ATI Critical Thinking Exam 2: Questions
& Answers
A nurse is caring for a client who is diagnosed with rheumatoid arthritis and
is prescribed dexamethasone (Prednisone). Which of the following
indicates the client is experiencing an adverse effect of the medication?
(Ans- Hyperglycemia.In this item, you need nursing knowledge of
dexamethasone to recall adverse effects associated with the medication.
This item requires foundational thinking because you only need to recall
knowledge related to adverse effects of dexamethasone. Dexamethasone,
a glucocorticoid, is a powerful anti-inflammatory and immunosuppressant
and is indicated for the treatment of multiple disorders, including
rheumatoid arthritis. Adverse effects of dexamethasone increase with the
dosage and duration of treatment and can include adrenal insufficiency,
osteoporosis, infection, myopathy, fluid and electrolyte disturbances,
cataracts, peptic ulcer disease, and iatrogenic Cushing’s syndrome among
others. Hyperglycemia, an elevated blood glucose level, is an adverse
effect of dexamethasone. Both hyperglycemia and glycosuria can be
manifested in clients who are taking dexamethasone because of its effect
on the production and use of glucose.
While collecting data on a client who is immobile, a nurse locates a
reddened area of skin on the left scapula. Which of the following actions
should the nurse take?
(Ans- In this item, you need knowledge of appropriate skin care
interventions for clients who are immobile with indications of a stage I
pressure ulcer. This item requires foundational thinking because you have
to recall interventions that are appropriate for maintaining skin integrity in
clients who are immobile. Damage to tissues caused by continuous
pressure is described as a pressure ulcer. The risk for pressure ulcers can
be complicated by factors such as immobility, inadequate nutrition, bowel
and bladder incontinence, decreased mental status, reduced sensation,
increasing age, and excessive body heat. Appropriate care of pressure
ulcers is based on the characteristics and stage of the wound. A wound
that manifests as a reddened area is a stage 1 pressure ulcer. A
transparent wound barrier applied to reddened skin or a stage 1 pressure
ulcer to prevent contamination and reduce friction to the area is an
appropriate action by the nurse.
A nurse is precepting a newly licensed nurse while he is charting. Use of
which of the following abbreviations indicates a need for further teaching?
(Ans- In this item, you need knowledge of abbreviations that the Joint
Commission has determined should not be used in documentation. This is
a negatively-worded item that asks you to select the option that indicates
the newly licensed nurse needs additional teaching. You will learn more
about negatively-worded items in Module 4. This item requires foundational
thinking because you only need to recall knowledge related to the
abbreviations that are not acceptable for use when charting. To reduce the
occurrence of medical errors, the Joint Commission developed a list of donot-use abbreviations that should be avoided in health care settings. The
abbreviation “q.d.” was previously used to indicate every day, which can be
mistaken as the abbreviation for “four times daily (qid),” resulting in medical
errors. The Joint Commission has recommended the use of “daily” to
indicate every day. This is not an acceptable abbreviation; therefore,
additional teaching is needed.
A nurse is caring for a client who is prescribed IV fluids. While inserting the
IV catheter, blood is spilled on the floor. Which of the following solutions
should the nurse use to clean the spill?
(Ans- Bleach
A nurse is conducting a breast examination on a client who has a family
history of breast cancer. Which of the following should the nurse report to
the provider?
(Ans- Dimpling of the tissue in the upper outer quadrant