ATI_NUR 275 Competencies for Contemporary Nursing Practice
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Free ATI_NUR 275 Competencies for Contemporary Nursing Practice Questions
1.
A home health nurse is performing a home assessment to determine a client's safety needs.
History
Medical history:
- Osteoarthritis
- Hypertension
- Macular degeneration
Social history:
- Client retired 8 years ago; partner died 4 years ago. Currently lives alone. Adult children live out of state. Client reports having several "good friends, but they're getting old like me."
Plan:
Home appraisal to identify safety issues.
Plan of Care
Two days ago:
- Client seen in provider's office following fall at home. Received prescription for home safety appraisal.
Today:
- Home appraisal conducted. Safety and nutrition education provided. Will return in 1 week for follow up visit.
Nurses' Notes
Today, home visit:
General client information:
- Reports blurred vision, requires magnifying glass to read, states, "but it's still hard to see all of the words."
- Uses cane to assist with balance during ambulation in and outside of home. Goes barefoot inside the house.
Kitchen: tile floor, small round table with 2 chairs, sink with multiple dirty dishes
- No fruits or vegetables found in pantry or refrigerator; processed frozen meals in freezer. Pantry with few cans of food; white bread, chips and crackers present. Minimal food found in refrigerator.
Client reports following meal plan:
- Breakfast: oatmeal and coffee.
- Lunch: peanut butter sandwich with chips and coffee.
- Dinner: prepared frozen meal and tea. Might have ice cream for an evening snack.
Living area:
- Carpet throughout the home except in the kitchen and bath. Couch and lounge chair with blankets and pillows. Many magazines next to the chair on the floor. Many decorative items on side tables and shelves. Room is filled with furniture, narrow walking pathway.
Bedroom: many pillows noted on the bed, no bedside lamps, multiple prescription and over-the-counter medication bottles on nightstand.
Bathroom: throw rug next to the bathtub, grab bar in bath-tub and next to the toilet. Low toilet. Hygiene products present in medicine cabinet.
The nurse returns in 1 week for a follow up appointment. For each client statement, indicate if the client understood the teaching or needs further teaching.
Client Statement
- "I switched to eating apples and oranges for a nighttime snack."
- "I added a nonslip throw rug at my kitchen sink."
- "Instead of being barefoot, I wear socks."
- "I purchased a large magnifying glass."
- "I moved my medicine bottles into the living room."
- "I placed a lamp on my bedside table."
- "I prepared a large batch of beans, so I have a fast meal every night."
- "I'm adding bananas to my oatmeal every morning."
Which client statements indicate the client understood the teaching? Select all that apply.
- A. "I switched to eating apples and oranges for a nighttime snack."
- B. "I purchased a large magnifying glass."
- C. "I placed a lamp on my bedside table."
- D. "I prepared a large batch of beans, so I have a fast meal every night."
- E. "I'm adding bananas to my oatmeal every morning."
Explanation
A. "I switched to eating apples and oranges for a nighttime snack."
This indicates understanding because the client replaced unhealthy snacks (ice cream/chips) with fruit. Fruit provides vitamins, fiber, and antioxidants, supporting nutritional health in older adults and improving blood sugar stability and digestion.
B. "I purchased a large magnifying glass."
Macular degeneration affects central vision. A magnifier helps enhance visual cues, improving reading ability and safety with medication labels and environment navigation. This supports independent functioning and decreases accident risk.
C. "I placed a lamp on my bedside table."
Adequate lighting reduces fall risk during nighttime movement and helps the client locate medications safely. Visual impairment combined with low light significantly increases fall risk in older adults, so this change demonstrates safety awareness.
D. "I prepared a large batch of beans, so I have a fast meal every night."
This supports healthier meal habits and reduces reliance on processed frozen meals. Beans are nutrient-dense, high-fiber, and heart-healthy. Batch cooking encourages consistent meal intake and reduces fatigue and fall risk associated with frequent cooking.
E. "I'm adding bananas to my oatmeal every morning."
Adding fruit provides potassium, fiber, and nutrients that support cardiovascular health and digestion. This shows the client is enriching breakfast with nutrient-dense food choices — a positive behavior change for older adult nutrition.
This indicates understanding because the client replaced unhealthy snacks (ice cream/chips) with fruit. Fruit provides vitamins, fiber, and antioxidants, supporting nutritional health in older adults and improving blood sugar stability and digestion.
B. "I purchased a large magnifying glass."
Macular degeneration affects central vision. A magnifier helps enhance visual cues, improving reading ability and safety with medication labels and environment navigation. This supports independent functioning and decreases accident risk.
