ATI Comprehensive Final Questions and Answers (100% all Correct)

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1- A nurse is providing teaching to a client who has come to the family planning clinic requesting an intrauterine device (IUD). Which of the following information should the nurse provide the client?... "Your risk for ectopic pregnancy increases with an IUD." 2- A nurse is assessing a preschooler who has recurrent and persistent otitis media. When obtaining the child's history from her parent, which of the following questions should the nurse ask? "Does anyone smoke around or in the same house as your child?" 3- A nurse is teaching the parent of a child who has severe reactive airway disease about glucocorticoid therapy. The parent asks why her child has to inhale the medication instead of taking it orally. Which of the following information should the nurse provide the parent? Oral glucocorticoids are more like to slow linear growth in children. 4- A nurse is providing teaching to a client who has a new prescription for sertraline. The client asks the nurse if he should continue to take St. John's wort for depression. Which of the following instructions should the nurse give the client? Stop taking the herbal supplement while taking the medication. 5- A nurse is caring for a client who is receiving bleomycin IV to treat lymphoma. Which of the following assessments is the nurse's priority? Pulmonary function 6- A nurse is reviewing the laboratory report for a client who has chronic kidney disease (CKD). The nurse finds the following laboratory test results: potassium 6.8 mEq/L, calcium 7.4 mg/dL, hemoglobin 10.2 g/dL, and phosphate 4.8 mg/dL. Which of the following findings is the priority for the nurse to report to the provider? Hyperkalemia 7- A nurse is facilitating a group discussion with preschool teachers about child abuse. Which of the following data should the nurse use as a common example of a suggestive finding? Arm cast for a spiral fracture of the forearm 8- Due to staffing shortages, a nurse manager floats a medical-surgical nurse to the pediatric unit. The nurse has limited experience with children. Which of the following actions should the nurse manager take? Assign a unit nurse to act as a resource to act as a resource for the medical-surgical nurse 9- A nurse is developing a plan of care for a client who has gastroesophageal reflux disease (GERD). The nurse should plan to monitor the client for which of the following complications? Aspiration 10- A client at a routine prenatal care visit asks the nurse if it is common to develop vaginal yeast infections during pregnancy. Which of the following responses should the nurse make? "The hormonal changes of pregnancy change the acidity of the vagina, making yeast infections more common. 11- A community health nurse is performing client triage while participating in a disaster drill. The nurse should recommend that which of the following clients receives treatment first? Hemothorax 12- A nurse is providing teaching to a school-age child who has just had a fiberglass cast application following lower extremity fracture. Which of the following instructions should the nurse give the child and his parents about care during the first 48 hours? "Keep the cast above the level of your heart. 13- A nurse is assessing a toddler who has AIDS. The nurse should identify which of the following findings as an indication of an opportunistic infection? Candidiasis 14- A nurse is assessing a client who has an abdominal aortic aneurysm (AAA). Which of the following findings should indicate to the nurse that the AAA is expanding? Report of sudden, severe back pain 15- A nurse is providing discharge teaching to a client who does not speak the same language as the nurse. The client's neighbor, who speaks the client's native language and the nurse's, arrives to drive the client home. Which of the following actions should the nurse take? Obtain the services of an interpreter 16- A nurse is caring for a client who is receiving IV ampicillin and develops urticaria and dyspnea. Which of the following actions should the nurse take first? Stop the medication infusion 17- A nurse on a pediatric unit is planning care for a preschooler who will be having a surgical procedure in the morning. The child has been crying despite his parent's presence at his bedside. The nurse should add engaging the child in therapeutic play to the care plan because it offers which of the following benefits? Allows the child to manipulate toy medical equipment 18- A nurse on a mental health unit is caring for a client who has depression. Which of the following actions should the nurse take to foster a therapeutic environment for this client? Build trust with the client by sitting quietly with him 19- A nurse is assessing a client who is receiving clozapine to treat schizophrenia. The nurse should identify an increase in which of the following parameters as an early indication of an adverse effect of this medication? Temperature 20- A nurse is planning care for a client who is postoperative following a hip arthroplasty. In the client's medical record, the nurse notes