ATI: Board Vitals NCLEX-PN Practice Test on 08-02-2023 Wednesday 8th.

ATI: Board Vitals NCLEX-PN Practice Test on 08-02-2023 Wednesday 8th.

75 Qs ScienceMedicineNursing Aloidnem Save PN Adult Medical Surgical Online Pr...90 terms kgoblish8Preview Exam Cram NCLEX-PN PRACTICE Q...103 terms summer3266Preview Board Vitals/ATI - NEED to KNOW 20 terms sia_simonePreview

ATI: Bo

22 terms Alo (4) A 66 year old client is diagnosed with peripheral neuropathy. The nurse knows they should include which of the following teaching points in the client's plan of care?Use assistive devices if indicated to reduce the risk of falls.A client with peripheral neuropathy should use assistive decides if indicated to reduce the risk of falls.Inspect the lower extremities for skin breakdown.A client with peripheral neuropathy should inspect their lower extremities for signs of skin breakdown. Nerve damage reduces the sensation of pain in the feet. They may be unaware or be unable to feel the damage in their lower extremities.Check the bathwater temperature with the hands to avoid burning skin without realizing.A client with peripheral neuropathy should check the bathwater temperature with their hands because they may not be able to feel changes in temperature with their lower extremities due to the neuropathy dulling their sensory perception. Nerve damage reduces the sensation of heat in the feet.Shoes should be properly fitted by a professional.A client with peripheral neuropathy should have shoes that are measured and fitted by a professional to provide sufficient room inside the toe box, cushioning, and support, all of which are important for clients with peripheral neuropathy.Clients with peripheral neuropathy suffer from pain and numbness in their feet. They may experience a loss of sensation, weakness, burning, or tingling in the lower extremities. The plan of care for a client with peripheral neuropathy includes inspection of the lower extremities for skin breakdown, using assistive devices such as a walker or cane if indicated to decrease the risk of falls, checking the bathwater temperature to avoid thermal injury, and getting footwear accurately fitted by a professional. Peripheral neuropathy does not involve a genetic component.Diabetes is a common cause of peripheral neuropathy, but it can also occur due to vascular insufficiency, neurological disorders, or metabolic disorders.

(15) A nurse is reinforcing teaching with a client who has rapid cycling bipolar disorder and a new prescription for carbamazepine. Which of the following information should the nurse reinforce in the teaching?"Blood test will be done weekly during the first several months of treatment." "You should not drink alcohol while taking this medication." "Refrain from taking Monoamine oxidase inhibitor medications with or within fourteen days of this treatment." "Do not abruptly discontinue this medication." Carbamazepine causes an elevation in liver enzymes, which can cause carbamazepine or other medications to be metabolized at a faster rate.The client should avoid alcohol or taking other sedatives while taking carbamazepine. Carbamazepine can cause dizziness and sedation. The client should follow a tapering schedule as directed by the provider when discontinuing carbamazepine. The client should not take Monoamine oxidase inhibitor MAOI medications with or within 14 days of taking carbamazepine.Carbamazepine is considered to be more effective than lithium for clients who have rapid cycling bipolar disorder. However, there are significant side effects of the medication. A client who is going to take carbamazepine must be given very specific oral and written instructions before starting the medication.(17) The nurse is caring for a 73 year old male client in a long term rehabilitation facility. Which of the following interventions can the nurse expect to use for a male client with urinary incontinence?Incontinence pads.Incontinence pads would commonly be used when caring for a client in a long-term care facility with urinary incontinence. For most older clients, incontinence pads are a convenient and minimally invasive intervention to deal with urinary incontinence, provided they are changed frequently.Intermittent self-catheterization.Intermittent self-catheterization may be encouraged for an incontinent client as it is less invasive and carries less of a risk of infection than an indwelling catheter.External condom catheter.External condom catheters may be used when caring for a client in a long-term care facility with urinary incontinence. They are less invasive and carry less of a risk of infection than an indwelling catheter.Nurses in long-term care facilities such as rehabilitation centers have to manage interventions safely and appropriately. For most older clients, incontinence pads are a convenient and minimally invasive intervention to deal with urinary incontinence, provided they are changed frequently.Intermittent self-catheterization is also an appropriate intervention for managing urinary incontinence, urinary retention, and overflow incontinence related to an overdistended bladder. External catheters or condom catheters are also a practical and less invasive intervention to manage urinary incontinence than indwelling catheters. Indwelling catheters should be avoided and might be used only as a last resort for urinary incontinence due to the high risk of urinary tract infection with their use.