C. "I placed a lamp on my bedside table."
Adequate lighting reduces fall risk during nighttime movement and helps the client locate medications safely. Visual impairment combined with low light significantly increases fall risk in older adults, so this change demonstrates safety awareness.
D. "I prepared a large batch of beans, so I have a fast meal every night."
This supports healthier meal habits and reduces reliance on processed frozen meals. Beans are nutrient-dense, high-fiber, and heart-healthy. Batch cooking encourages consistent meal intake and reduces fatigue and fall risk associated with frequent cooking.
E. "I'm adding bananas to my oatmeal every morning."
Adding fruit provides potassium, fiber, and nutrients that support cardiovascular health and digestion. This shows the client is enriching breakfast with nutrient-dense food choices — a positive behavior change for older adult nutrition.
2.
A nurse is caring for a client who is at 32 weeks of gestation.
Medical History
0800:
- Client admitted to antepartum clinic for management of preeclampsia. Client has been on bedrest for 2 weeks and Labetalol PO 100 mg twice daily.
- Gravida 3 Para 2
- 32 weeks of gestation with preeclampsia
- History of preeclampsia during the last pregnancy
Vital Signs
0800:
- Temperature 36.8° C (98.2° F)
- Blood pressure 168/108 mmHg
- Heart rate 87/min
- Respiratory rate 18/min
- O2 saturation 97%
0830:
- Blood pressure 172/104 mm Hg
- Heart rate 89/min
- Respiratory rate 16/min
- O2 saturation 98%
0900:
- Blood pressure 176/102 mm Hg
- Heart rate 86 beats/min
- Respiratory rate 18/min
- O2 saturation 96%
Nurses' Notes
0800:
- Client awake, alert and oriented x 4. Client reports headache that started 2 days ago. Client reports pain as 6 on a scale of 0 to 10.
0830:
- Deep tendon reflexes (DTRs) 3+ with a negative clonus (Pitting pedal edema +2 in lower extremities
- Client reports blurred vision
Diagnostic Results
- Hemoglobin 10 g/dL (> 11g/dL)
- Hematocrit 34% (>33%)
- Platelets 120,000 mm3 (150,000 to 400,000 mm3)
- Creatinine 1.8 mg/dL (0.5 to 1.0 mg/dL)
- BUN 28 mg/dL (10 to 20 mg/dL)
- Uric acid 9 mg/dL (2.7 to 7.3 mg/dL)
- Proteinuria 3+
Which of the following provider prescriptions should the nurse anticipate implementing?
- A. Collect a urine specimen for culture and sensitivity, administer magnesium sulfate 4 g IV bolus, tell the client to lie in a supine position, and monitor blood pressure and respiratory status every 15 minutes.
- B. Collect a urine specimen for culture and sensitivity and place the client in a supine position; magnesium sulfate and frequent vital signs are not necessary at this time.
- C. Administer magnesium sulfate 4 g IV bolus and monitor blood pressure and respiratory status every 15 minutes; collect a urine culture if symptoms of infection develop and avoid placing the client supine.
- D. Tell the client to remain supine and monitor blood pressure every 4 hours; urine culture and magnesium sulfate therapy are unnecessary at this stage.
Explanation
C. Administer magnesium sulfate 4 g IV bolus and monitor blood pressure and respiratory status every 15 minutes; collect a urine culture if symptoms of infection develop and avoid placing the client supine.
This client is showing signs of severe preeclampsia: severe hypertension, headache, blurred vision, hyperreflexia, thrombocytopenia, elevated creatinine, elevated uric acid, and significant proteinuria. The priority intervention is to initiate magnesium sulfate to prevent seizures and monitor vital signs and respiratory status closely (every 15 min). The client should not be placed supine due to the risk of supine hypotensive syndrome. A urine culture is not routinely indicated unless infection is suspected.
This client is showing signs of severe preeclampsia: severe hypertension, headache, blurred vision, hyperreflexia, thrombocytopenia, elevated creatinine, elevated uric acid, and significant proteinuria. The priority intervention is to initiate magnesium sulfate to prevent seizures and monitor vital signs and respiratory status closely (every 15 min). The client should not be placed supine due to the risk of supine hypotensive syndrome. A urine culture is not routinely indicated unless infection is suspected.
3. A nurse is teaching a class on torts. The nurse should include which of the following situations as an example of negligence?
A client who is alert and oriented makes an informed decision to leave the hospital against medical advice. The nurse applies restraints to the client to prevent him from leaving.
A nurse identifies the absence of peripheral pulsation in a casted extremity in the early morning and reports it to the provider in the early afternoon.