a history of chronic obstructive pulmonary disease (COPD). Which of the following oxygen-delivery methods should the nurse plan to use for this client? A nasal cannula 21- A nurse is caring for a client who has dehydration and has developed hypovolemic shock. Which of the following laboratory values should the nurse expect for the client? Hct 55% 22- During a client care staff meeting, a nurse manager discusses potential problems with data security that affect confidential client information. Which of the following environments should the nurse manager identify as an acceptable area for discussing clients' information? Areas with no public access 23- A nurse is providing preoperative teaching for a client who will undergo laser-assisted in situ keratomileusis (LASIK) surgery. Which of the following information should the nurse include? "You might need glasses after surgery 24- A nurse is monitoring the electrocardiogram of a client who has hypocalcemia. Which of the following findings should the nurse expect? Prolonged Q-T intervals 25- A nurse is caring for a client who had a precipitous delivery. The nurse should identify which of the following assessments as the priority during the fourth stage of labor? Palpating the client's fundus 26- A hospice nurse is visiting with the family member of a client. The family member states that the client has insomnia almost nightly. Which of the following practices should the nurse identify as contributing to the client's insomnia? The client watches television in her bed during the day. 27- A nurse at a long-term care facility hears an assistive personnel (AP) talking with an older adult client who has dementia with periods of confusion. Which of the following statements should indicate that the AP requires further teaching? "Its almost time for your appointment. Let me do your hair for you and brush your teeth. 28- A nurse in the labor and delivery suite is planning care for a group of four clients. Which of the following clients should the nurse see first? A client who is in active labor and has late decelerations on the fetal heart monitor's strip A nurse is teaching a client who has chronic kidney disease about predialysis dietary recommendations. The nurse should include information about restricting his intake of which of the following nutrients? Protein 29- A nurse participating in a community health fair is providing information to a client who has a BP of 150/90 mmHg during a blood pressure screening. Which of the following actions should the nurse take? Give the client a written record of his BP to bring to their provider. 30- A nurse on an oncology unit receives report at the beginning of her shift about four clients who are postoperative. Which of the following clients should the nurse see first? A client who is 2 days postoperative following a colectomy d/t colorectal cancer and has an ostomy bag full of bright red, bloody drainage. 31- A community health nurse is conducting a class about body mechanics for county office workers. Which of the following instructions should the nurse include? (Select all that apply.) Sit with your back supported Keep your knees at hip level Use ergonomically designed computer keyboard 32- A provider tells a client who reports practicing Hinduism that at 12-weeks of gestation she needs more protein in her diet and suggest eating more meat. After the provider leaves the examination room, the client tells the nurse that eating animal products will cause her to miscarry. Which of the following responses should the nurse make? "Let's discuss other foods that are also high in protein that you could substitute for meat." 33- A nurse is preparing to administer medications to a client who is unconscious. The nurse should bring the medication administration record (MAR) to the client's bedside and perform which of the following verification procedures? Compare the medical record number and name on the MAR with the client's identification band. 34- A nurse is teaching a client who has coronary artery disease about the difference between angina pectoris and a myocardial infarction. Which of the following manifestations should the nurse identify as indications of an MI? (Select all that apply) Nause/Vomite Diaphoresis and dizziness Anxiety and feelings of doom 34- A nurse is preparing an older adult client who had a TIA for discharge. The nurse should teach the client to monitor which of the following parameters at home? Blood pressure 35- A nurse delegates a LPN to provide one-on-one observation for a client who requires suicide precautions. Which of the following actions by the LPN should indicate to the nurse that she requires further teaching? Ambulates the client's roommate while the client sleeps. 36- A nurse is preparing to care for a client who is in balanced skeletal traction to stabilize a femur fracture. Which of the following actions should the nurse include in the client's plan of care? Offering the client a diet high in fluid and fiber 37- A nurse is caring for a client who takes warfarin to treat chronic A-fib and has early manifestations of Alzheimer's disease. The client's partner asks the nurse if the client would benefit from taking ginkgo biloba. Which of the following responses should the nurse make? "It is likely that ginkgo biloba will interfere with the effectiveness of his other medications." 