ATI- RN Concept-Based Assessment Level 2 & 3
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Free ATI- RN Concept-Based Assessment Level 2 & 3 Questions
A nurse is teaching a client who has chronic pancreatitis about self-managing his disease at home. Which of the following client statements indicates an understanding of the teaching?
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"I should eat at least 60 grams of fat per day."
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"I should consume several small meals each day."
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"I should consume up to 2,000 calories per day."
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"I should use spices to season my food."
Explanation
The Correct Answer is:
B. "I should consume several small meals each day."
Detailed Explanation:
Clients with chronic pancreatitis should eat small, frequent, low-fat meals throughout the day to reduce pancreatic stimulation and prevent abdominal pain and malabsorption. Large or high-fat meals can trigger enzyme secretion and exacerbate inflammation. The diet should emphasize complex carbohydrates, lean protein, and low-fat foods, while avoiding spicy, greasy, or fried foods. Caloric intake is individualized, often higher than 2,000 calories if malnutrition is present, but fat intake must remain restricted. Therefore, small, frequent meals are essential for managing symptoms and maintaining nutritional balance.
A nurse is providing preconception counseling about folic acid for a client who is trying to conceive. Which of the following client responses indicates an understanding of the teaching?
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"Folic acid will decrease the risk of neural tube defects."
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"Folic acid will increase my milk production."
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"Folic acid will increase my baby's healthy bone growth."
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"Folic acid will reduce my baby's risk of developing heart disease."
Explanation
The Correct Answer is:
A. "Folic acid will decrease the risk of neural tube defects."
Detailed Explanation:
Folic acid (vitamin B9) is essential during the preconception period and early pregnancy because it supports DNA synthesis and cell division, which are critical for fetal development. Adequate intake—at least 400 to 800 mcg daily—reduces the risk of neural tube defects (NTDs) such as spina bifida and anencephaly, which form during the first month of gestation. Folic acid does not affect milk production, bone growth, or cardiac disease prevention in infants. Women are encouraged to start supplementation before conception since neural tube formation occurs before many realize they are pregnant.
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 facilitating a support group for clients who have anorexia nervosa. Which of the following client statements should the nurse investigate further?
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"The amount of food I eat could affect my menstrual cycle."
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"I took a laxative for constipation yesterday."
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"I realize my body will never be perfect."
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"I am gaining about 2 pounds per week."
Explanation
The Correct Answer is:
B. "I took a laxative for constipation yesterday."
Detailed Explanation:
The nurse should investigate further the statement about laxative use, as this indicates continued maladaptive behavior commonly associated with purging in eating disorders. Laxative misuse can lead to electrolyte imbalances, dehydration, and cardiac dysrhythmias, posing significant health risks. The other statements demonstrate progress in recovery: recognizing the connection between nutrition and menstrual function shows insight, accepting imperfection reflects improving body image, and a 2-pound weekly weight gain is within the safe therapeutic goal for recovery. Therefore, laxative use requires immediate follow-up to ensure the client’s safety and address relapse behaviors.
A nurse is completing an admission assessment for a client who has obsessive-compulsive disorder and is becoming increasingly anxious. Which of the following actions should the nurse take first?
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Administer an anti-anxiety medication to the client.
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Provide reassurance of safety to the client.
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Complete the client's assessment.
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Teach the client about manifestations of anxiety
Explanation
The Correct Answer is:
B. Provide reassurance of safety to the client.
Detailed Explanation:
When a client with obsessive-compulsive disorder (OCD) becomes increasingly anxious, the nurse’s first priority is to ensure the client’s sense of safety. Anxiety can quickly escalate into panic, and reassurance helps the client regain emotional stability. Once the client feels safe, further interventions—such as administering medication, completing the assessment, or providing education—can follow. Administering medication without addressing immediate emotional needs is premature, and teaching should occur only after the client’s anxiety is reduced enough to focus and retain information.
A nurse is providing discharge teaching to a client who has methicillin-resistant Staphylococcus aureus (MRSA) in a leg wound. Which of the following instructions should the nurse include in the teaching about this antibiotic-resistant infection?
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Take a tub bath every other day using a mild soap.