A nurse finds a client who is on a low-sodium diet eating salted potato chips. The nurse tells the client that she will apply wrist restraints if he does not stop eating the potato chips.
A client who is competent refuses an antidepressant medication. The nurse dissolves the medication in food and administers it to her without her knowledge.
A client who is alert and oriented makes an informed decision to leave the hospital against medical advice. The nurse applies restraints to the client to prevent him from leaving.
A nurse identifies the absence of peripheral pulsation in a casted extremity in the early morning and reports it to the provider in the early afternoon.
A nurse finds a client who is on a low-sodium diet eating salted potato chips. The nurse tells the client that she will apply wrist restraints if he does not stop eating the potato chips.
A client who is competent refuses an antidepressant medication. The nurse dissolves the medication in food and administers it to her without her knowledge.
- A client who is alert and oriented makes an informed decision to leave the hospital against medical advice. The nurse applies restraints to the client to prevent him from leaving.
- A nurse identifies the absence of peripheral pulsation in a casted extremity in the early morning and reports it to the provider in the early afternoon.
- A nurse finds a client who is on a low-sodium diet eating salted potato chips. The nurse tells the client that she will apply wrist restraints if he does not stop eating the potato chips.
- A client who is competent refuses an antidepressant medication. The nurse dissolves the medication in food and administers it to her without her knowledge.
Explanation
A nurse identifies the absence of peripheral pulsation in a casted extremity in the early morning and reports it to the provider in the early afternoon.
Negligence occurs when a nurse fails to take appropriate action, resulting in harm or risk of harm to the client. Failing to promptly report the absence of peripheral pulses in a casted limb is negligent because it delays treatment for a possible compartment syndrome, a medical emergency requiring immediate action to prevent permanent nerve or tissue damage. Delayed reporting can result in serious complications, including loss of limb function. The other options describe assault, false imprisonment, and battery, not negligence.
Negligence occurs when a nurse fails to take appropriate action, resulting in harm or risk of harm to the client. Failing to promptly report the absence of peripheral pulses in a casted limb is negligent because it delays treatment for a possible compartment syndrome, a medical emergency requiring immediate action to prevent permanent nerve or tissue damage. Delayed reporting can result in serious complications, including loss of limb function. The other options describe assault, false imprisonment, and battery, not negligence.
4.
A nurse is caring for a client who is 36 hr postpartum.
Nurses Notes
1130:
- Breasts soft, warm, and tender to touch. Client denies nipple or breast discomfort. Fundus boggy, located 1 cm above umbilicus, and deviated to the right. Fundus firm with massage. Client reports abdominal cramping and rates pain as 4 on a scale of 0 to 10. Perineal pad with moderate amount of lochia rubra. Assisted client to bathroom. Voided 250 mL yellow urine. Fundus midline, 1 cm above umbilicus. Fundus firm with massage. Client given prescribed analgesic
1230:
- Client continues to report cramping and rates pain as 4 on a scale of 0 to 10. Fundus boggy, midline above the umbilicus. Fundus firms with fundal massage. Perineal pad saturated with lochia rubra and small clots expressed. Provider notified.
Vital Signs
1130:
- Temperature 37.2° C (99° F)
- Heart rate 68/min
- Respiratory rate 18/min
- Blood pressure 130/78 mm Hg
1230:
- Temperature 37.4° C (99.4° F)
- Heart rate 92/min
- Respiratory rate 20/min
- Blood pressure 110/76 mm Hg
Medical History
- Gravida 2, Para 2
- Spontaneous vaginal delivery without any complications
- Group B streptococcus negative
After reviewing the information in the client's medical record, which of the following complications pose a greater risk for the client?
Complete the following sentence by using the list of options.
The complication that poses the greatest risk for the client is (hemorrhage/ mastitis/ endometritis) as evidenced by their (amount of lochia/ breast findings/ temperature)
- A. Hemorrhage; amount of lochia
- B. Mastitis; breast findings
- C. Endometritis; temperature
- D. Hemorrhage; breast findings
Explanation
A. Hemorrhage; amount of lochia
The client has a boggy uterus repeatedly, saturated pads, clots, and requires repeated fundal massage to stay firm, indicating uterine atony, the major cause of postpartum hemorrhage. Lochia rubra saturation and clots show excessive bleeding, making hemorrhage the priority risk.
The client has a boggy uterus repeatedly, saturated pads, clots, and requires repeated fundal massage to stay firm, indicating uterine atony, the major cause of postpartum hemorrhage. Lochia rubra saturation and clots show excessive bleeding, making hemorrhage the priority risk.