38- A nurse is providing teaching to the parents of a child who has strabismus. Which of the following instructions should the nurse include to prevent the development of amblyopia? Patch the unaffected eye. 39- A nurse is assessing a 66-year-old client during a routine physical examination at her first clinic visit and does not have her medical records. When the nurse asks if she has received the pneumococcal immunization, the client replies, "I am not sure, but it's been at least 5 years since I had any immunizations." Which of the following responses should the nurse make? "Let's go ahead with giving you this immunization." 40- A nurse is admitting a client who has manifestations that suggest TB. Which of the following actions is the nurse's priority? Initiate airborne precautions. 41- A nurse is discussing medication administration for an older adult client with a newly licensed nurse. The nurse should identify that, due to physiological changes of aging, older adult clients might need dosage adjustments d/t an increase in which of the following parameters? Body fat. 42- A nurse is teaching a client who has a spinal cord injury to perform intermittent urinary self-catheterization at home after discharge. Which of the following statements indicates that the client understands the procedure? "I will perform intermittent self-catheterization every 2-3 hours." 43- A nurse is providing discharge teaching for a client who had a bone marrow transplant and has thrombocytopenia. Which of the following statements indicates that the client understands the precautions he must take at home? "I'll stick with soft foods for now." 44- A nurse is preparing to administer 100 units of insulin glargine and 4 units of NPH insulin subcutaneously to a client. Which of the following actions should the nurse plan to take? Use separate syringes for administering insulin glargine and NPH insulin. 45- A nurse is accepting a transfer from the PACU of a client who has had a subtotal thyroidectomy. Which of the following equipment should the nurse have available at the bedside for this client? Tracheostomy tray 46- A nurse is planning care for a client who has acute systemic lupus erythematosus (SLE) and is to begin treatment for systemic manifestations. Which of the following types of medications should the nurse plan to administer? Corticosteroids 47- A nurse in the emergency department is caring for a group of clients who all have an odor of alcohol on their breath and multiple injuries to the head and extremities. Which of the following clients should the nurse assess first? A client who is difficult to arouse and is unable to respond to questions. 48- A charge nurse is coordinating the evacuation of clients from a facility following a bomb threat. Which of the following actions should the nurse take when implementing the evacuation process? Instruct clients who are able to ambulate to leave. 49- A nurse is admitting a child who has a UTI and a history of myelomeningocele. After completing the admission history, which of the following actions should the nurse plan to take? Attach a latex allergy alert identification band. 50- A nurse is providing teaching to the parents of a child who has a new prescription of lamotrigine for a seizure disorder. The nurse should instruct the parents that which of the following adverse effects is the priority to report to the provider? Rash 51- A nurse is evaluating the injection site for a client who had a Mantoux skin test 48 hours ago. The nurse finds 10 mm induration with slight redness. Which of the following conclusions should the nurse make? The client has had an exposure to TB. A nurse is caring for an adolescent client who gave birth to a stillborn preterm fetus. The client is crying and says to the nurse, "Why did this happen to me?" Which of the following responses should the nurse make? "This must be so difficult for you." A nurse is teaching self-administration of NPH insulin to a client who has type 2 DM. which of the following instructions should the nurse include? Rotate injection sites within the same area. A nurse in a substance use disorder program is interacting with a client. Which of the following statements indicates that the client is using intellectualization as a way of coping with the anxiety of admission? "I have read that problems with substances can have a variety of predisposing factors." A charge nurse on a pediatric unit receives the laboratory results for several clients. Which of the following results should the nurse report to the provider? A client who has DKA and a blood glucose of 375 mg/dL. A nurse is assessing a client who is receiving a transfusion of packed RBCs. Which of the following findings should the nurse identify as an indication of an acute intravascular hemolytic reaction? Sudden oliguria a nurse is providing discharge teaching to parents whose infant has had a ventriculoperitoneal shunt placement for the treatment of