ATI_NUR 275 Competencies for Contemporary Nursing Practice
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Free ATI_NUR 275 Competencies for Contemporary Nursing Practice Questions
1. A nurse is teaching an older adult client who has diabetes mellitus about preventing the long-term complications of retinopathy and nephropathy. Which of the following instructions should the nurse include?
- "Maintain stable blood glucose levels."
- "Have an eye examination once per year."
- "Wear compression stockings daily."
- "Examine your feet carefully every day."
Explanation
A. "Maintain stable blood glucose levels."
Maintaining stable blood glucose levels is the most important intervention to prevent long-term microvascular complications of diabetes, including retinopathy (damage to retinal blood vessels) and nephropathy (kidney damage). Consistent glycemic control slows progression of vascular injury by preventing glycation of blood vessels and limiting inflammatory damage to delicate capillaries in the eyes and kidneys. Research shows that maintaining an A1C within the recommended range significantly reduces the risk of blindness and chronic kidney disease in diabetic clients.
Maintaining stable blood glucose levels is the most important intervention to prevent long-term microvascular complications of diabetes, including retinopathy (damage to retinal blood vessels) and nephropathy (kidney damage). Consistent glycemic control slows progression of vascular injury by preventing glycation of blood vessels and limiting inflammatory damage to delicate capillaries in the eyes and kidneys. Research shows that maintaining an A1C within the recommended range significantly reduces the risk of blindness and chronic kidney disease in diabetic clients.
2. A nurse is observing the closed chest drainage system of a client who is 24 hr post thoracotomy. The nurse notes slow, steady bubbling in the suction control chamber. Which of the following actions should the nurse take?
- Check the tubing connections for leaks.
- Check the suction control outlet on the wall.
- Continue to monitor the client's respiratory status.
- Clamp the chest tube.
Explanation
C. Continue to monitor the client's respiratory status.
Slow, steady bubbling in the suction control chamber is an expected finding in a chest drainage system when suction is applied. This indicates the system is functioning properly to remove air and fluid from the pleural space. Since the bubbling is occurring where it should be, the priority action is to continue monitoring the client's respiratory status and overall chest tube function, ensuring adequate lung expansion and ventilation.
Slow, steady bubbling in the suction control chamber is an expected finding in a chest drainage system when suction is applied. This indicates the system is functioning properly to remove air and fluid from the pleural space. Since the bubbling is occurring where it should be, the priority action is to continue monitoring the client's respiratory status and overall chest tube function, ensuring adequate lung expansion and ventilation.
3. A nurse is caring for a client who recently had surgery for insertion of a permanent pacemaker. Which of the following prescriptions should the nurse clarify?
- Serum cardiac enzyme levels
- MRI of the chest
- Low-sodium diet
- Physical therapy
Explanation
MRI of the chest
An MRI is contraindicated for clients with most permanent pacemakers because the strong magnetic field can interfere with pacemaker function, damage internal components, or dislodge the device leads. Any MRI order must be clarified before proceeding unless the pacemaker is specifically MRI-compatible and verified. The other orders are safe and appropriate: checking cardiac enzymes monitors cardiac injury, a low-sodium diet supports cardiovascular health, and physical therapy promotes safe mobility and recovery after surgery.
An MRI is contraindicated for clients with most permanent pacemakers because the strong magnetic field can interfere with pacemaker function, damage internal components, or dislodge the device leads. Any MRI order must be clarified before proceeding unless the pacemaker is specifically MRI-compatible and verified. The other orders are safe and appropriate: checking cardiac enzymes monitors cardiac injury, a low-sodium diet supports cardiovascular health, and physical therapy promotes safe mobility and recovery after surgery.
4. A nurse is providing teaching to a client who is postoperative following coronary artery bypass graft (CABG) surgery and is receiving opioid medications to manage discomfort. Aside from managing pain, which of the following desired effects of medications should the nurse identify as most important for the client's recovery?
- It decreases the client's level of anxiety.
- It facilitates the client's deep breathing.
- It enhances the client's ability to sleep.
- It reduces the client's blood pressure.
Explanation
B. "It facilitates the client's deep breathing."
Following CABG surgery, maintaining adequate ventilation and preventing pulmonary complications such as atelectasis, pneumonia, and hypoxemia is critical. Effective pain control allows the client to take deep breaths, cough, and participate in pulmonary hygiene (e.g., incentive spirometry). Without adequate analgesia, the client may splint their chest to avoid pain, resulting in shallow breathing and ineffective lung expansion, significantly increasing postoperative respiratory risk.
Following CABG surgery, maintaining adequate ventilation and preventing pulmonary complications such as atelectasis, pneumonia, and hypoxemia is critical. Effective pain control allows the client to take deep breaths, cough, and participate in pulmonary hygiene (e.g., incentive spirometry). Without adequate analgesia, the client may splint their chest to avoid pain, resulting in shallow breathing and ineffective lung expansion, significantly increasing postoperative respiratory risk.