5. A charge nurse is providing an in-service to a group of nurses about benefits of an interprofessional team. Which of the following information should the nurse include?
- A. Increase in length of stay for client
- B. Decrease the number of visits to client by staff
- C. Efficiency in client-care services
- D. Decrease number of referrals needed for client
Explanation
C. Efficiency in client-care services
Interprofessional collaboration brings together multiple disciplines to coordinate care, decrease fragmentation, and streamline services. This teamwork enhances efficiency, reduces duplicate interventions, improves communication, and ensures that client needs are met more comprehensively and quickly. Efficient care supports better outcomes, faster recovery, and improved satisfaction.
Interprofessional collaboration brings together multiple disciplines to coordinate care, decrease fragmentation, and streamline services. This teamwork enhances efficiency, reduces duplicate interventions, improves communication, and ensures that client needs are met more comprehensively and quickly. Efficient care supports better outcomes, faster recovery, and improved satisfaction.
6. A nurse is caring for an older adult client who has a terminal illness and is ventilator-dependent. The client is alert and oriented and he wants to discontinue use of the ventilator. The nurse should be aware that continued treatment against the client's wishes is a violation of which of the following ethical principles?
- A. Veracity
- B. Justice
- C. Autonomy
- D. Fidelity
Explanation
C. Autonomy
Autonomy is the ethical principle that supports a client's right to make decisions about their own care, including the refusal or withdrawal of treatment, even if it results in death. Because this client is alert, oriented, and capable of informed decision-making, forcing continued ventilation violates their personal right to control their own medical choices and bodily integrity.
Autonomy is the ethical principle that supports a client's right to make decisions about their own care, including the refusal or withdrawal of treatment, even if it results in death. Because this client is alert, oriented, and capable of informed decision-making, forcing continued ventilation violates their personal right to control their own medical choices and bodily integrity.
7. A nurse is caring for a client who was involved in heavy combat and observed war casualties. The nurse should suspect that the client is suffering from posttraumatic stress disorder (PTSD) if the client makes which of the following statements?
- A. "My child was born with a birth defect due to an exposure I had overseas."
- B. "In my dreams, all I can see are the wounded reaching out and trying to grab me."
- C. "I check any room I enter because the enemy is still after me and could be hiding anywhere."
- D. "I killed four enemy soldiers with my bare hands and saved my entire battalion."
Explanation
B. "In my dreams, all I can see are the wounded reaching out and trying to grab me."
Recurrent nightmares or intrusive recollections of traumatic events are hallmark symptoms of PTSD. This statement reflects re-experiencing the trauma through distressing dreams related to combat exposure. Clients may wake up fearful, anxious, or sweating, and these nightmares interfere with sleep and functioning. Recognizing this pattern helps the nurse provide trauma-informed care and prompt appropriate psychological support and treatment.
Recurrent nightmares or intrusive recollections of traumatic events are hallmark symptoms of PTSD. This statement reflects re-experiencing the trauma through distressing dreams related to combat exposure. Clients may wake up fearful, anxious, or sweating, and these nightmares interfere with sleep and functioning. Recognizing this pattern helps the nurse provide trauma-informed care and prompt appropriate psychological support and treatment.
8. While performing an admission assessment for a client, the nurse notes that the client has varicose veins with ulcerations and lower extremity edema with a report of a feeling of heaviness. Which of the following nursing diagnoses should the nurse identify as being the priority in the client's care?
- A. Alteration in activity tolerance
- B. Impaired tissue perfusion
- C. Alteration in body image
- D. Impaired skin integrity
Explanation
B. Impaired tissue perfusion
This client has venous insufficiency signs: varicose veins, edema, heaviness, and ulcerations. These findings indicate compromised circulation, causing poor oxygen/nutrient delivery to tissues. Addressing perfusion first is essential because adequate blood flow is required for wound healing, prevention of infection, and maintenance of tissue viability. In nursing priority frameworks (ABCs & circulation), circulation comes first, making impaired tissue perfusion the priority diagnosis.
This client has venous insufficiency signs: varicose veins, edema, heaviness, and ulcerations. These findings indicate compromised circulation, causing poor oxygen/nutrient delivery to tissues. Addressing perfusion first is essential because adequate blood flow is required for wound healing, prevention of infection, and maintenance of tissue viability. In nursing priority frameworks (ABCs & circulation), circulation comes first, making impaired tissue perfusion the priority diagnosis.
9.
A home health nurse is performing a home assessment to determine a client's safety needs.