hydrocephalus. which of the following statements by the parents indicates an understanding of the teaching? we will notify the doctor right away if he has a fever A nurse is assessing a client who has multidrug-resistant TB and takes ethambutol. The nurse should identify which of the following findings as an adverse effect of this medication? Loss of red/green color discrimination A nurse is caring for a client who has borderline personality disorder and is expressing concern about needing prolonged hospitalization. Which of the following statements should the nurse make? "Tell me what concerns you the most about being hospitalized." A nurse is caring for a client who is taking acarbose to treat type 2 DM. For which of the following adverse effects of this medication should the nurse monitor? Diarrhea A nurse is providing teaching to a client who has type 2 DM. The client states, "I eat pasta every day. I can't imagine giving it up." Which of the following responses should the nurse make? "You don't have to give up pasta; just adjust the amount you eat." A nurse is reviewing the use of side rails with an assistive personnel (AP). Which of the following statements by the AP should indicate that further teaching is required? "if the client seems confused i will raise all 4 side rails so that he doesn't hurt himself" A nurse is assessing a client who has AIDS and is taking zidovudine. Which of the following findings is the priority for the nurse to report to the provider? Decreased hemoglobin A nurse is planning recreational activities for a young adult client who has an acute exacerbation of schizophrenia. Which of the following activities should the nurse plan for this client? Walking with a staff member A nurse in the emergency department is caring for a client who has Addison's disease and reports N/V, diarrhea, and abdominal pain. To prevent Addisonian crisis, the nurse should prepare to administer which of the following medications? Hydrocortisone A nurse in a provider's office is talking with an older adult client who reports having trouble sleeping. Which of the following statements should the nurse identify as a possible cause for the client's sleeping difficulties? "I often have a cup of coffee with my dessert before going to bed." A nurse is reviewing the medical record of a client who is requesting a prescription for sildenafil citrate. Which of the following data in the client's record should the nurse identify as a contraindication for the use of this medication? Current use of isosorbide to treat HF. A nurse is caring for an infant who has a cleft palate. The parents ask the nurse how long they should wait before he should have corrective surgery. The nurse should explain that the parents should wait no longer than 6-12 months to prevent which of the following outcomes? Difficulty with language acquisition A nurse in an acute care facility is implementing the facility's disaster plan following a flood in the community. Which of the following actions should the nurse take? Identify stable clients in the ICU to transfer to the medical-surgical units. A nurse is teaching the parent of a child who has type 1 diabetes mellitus how to manage the child's disorder during illness, such as colds. Which of the following statements by the parent indicates an understanding of the teaching? "I'll check his blood glucose more often." A nurse is caring for a group of clients in a long-term facility. One of the clients is walking in the hallway and bumping into walls and does not respond to his name. which of the following actions should the nurse take first? Accompany the client back to his room. A nurse is caring for a toddler. Which of the following objects should the nurse select from the playroom for this child during hospitalization? A 10-piece wooden puzzle. A nurse is caring for a client who is receiving mechanical ventilation and develops acute respiratory distress. Which of the following actions should the nurse take first? Initiate bag-valve-mask ventilation. A nurse is caring for a client who spent the past several minutes mumbling about being "doomed to die" and is now pacing in an increasingly agitated and angry manner. Which of the following actions should the nurse take first? Attempt to reduce environmental stimuli. A nurse on a pediatric mental health unit is caring for a school-age child. Which of the following questions or statements should the nurse make to foster rapport and engage him in conversation? "Tell me about your favorite video game." A community health nurse is planning care for four high-risk newborns who were discharged yesterday. Which of the following newborns should the nurse plan to care for first? A 4-day-old newborn who has an elevated bilirubin level and requires phototherapy. A client comes to the emergency department in severe respiratory distress following left- sided blunt chest trauma. The nurse finds that the client has absent breath sounds on the left side and a tracheal shift to the right. For which of the following procedures should the nurse prepare the client? Chest tube insertion A nurse is teaching a client who has extensive deep partial- ad full-thickness