5. A nurse is admitting a client who has active tuberculosis to a room on a medical-surgical unit. Which of the following room assignments should the nurse make for the client?
- A room that is within view of the nurses' station
- A room with air exhaust directly to the outdoor environment
- A room with another nonsurgical client
- A room in the ICU
Explanation
A room with air exhaust directly to the outdoor environment
Clients with active tuberculosis require airborne precautions. This includes placement in a negative-pressure room that exhausts air directly to the outside or filters it through a high-efficiency system before recirculation. This setup prevents airborne Mycobacterium tuberculosis particles from spreading to other clients and staff. Placing the client near the nurses’ station or in the ICU does not address infection control needs, and sharing a room is contraindicated for airborne infections.
Clients with active tuberculosis require airborne precautions. This includes placement in a negative-pressure room that exhausts air directly to the outside or filters it through a high-efficiency system before recirculation. This setup prevents airborne Mycobacterium tuberculosis particles from spreading to other clients and staff. Placing the client near the nurses’ station or in the ICU does not address infection control needs, and sharing a room is contraindicated for airborne infections.
6.
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.
- "I switched to eating apples and oranges for a nighttime snack."
- "I purchased a large magnifying glass."
- "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."
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.
7. 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?
- Compassion fatigue
- Connects well with others
- High energy
- 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.
8. A nurse is establishing health promotion goals for a female client who smokes cigarettes, has hypertension, and has a BMI of 26. Which of the following goals should the nurse include?
- The client will list foods that are high in calcium, which should be avoided.
- The client will increase calorie intake by 200 cal per day.
- The client will walk for 30 min 5 days a week.
- The client will replace cigarettes with smokeless tobacco products.
Explanation
C. "The client will walk for 30 min 5 days a week."
This goal supports cardiovascular health and weight management. A BMI of 26 is overweight, hypertension is present, and smoking increases cardiovascular risk. Regular exercise helps lower blood pressure, improve heart health, support weight control, and reduce stress — making it the safest and most beneficial goal for this client.
This goal supports cardiovascular health and weight management. A BMI of 26 is overweight, hypertension is present, and smoking increases cardiovascular risk. Regular exercise helps lower blood pressure, improve heart health, support weight control, and reduce stress — making it the safest and most beneficial goal for this client.
9. A nurse is caring for a client who is in preterm labor at 32 weeks of gestation. The client asks the nurse, "Will my baby be okay?" Which of the following responses should the nurse offer?
- "Everyone worries about her baby when she's in labor."
- "Your pregnancy is advanced so your baby should be fine."
- "We have a neonatal unit here that's equipped to handle emergencies."
- "You must be feeling scared and powerless."
Explanation
D. "You must be feeling scared and powerless."
This response acknowledges the client's emotional state and encourages further communication, demonstrating therapeutic communication. It validates feelings without giving false reassurance.
This response acknowledges the client's emotional state and encourages further communication, demonstrating therapeutic communication. It validates feelings without giving false reassurance.
10.
A nurse is caring for a client who is exhibiting increased agitation. The nurse offered toileting, lowered the lights in the client's room and closed door to client's room.
Admission Assessment
82-year-old client admitted with nondisplaced hip fracture awaiting surgery. History of mild dementia, and hypotension. The family is concerned about malnutrition and living alone. The client's daughter who is the power of attorney (POA) is currently out of state.
Vital Signs:
- Temperature 36.5° C (97.7° F)
- Heart rate 88/min
- Respiratory rate 16/min
- Blood pressure 98/64 mm/Hg
Medications: Donepezil (Aricept) q AM,
Vital Signs
2200:
- Temperature 37.7° C (99.9° F)
- Heart rate 110/min
- Respiratory rate 20/min
- Blood pressure 110/64 mm/Hg
Nurses' Notes
2200:
- Increasing agitation, and states, "I am getting out of this bed."
2215:
- Daughter who is POA was contacted and states, "They get more agitated at night, and this is when they falls. We don't know what to do. I am unable to come in as I am out of state."
2218:
- Provider contacted no new prescriptions received.
2220:
- Client remains agitated and repeats, "I am getting out of this bed and leaving this place."
The nurse states, "You may not climb out of bed" and applied a wrist restraint and raised all bedside rails.
Complete the following sentence by using the lists of options.
The nurse is at risk for ________ as evidenced by ________.
- False imprisonment; applying wrist restraints to the client
- Negligence; calling the daughter
- Assault; decreasing environmental stimuli
- Slander; closing the door
Explanation
A. False imprisonment; applying wrist restraints to the client
False imprisonment occurs when a patient is unlawfully restrained or restricted without appropriate justification or a provider order. The client was alert, only agitated, and no new restraint order was obtained. Applying wrist restraints and preventing movement legally puts the nurse at risk for false imprisonment.
False imprisonment occurs when a patient is unlawfully restrained or restricted without appropriate justification or a provider order. The client was alert, only agitated, and no new restraint order was obtained. Applying wrist restraints and preventing movement legally puts the nurse at risk for false imprisonment.
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