(18) The nurse works with an RN to care for the following four clients on the medical-surgical floor.How should the nurse prioritize reporting on these clients to the RN? Place all options into the appropriate order.1st. A 61 year old client with COPD reporting shortness of breath.2nd. A 75 year old client who is one day s/p hip replacement surgery requesting assistance to the bathroom.3rd. A 35 year old client who is two days s/p appendectomy reporting incision pain when coughing.4th. A 68 year old client with dementia and a urinary tract infection stating, "I need to get the kids off the bus." Prioritize physiological needs and safety over psychosocial needs and safety. The nurse will see the client with shortness of breath because breathing needs to be addressed first based on the ABCs of nursing (airway, breathing, circulation). Elimination is the next priority, as delay in assistance can lead to incontinence. The pain at the incision site only occurs while coughing, which warrants the client's teaching splinting.Reorienting the client with dementia is important but does not prioritize physiological needs.A client assignment can be prioritized similarly to prioritizing client care for one client. Maslow’s Hierarchy of needs can be utilized to identify what level of need each client is in, followed by the ABCs of nursing (airway, breathing, circulation). Psychosocial needs and safety should not be addressed until after physiologic needs and safety have been addressed.(24) A nurse should instruct a client with uric acid kidney stones to avoid which of the following food?Red meat.Consumption of foods high in animal protein such as red meat, fish, shellfish, etc., causes increased formation of uric acid. So the clients with uric acid kidney stones should avoid intake of animal proteins.Gout is largely prevented by controlling the intake of foods the lead to high levels of uric acid. Organ meats, red meats, seafood, and some other foods should be avoided.

(28) The nurse is rounding and finds a client has fallen in the hall. The client is awake and responsive. The client states, "I felt dizzy and light- headed, and then my legs gave out." What following actions should the nurse take? Place all options into the appropriate order.1st. Call for assistance and stay with the client until help arrives.2nd. Inspect the client for obvious injury and collect vital signs.3rd. Notify the primary healthcare provider.4th. Complete an agency occurrence or sentinel event report (per agency policy).Lastly. Participate in a post-fall huddle/debrief.When a client experiences an unwitnessed fall, the priority is to call for assistance. Extra staff will assist with evaluating and transferring the client to a wheelchair or stretcher. Notify the healthcare provider to report the event and obtain additional orders for diagnostic testing. Prompt completion of an agency occurrence or sentinel event report will allow for the most accurate event recollection. Finally, participate in a post-fall huddle/debrief to discuss the event.Calling for assistance after a client has fallen is the first step because the nurse will need additional help with assessment, vital signs, and safe client transfer to a stretcher or a wheelchair. The healthcare provider must be notified for further interventions or diagnostic tests.Documentation and post-fall huddles are important after a fall event but do not take priority.(30) A client was admitted with cataracts. Which of the following manifestations is the most common complaint associated with cataracts?Blurred vision.The early signs of cataract are blurred vision and decreased color perception. The late signs are diplopia, reduced visual acuity, white pupil, etc.(36) A client with urinary tract infection is taking sulfadiazine. Which of the following instruction should the nurse give to the client?Withhold the medication if a rash appears.The client should be instructed to withhold the medication if a rash appears and also inform it to the health care practitioner.(38) A 34 year old male is admitted to the hospital with a diagnosis of pheochromocytoma. Which of the following symptoms is an unexpected finding during an attack?Bradycardia.This is a catecholamine producing tumor of the adrenal gland. Most are benign, however the tumor synthesizes the catecholamine's epinephrine and norepinephrine, which stimulates beta receptors. This stimulation causes tachycardia, peripheral vasodilation, diaphoresis, and postural hypotension due to decreased blood flow to the brain.