burns and requires a topical antimicrobial medication. The nurse should explain to the client that the goal of this medication therapy is to reduce which of the following outcomes? Bacterial growth A nurse is caring for a client who is taking warfarin. Which of the following laboratory values should the nurse recognize as an effective response to the medication? INR 3.0 A nurse is caring for a client who is postoperative following a laparotomy and has an indwelling urinary catheter and a Jackson-Pratt drain in place. Which of the following findings should indicate that the client is developing a postoperative complication? Pulse oximetry of 85% A nurse in the emergency department is caring for a child who has bruises that the nurse suspects are d/t child abuse. Which of the following actions should the nurse take? Report the suspected abuse to local authorities. A nurse is caring for a client who has chronic phantom limb pain following an above- knee amputation. Which of the following medication prescriptions should the nurse verify with the provider? Meperidine. A nurse is caring for a client who has pseudomembrane colitis d/t Clostridium difficile infection. Which of the following interventions is the nurse's priority? Performing hand hygiene before and after contact with the client. A nurse in the emergency department is caring for an unaccompanied infant following a motor-vehicle crash. During assessment, the nurse notes that the infant's anterior fontanel is almost closed. She has six teeth, is able to sit unsupported, and can drink from a cup. The child cries whenever anyone new to her enters the room, says a few words, and is asking for "mama" and "dada". The nurse should make which of the following age assessments for this child? 12 months old A nurse is caring for a client who has a tracheostomy and is receiving mechanical ventilation. The low-pressure alarm on the ventilator sounds, indicating which of the following to the nurse? A leak within the ventilator's circuitry A nurse in the emergency department is caring for a client who reports pain in her left leg following a motor-vehicle crash. The nurse notes that her left leg has bruising, swelling, and displacement of the bones. Which of the following actions should the nurse take first? Check neurovascular status distal to the injury A nurse is assessing a client who is receiving hemodialysis for the first time. Which of the following findings indicates to the nurse that the client is developing dialysis disequilibrium syndrome (DDS)? Headache A nurse is caring for a child who has epistaxis. Which of the following actions should the nurse take? Apply continuous pressure to the lower part of his nose. A nurse in a prenatal clinic is performing telephone triage for several clients. Which of the following client reports should the nurse identify as an expected physiologic adaptation of pregnancy? Breast tenderness. A nurse in the emergency department is assessing a client who has deep, rapid respirations. Arterial blood gas analysis includes these values: pH 7.25, PaCO2 40, and HCO3_ 18. Which of the following acid-base imbalances should the nurse identify and report to the provider? Metabolic acidosis A nurse is caring for a client during her first prenatal visit and notes that she is lactose intolerant. Which of the following foods should the nurse include on a list of calcium sources for this client? Collard greens A nurse is planning to delegate the postoperative care of a client following an appendectomy. Which of the following actions should the nurse assign to an assistive personnel (AP)? Record urinary output after emptying the indwelling urinary catheter. A nurse in an acute care clinic is talking with a client who reports that her osteoarthritis pain in her knees is increasing each day. The client wants to discuss non-pharmacological approaches that would help relieve her pain. Which of the following interventions should the nurse suggest? Applying warm compresses to sore joints. A nurse is reviewing the medical history of a client who has presbyopia. With which of the following activities should the nurse expect the client to have difficulty? Reading the newspaper. A nurse is caring for a client who has methicillin-resistant Staphylococcus aureus (MRSA) infection. A dietary assistant asks the nurse what precautions are necessary for entering the client's room with the lunch tray. Which of the following instructions should the nurse give the dietary assistant? Don gloves when entering the room and use hand sanitizer when exiting. A nurse at a LTC facility notes that a client who has dementia is having problems with orientation. Which of the following actions should the nurse take to improve the client's LOC? Post a large calendar on the bulletin board. A health care facility's leadership team is implementing a new computerized charting system. When preparing for the implementation date, which of the following actions should the nurse manager take first? Collect the staff's input about planning and implementing the change. A nurse is providing teaching to a client who has a new prescription for doxycycline. The nurse