicidal behavior. Age 37 is not considered a high-risk range; the highest suicide rates are typically found among adolescents and older adults.
A nurse is teaching about organ donation to a client who has a terminal illness. Which of the following client statements indicates an understanding of the teaching?
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"I will be kept on life support until my organs are retrieved."
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"I am required to be a registered donor before my death."
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"I must list the organs I want to donate before my death."
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"I need to consult an attorney about donating my organs."
Explanation
The Correct Answer is:
C. "I must list the organs I want to donate before my death."
Detailed Explanation:
When discussing organ donation, clients should understand that they can specify which organs or tissues they wish to donate before death, either on a donor card, driver’s license, or through an advance directive. This ensures their wishes are honored. Clients are not legally required to be registered donors beforehand; family consent can still authorize donation. An attorney’s involvement is unnecessary, as the process is voluntary and guided by consent laws. Life support is only maintained if needed to preserve organ viability until retrieval, not automatically. Thus, stating that they must list which organs to donate reflects accurate understanding of the process.
A nurse is caring for a client who has benign prostatic hypertrophy and a new prescription for tamsulosin. The nurse should instruct the client to notify the provider of which of the following findings as an adverse effect of tamsulosin?
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Decreased heart rate
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Oliguria
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Orthostatic hypotension
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Muscle tenderness
Explanation
The Correct Answer is:
C. Orthostatic hypotension.
Detailed Explanation:
Tamsulosin is an alpha-adrenergic blocker used to relax smooth muscles in the bladder neck and prostate to improve urine flow in clients with benign prostatic hypertrophy. One of its primary adverse effects is orthostatic hypotension, which can cause dizziness or fainting when changing positions. The client should be instructed to change positions slowly and report significant dizziness, lightheadedness, or falls to the healthcare provider promptly.
A nurse is teaching a client who is newly diagnosed with acute glomerulonephritis. Which of the following statements should the nurse make?
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"Weigh yourself once per week."
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"Increase your fluid intake to 3 liters per day."
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"Expect your urine to be a cloudy, reddish-brown color."
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"Retaining sodium will cause your blood pressure to decrease."
Explanation
Correct Answer:
C. "Expect your urine to be a cloudy, reddish-brown color."
Explanation of Correct Answer
Cloudy, reddish-brown urine is a classic manifestation of acute glomerulonephritis due to the presence of red blood cells and protein in the urine from glomerular inflammation. This discoloration is often described as "tea-colored" or "cola-colored" and reflects damage to the filtration barrier within the kidneys, allowing blood to leak into the urine.
A home health nurse is assessing a client who is 2 weeks postpartum. The nurse should identify that which of the following client reports is an indication of postpartum depression and should be investigated further?
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Intermittent abdominal pain
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Feelings of intense guilt
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Hot flashes
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Blurred vision
Explanation
Correct Answer:
B. Feelings of intense guilt
Explanation of Correct Answer
Feelings of intense guilt are a hallmark indication of postpartum depression and warrant further assessment. Postpartum depression is more severe and persistent than typical “baby blues” and can include guilt, hopelessness, difficulty bonding with the infant, loss of interest in usual activities, and thoughts of self-harm or harm to the baby. Early identification and intervention are critical for both maternal and infant well-being.
A nurse is collecting an admission history from a client who has a history of peptic ulcer disease. The client requests pain medication for a sprained ankle. Which of the following medications should the nurse expect the provider to prescribe for this client short-term?
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Ibuprofen
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Ketorolac
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Tramadol
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Aspirin
Explanation
The Correct Answer is:
C. Tramadol.
Detailed Explanation:
Clients with a history of peptic ulcer disease should avoid nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, ketorolac, and aspirin, as these medications can irritate the gastric mucosa and increase the risk of bleeding. Tramadol is a centrally acting analgesic that does not inhibit prostaglandin synthesis, making it safer for short-term pain relief in these clients. It provides effective pain management without worsening ulcer symptoms.
A nurse is assessing a school-age child who has sickle cell anemia and is experiencing a vaso-occlusive crisis. Which of the following findings should the nurse expect?
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Hemoglobin 14.5 g/dL
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Increased urination
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Hepatomegaly
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Periorbital edema
Explanation
The Correct Answer is:
C. Hepatomegaly.
Detailed Explanation:
During a vaso-occlusive crisis, the sickled red blood cells obstruct blood flow to tissues and organs, leading to ischemia, severe pain, and organ enlargement. The liver (hepatomegaly) and spleen (splenomegaly) often become enlarged due to vascular congestion and red blood cell sequestration. This can result in tenderness in the upper abdomen and impaired liver function if the crisis is prolonged.
The child may also experience pallor, jaundice, and pain in joints or bones. The hemoglobin level is typically low (6–9 g/dL) due to chronic hemolysis, not elevated. Increased urination is not expected; rather, dehydration can worsen the crisis. Periorbital edema is not a common finding—it is more associated with renal or cardiac conditions, not sickle cell vaso-occlusion.
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