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 discussing kidney transplant with a client who has end-stage renal disease (ESRD). Which of the following should the nurse identify as a contraindication for this treatment?
- A. Alcohol use disorder
- B. Pacemaker
- C. Breast cancer survivor for 8 years
- D. 65-years of age
Explanation
A. Alcohol use disorder
Active substance use disorder, including alcohol use disorder, is a contraindication to kidney transplantation. Successful transplant requires strict lifelong adherence to immunosuppressive medications and follow-up care; substance misuse increases risk of nonadherence and poor outcomes. Clients must demonstrate sustained sobriety and rehabilitation before being considered candidates. Transplant programs typically require documentation of treatment participation and a period of abstinence prior to listing.
Active substance use disorder, including alcohol use disorder, is a contraindication to kidney transplantation. Successful transplant requires strict lifelong adherence to immunosuppressive medications and follow-up care; substance misuse increases risk of nonadherence and poor outcomes. Clients must demonstrate sustained sobriety and rehabilitation before being considered candidates. Transplant programs typically require documentation of treatment participation and a period of abstinence prior to listing.
2. A nurse is assessing a client who has had staples removed from an abdominal wound postoperatively. The nurse notes separation of the wound edges with copious light-brown serous drainage. Which of the following actions should the nurse perform first?
- Check the client's vital signs.
- Obtain a culture and sensitivity of the wound drainage.
- Assess the client's pain level.
- Cover the wound with a moist, sterile gauze dressing.
Explanation
Cover the wound with a moist, sterile gauze dressing.
The client is showing signs of wound dehiscence, and the light-brown drainage may indicate possible evisceration (serosanguineous drainage can precede it). The priority is to protect the exposed tissues and prevent drying by immediately covering the wound with moist, sterile gauze. This action reduces the risk of further tissue damage and infection.
The client is showing signs of wound dehiscence, and the light-brown drainage may indicate possible evisceration (serosanguineous drainage can precede it). The priority is to protect the exposed tissues and prevent drying by immediately covering the wound with moist, sterile gauze. This action reduces the risk of further tissue damage and infection.
3. A nurse is assessing a client who is 48 hr postoperative following abdominal surgery. Which of the following findings should the nurse report to the provider?
Blood pressure 102/66 mm Hg
Yellow-green drainage on the surgical incision
Straw-colored urine from an indwelling urinary catheter
Respiratory rate 18/min
Blood pressure 102/66 mm Hg
Yellow-green drainage on the surgical incision
Straw-colored urine from an indwelling urinary catheter
Respiratory rate 18/min
- Blood pressure 102/66 mm Hg
- Yellow-green drainage on the surgical incision
- Straw-colored urine from an indwelling urinary catheter
- Respiratory rate 18/min
Explanation
Yellow-green drainage on the surgical incision
Yellow-green drainage from a surgical incision 48 hours post-operation is an abnormal finding and indicates possible wound infection. Normal postoperative wound drainage is typically serous or serosanguineous. Purulent or foul-smelling drainage, especially yellow-green, suggests the presence of bacteria. Infection at the surgical site requires immediate provider notification for culture, antibiotic therapy, and wound management to prevent sepsis or wound dehiscence. The other findings are expected postoperative findings and do not require urgent intervention.
Yellow-green drainage from a surgical incision 48 hours post-operation is an abnormal finding and indicates possible wound infection. Normal postoperative wound drainage is typically serous or serosanguineous. Purulent or foul-smelling drainage, especially yellow-green, suggests the presence of bacteria. Infection at the surgical site requires immediate provider notification for culture, antibiotic therapy, and wound management to prevent sepsis or wound dehiscence. The other findings are expected postoperative findings and do not require urgent intervention.
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?
- A. It decreases the client's level of anxiety.
- B. It facilitates the client's deep breathing.
- C. It enhances the client's ability to sleep.
- D. 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 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 ________.
- A. False imprisonment; applying wrist restraints to the client
- B. Negligence; calling the daughter
- C. Assault; decreasing environmental stimuli
- D. 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.
6. 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?
- A. "Everyone worries about her baby when she's in labor."
- B. "Your pregnancy is advanced so your baby should be fine."
- C. "We have a neonatal unit here that's equipped to handle emergencies."
- D. "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.
7. A nurse is reviewing the laboratory data of a client who has acute pancreatitis. The nurse should expect to find an elevation of which of the following values?