should instruct the client to monitor for which of the following adverse effects? Photosensitivity. A nurse is talking with a parent of a preschooler. The parent reports that it is very difficult to get her child to go to bed at a consistent time. She tells the nurse that the child gets out of bed, enters her parents' room, and cries when they tell him to stay in bed. Which of the following instructions should the nurse give the parent? "Use a stable, relaxing routine, such as a bath and story time, before bed." A nurse is preparing to administer a feeding via a gastrostomy tube to a client who had a stroke. Which of the following actions should the nurse take prior to initiating the feeding? Elevate the head of the bed A nurse manager notes that several staff members are late in completing an annual mandatory educational session about extremity restraint safety. Which of the following actions should the nurse manager plan to take? Send an e-mail to each nonadherent employee that includes a link to upcoming educational sessions. A nurse is planning care for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) with mild manifestations. The nurse should expect that the provider will prescribe which of the following medications? Tolvaptan A nurse in an acute mental health facility is caring for a client who has schizophrenia. The client asks the nurse, "Can I vote in the upcoming presidential election?" Which of the following responses should the nurse make? "We can work together to find out how you can get a mail-in ballot." A nurse is caring for an older adult client who has an in-the-canal hearing aid. The client states that the hearing aid is making a whistling sound. The nurse should identify which of the following factors as the source for this sound? Excessive wax in the ear canal. A nurse at a family planning clinic is preparing to teach a class about how to use a diaphragm. Which of the following information should the nurse plan to include in the teaching? "Use spermicidal jelly whenever you use your diaphragm." A nurse is reviewing the laboratory data of a client who reports manifestations that suggest SLE. The nurse should expect an increase in which of the following parameters for a client who has SLE? Erythrocyte sedimentation rate A nurse is admitting a client to the medical unit and asks him if he has advanced directives. The client states, "I have a document with me that names someone who can make health care decisions for me if I am not able." The nurse should identify that the client is referring to which of the following documents? Durable power of attorney document. A nurse in a rehabilitation facility is observing an AP help a client transfer from the bed to a wheelchair. Which of the following actions indicates to the nurse that the AP understands how to perform this task? Locks the brakes on the bed and the WC before moving the client. A nurse is planning teaching about secondary prevention actions for colorectal cancer for a health fair for adults in the community. Which of the following topics should the nurse plan to include? The importance of colonoscopy screening starting at age 50 years old. A nurse in an emergency department is assessing an infant who has laryngotracheobronchitis. Which of the following findings should the nurse report as an indication of impending airway obstruction? Nasal flaring. A nurse is providing teaching to a client who is scheduled for an electroencephalogram (EEG) in the morning. Which of the following information should the nurse provide the client? "Shampoo your hair before the procedure, and don't put any styling products on it afterward." A nurse manager notes several recent conflicts among nurses on different shifts. Which of the following strategies should the nurse manager use to resolve these conflicts? Set up a series of meetings for all staff members to attend to discuss issues. A new resident provider asks the charge nurse for an access code to review clients' online records. The resident is not scheduled to attend the facility's orientation computer class until next week. Which of the following actions should the nurse take? Explain that it is against policy to share access codes and refer the resident to his supervisor. A nurse is assessing a client who reports an acute visual disturbance and describes it as a "curtain" pulled over his visual field with occasional flashes of light. The nurse should notify the provider that this client might have which of the following disorders? Retinal detachment. A nurse in the emergency department is assessing a client who has pancreatitis. In which of the following laboratory results should the nurse expect to see an elevation? Amylase. A nurse is providing teaching to a client who is receiving chemotherapy and has developed neutropenia. Which of the following statements should indicate that the client needs further instructions? "I'm planning a large gathering of friends and family for the holidays." A nurse is assessing a school-age child who has celiac disease. Which of the following findings should the nurse expect? Steatorrhea. A nurse is discussing fire safety with newly hired