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Place the soiled dressing in a sealed plastic bag before placing it in the trash can.
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Wash the wound area before washing the surrounding skin.
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Wash bathroom surfaces daily with isopropyl alcohol.
Explanation
The Correct Answer is:
B. Place the soiled dressing in a sealed plastic bag before placing it in the trash can.
Detailed Explanation:
Proper disposal of contaminated dressings is essential to prevent the spread of MRSA. The client should seal soiled dressings in a plastic bag before discarding them in the household trash. Showering, not tub bathing, is recommended to prevent contamination of bathwater. The wound should be cleaned after washing surrounding skin to avoid spreading bacteria. Bathroom surfaces should be disinfected with a bleach solution, as isopropyl alcohol is less effective against MRSA.
A nurse is providing discharge teaching to a client who had a laparoscopic cholecystectomy for cholecystitis. Which of the following information should the nurse include in the teaching?
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"Apply heat to the right shoulder for pain."
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"Cleanse the incision sites with hydrogen peroxide."
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"You should remain on a clear liquid diet for 1 week after surgery."
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"Avoid showering for 1 week after surgery."
Explanation
The Correct Answer is:
A. "Apply heat to the right shoulder for pain."
Detailed Explanation:
After a laparoscopic cholecystectomy, clients often experience referred pain in the right shoulder caused by residual carbon dioxide gas used to inflate the abdomen during surgery. Applying heat and engaging in early ambulation help relieve this discomfort. The incision sites should be kept clean and dry, washed gently with mild soap and water, not hydrogen peroxide. Clients may shower within 1–2 days postoperatively and typically resume a normal diet as tolerated, avoiding fatty foods temporarily.
A nurse is providing discharge teaching for a client who has breast cancer and is postoperative following a single mastectomy with reconstruction. Which of the following statements should the nurse include in the teaching?
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"You will no longer need to perform breast self-examination each month."
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"Keep the arm on your affected side elevated on pillows when you are resting."
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"The pressure dressing on your chest will be removed during the first postoperative visit."
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"You should maintain the activity restrictions for the next 2 weeks."
Explanation
The Correct Answer is:
B. "Keep the arm on your affected side elevated on pillows when you are resting."
Detailed Explanation:
After a mastectomy with reconstruction, it is essential for the client to elevate the affected arm on pillows while resting to promote lymphatic drainage, reduce edema, and prevent lymphedema. Gentle arm exercises are also encouraged to maintain mobility and circulation once cleared by the provider.
Clients must continue monthly breast self-examinations on the remaining breast and the surgical site to detect any new lumps or changes. The pressure dressing is usually removed within 24 to 48 hours, not delayed until the first postoperative visit. Activity restrictions often last 4 to 6 weeks, not just 2, depending on the provider’s instructions and healing progress.
A nurse is planning care for a school-age child who has sickle cell anemia and is experiencing vaso-occlusive crisis. Which of the following actions should the nurse plan to take?
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Provide a low-potassium diet.
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Apply cold compresses to joints.
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Implement a fluid restriction.
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Maintain bed rest.
Explanation
The Correct Answer is:
D. Maintain bed rest.
Detailed Explanation:
During a vaso-occlusive crisis, sickled red blood cells block blood flow, causing severe pain and tissue ischemia. The nurse should maintain bed rest to reduce oxygen demand and prevent further sickling. Adequate hydration and pain management are essential to promote circulation and decrease viscosity. Cold compresses cause vasoconstriction and worsen pain, while fluid restriction can exacerbate dehydration and sickling. A low-potassium diet is unnecessary unless the child has renal impairment.
A nurse is assessing an older adult client who has depressive disorder. Which of the following findings should the nurse expect?
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Reports persistent headaches
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Reports increase in sexual desire
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Pressured speech
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Concrete thinking
Explanation
The Correct Answer is:
A. Reports persistent headaches.
Detailed Explanation:
In older adults, depression often presents with somatic (physical) symptoms rather than overt emotional complaints. The client may report persistent headaches, fatigue, gastrointestinal discomfort, or generalized pain, which can mask the underlying mood disorder. These physical symptoms are common manifestations of psychological distress in the geriatric population and should prompt screening for depression.
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