History
Medical history:
- Osteoarthritis
- Hypertension
- Macular degeneration
Social history:
- Client retired 8 years ago; partner died 4 years ago. Currently lives alone. Adult children live out of state. Client reports having several "good friends, but they're getting old like me."
Plan:
Home appraisal to identify safety issues.
Plan of Care
Two days ago:
- Client seen in provider's office following fall at home. Received prescription for home safety appraisal.
Today:
- Home appraisal conducted. Safety and nutrition education provided. Will return in 1 week for follow up visit.
Nurses' Notes
Today, home visit:
General client information:
- Reports blurred vision, requires magnifying glass to read, states, "but it's still hard to see all of the words."
- Uses cane to assist with balance during ambulation in and outside of home. Goes barefoot inside the house.
Kitchen: tile floor, small round table with 2 chairs, sink with multiple dirty dishes
- No fruits or vegetables found in pantry or refrigerator; processed frozen meals in freezer. Pantry with few cans of food; white bread, chips and crackers present. Minimal food found in refrigerator.
Client reports following meal plan:
- Breakfast: oatmeal and coffee.
- Lunch: peanut butter sandwich with chips and coffee.
- Dinner: prepared frozen meal and tea. Might have ice cream for an evening snack.
Living area:
- Carpet throughout the home except in the kitchen and bath. Couch and lounge chair with blankets and pillows. Many magazines next to the chair on the floor. Many decorative items on side tables and shelves. Room is filled with furniture, narrow walking pathway.
Bedroom: many pillows noted on the bed, no bedside lamps, multiple prescription and over-the-counter medication bottles on nightstand.
Bathroom: throw rug next to the bathtub, grab bar in bath-tub and next to the toilet. Low toilet. Hygiene products present in medicine cabinet.
Client Statement
- "I switched to eating apples and oranges for a nighttime snack."
- "I added a nonslip throw rug at my kitchen sink."
- "Instead of being barefoot, I wear socks."
- "I purchased a large magnifying glass."
- "I moved my medicine bottles into the living room."
- "I placed a lamp on my bedside table."
- "I prepared a large batch of beans, so I have a fast meal every night."
- "I'm adding bananas to my oatmeal every morning."
Which client statements indicate the client needs further teaching? Select all that apply.
- A. "I added a nonslip throw rug at my kitchen sink."
- B. "Instead of being barefoot, I wear socks."
- C. "I moved my medicine bottles into the living room."
Explanation
A. "I added a nonslip throw rug at my kitchen sink."
Even “nonslip” rugs increase fall risk, especially on tile. Older adults with vision impairment and mobility issues should avoid all loose floor coverings in fall-prone areas like kitchens and bathrooms.
B. "Instead of being barefoot, I wear socks."
Wearing socks indoors increases slipping risk. Older adults should wear secure footwear with non-skid soles. Lack of proper footwear increases falls, especially when using a cane or walking on mixed flooring surfaces.
C. "I moved my medicine bottles into the living room."
Medication should be stored in a consistent, organized, well-lit location to prevent medication errors. Random relocation increases confusion and risk of missed or duplicated doses. A pill organizer near a safe, well-lit surface would be appropriate.
Even “nonslip” rugs increase fall risk, especially on tile. Older adults with vision impairment and mobility issues should avoid all loose floor coverings in fall-prone areas like kitchens and bathrooms.
B. "Instead of being barefoot, I wear socks."
Wearing socks indoors increases slipping risk. Older adults should wear secure footwear with non-skid soles. Lack of proper footwear increases falls, especially when using a cane or walking on mixed flooring surfaces.
C. "I moved my medicine bottles into the living room."
Medication should be stored in a consistent, organized, well-lit location to prevent medication errors. Random relocation increases confusion and risk of missed or duplicated doses. A pill organizer near a safe, well-lit surface would be appropriate.
10. A nurse on an inpatient mental health unit attends a training session about nurse burnout. The nurse should identify that burnout is most common in nurses who have which of the following traits?
- A. Compassion fatigue
- B. Connects well with others
- C. High energy
- D. Consistent self-care
Explanation
A. Compassion fatigue
Burnout is most common in nurses who experience compassion fatigue, which occurs when continuous emotional demands and exposure to suffering lead to emotional exhaustion, reduced empathy, and decreased ability to provide compassionate care. Mental health nursing involves intense emotional involvement, making nurses prone to burnout when coping resources and support are insufficient.
Burnout is most common in nurses who experience compassion fatigue, which occurs when continuous emotional demands and exposure to suffering lead to emotional exhaustion, reduced empathy, and decreased ability to provide compassionate care. Mental health nursing involves intense emotional involvement, making nurses prone to burnout when coping resources and support are insufficient.
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