nurses. The nurse should identify which of the following actions as the priority if a fire occurs in the health care facility? Evacuate clients from the unit. A nurse is providing discharge teaching to a client who has had a TIA. Which of the following instructions should the nurse include? Reduce dietary sodium. A nurse is providing discharge teaching for a client who has a new prescription for metoprolol. Which of the following instructions should the nurse include? (select all that apply.) "Do not stop taking this medication abruptly." "Count your radial pulse daily." "Change positions slowly." A nurse on the antepartum unit is caring for a client who is at 28 weeks of gestation and reports dizziness when lying on her back. Into which of the following positions should the nurse assist the client? Lateral. A nurse is caring for a client who has regular occupational exposure to sunlight and comes to the clinic for evaluation of several skin lesions. Which of the following findings should alert the nurse to the possibility of malignant melanoma? An irregularly shaped brown lesion with light blue areas on the neck. A nurse is assessing a child who has acute lymphocytic leukemia and is receiving vincristine sulfate. Which of the following findings is the nurse's priority? Paresthesia A nurse is observing a client who has schizophrenia and is in the dayroom when another client asks him if two items of clothing match. He replies, "A match. I like matches. They are the givers of light, the light of the world. God will light the world. Let your light shine on." The nurse should identify these statements as which of the following speech alterations? Associative looseness. A nurse is teaching a group of clients at a senior center about the risk factors for osteoporosis. Which of the following statements should the nurse include in teaching? "Extended periods of immobility increase your risk for osteoporosis." A nurse observes tachycardia, dyspnea, a cough, and distended neck veins in a client who is receiving a transfusion of packed RBCs. Which of the following interventions should the nurse use to prevent these manifestations with the client's next transfusion? Use a transfusion pump to regulate and maintain the transfusion at a slower rate. A nurse is caring for a client who has a platelet count of 50,000/mm3. After discontinuing the client's peripheral IV site, which of the following actions should the nurse take? Apply pressure to the catheter removal site for 5 minutes. A nurse is teaching the parents of an infant about treatment options for profound sensorineural hearing loss. The nurse should include which of the following information about the function of cochlear implants? Direct stimulation of auditory nerve fibers. A nurse is providing teaching to the family of a child who has autism spectrum disorder. Which of the following statements indicates that the family understands the teaching? "It will help our child if we structure our daily routine." A nurse is caring for a client who is at 38 weeks of gestation and in the active phase of the first stage of labor. The nurse notes two late decelerations of the FHR during the last 5 contractions. Which of the following actions should the nurse take? Assist the client to a lateral position. A nurse is providing teaching to the parent of a toddler who is undergoing insertion of tympanostomy tubes. Which of the following statements should the nurse include? "The tubes should stay in place until they fall out on their own." Results of enzyme-linked immunosorbent assay (ELISA) testing for an 18-month-old infant who has Pneumocystis carinii pneumonia indicate that she is HIV-positive. When planning care, the nurse should consider which of the following factors? The infant's mother is likely HIV positive. A nurse is caring for a client who has a terminal illness. The family wants to care for the client at home. Which of the following statements indicates that the nurse understands family-centered care? "Let's set up a meeting time with the doctor to discuss your options for home care." A nurse is teaching an AP about dietary restrictions for a client who is taking phenelzine to treat depression. The AP's selection of which of the following foods for the client's lunch indicates an understanding of the teaching? Chicken salad. A nurse is assigned to care for several clients who are postoperative. The nurse should identify the client taking which of the following medications is at risk for delayed wound healing? Prednisone to treat persistent arthritis exacerbations. A nurse is beginning her shift and reviewing the medication administration records for her clients. She notes a dosage of a medication above the safe range and sees that a nurse administered that dosage during the previous shift. Which of the following actions should the nurse take? Call the provider to clarify the dosage. A nurse is providing teaching to a client who has hypothyroidism and is taking levothyroxine. The nurse should instruct the client that which of the following findings is an indication of thyrotoxicosis? [Show More]

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