- A. RBC count
- B. Amylase
- C. Magnesium
- D. Calcium
Explanation
B. Amylase
In acute pancreatitis, pancreatic enzymes such as amylase become significantly elevated due to inflammation and autodigestion of the pancreatic tissue. Amylase levels typically rise within hours of pancreatitis onset and serve as a key diagnostic indicator alongside elevated lipase. Elevated amylase confirms enzyme leakage into the bloodstream as the pancreas becomes inflamed and damaged.
In acute pancreatitis, pancreatic enzymes such as amylase become significantly elevated due to inflammation and autodigestion of the pancreatic tissue. Amylase levels typically rise within hours of pancreatitis onset and serve as a key diagnostic indicator alongside elevated lipase. Elevated amylase confirms enzyme leakage into the bloodstream as the pancreas becomes inflamed and damaged.
8. A nurse in a clinic is caring for a client who has recently begun taking warfarin. The nurse is reviewing potential drug and food interaction risks and should instruct the client to avoid which of the following?
- A. Green beans
- B. Cantaloupe
- C. White beans
- D. Cabbage
Explanation
D. Cabbage
Cabbage is high in vitamin K, which can interfere with the anticoagulant effects of warfarin by promoting clotting factor production. Consuming large amounts of vitamin K–rich foods can reduce warfarin's effectiveness and increase the risk of blood clots. Clients taking warfarin should maintain consistent vitamin K intake and avoid sudden increases in foods such as cabbage, spinach, kale, and other leafy greens.
Cabbage is high in vitamin K, which can interfere with the anticoagulant effects of warfarin by promoting clotting factor production. Consuming large amounts of vitamin K–rich foods can reduce warfarin's effectiveness and increase the risk of blood clots. Clients taking warfarin should maintain consistent vitamin K intake and avoid sudden increases in foods such as cabbage, spinach, kale, and other leafy greens.
9. A charge nurse is providing an in-service for a group of staff nurses about deep vein thrombosis (DVT). Which of the following information should the nurse include about this condition?
- A. DVTs cannot be prevented.
- B. There are always warning signs of a DVT.
- C. Clients only develop DVTs if they have clotting disorders.
- D. Approximately half of DVTs occur during a hospitalization.
Explanation
D. Approximately half of DVTs occur during a hospitalization.
Approximately half of all DVTs occur during or shortly after hospitalization. Hospitalized clients are at increased risk because of immobility, surgery, trauma, certain medications, and acute illnesses. Prevention strategies such as early ambulation, sequential compression devices, and anticoagulants are critical in the inpatient setting. Recognizing hospitalized patients as a high-risk group reinforces the importance of evidence-based DVT prophylaxis in maintaining patient safety and preventing life-threatening pulmonary embolism.
Approximately half of all DVTs occur during or shortly after hospitalization. Hospitalized clients are at increased risk because of immobility, surgery, trauma, certain medications, and acute illnesses. Prevention strategies such as early ambulation, sequential compression devices, and anticoagulants are critical in the inpatient setting. Recognizing hospitalized patients as a high-risk group reinforces the importance of evidence-based DVT prophylaxis in maintaining patient safety and preventing life-threatening pulmonary embolism.
10. A nurse is caring for a client who is unconscious and has a breathing pattern characterized by alternating periods of hyperventilation and apnea. The nurse should document that the client has which of the following respiratory alterations?
- A. Stridor
- B. Cheyne-Stokes respirations
- C. Apneustic respirations
- D. Kussmaul respirations
Explanation
B. Cheyne-Stokes respirations
Cheyne-Stokes respirations are characterized by a cyclical pattern of progressively deep, rapid breathing followed by periods of apnea. This pattern often occurs in clients who are unconscious and may indicate severe neurologic injury, increased intracranial pressure, or end-of-life changes. Recognizing this pattern allows the nurse to notify the provider, monitor neurologic status, and support respiratory needs appropriately.
Cheyne-Stokes respirations are characterized by a cyclical pattern of progressively deep, rapid breathing followed by periods of apnea. This pattern often occurs in clients who are unconscious and may indicate severe neurologic injury, increased intracranial pressure, or end-of-life changes. Recognizing this pattern allows the nurse to notify the provider, monitor neurologic status, and support respiratory needs appropriately.
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