ATI NCLEX Study guides, Class notes & Summaries

A nurse is caring for a client who smokes and has lung cancer. The client reports, "I'm coughing because I have that cold that everyone has been getting." The nurse should identify that the client is using which of the following defense mechanisms? A. reaction formation B. denial C. displacement D. sublimation - correct answer B. denial A nurse is providing preoperative teaching for a client who was informed of the need for emergency surgery. The client has a respiratory rate 30...

STOP - correct answer S= Story: Issue & Client T= Think: Stem, Type, & Key Words O= Options: Consider Choices P= Pick: Correct Answer (& Stick to it!!) Multiple Response (SATA) - correct answer STOP--- > or = 2 correct answers (NEVER all)--- True/False--- In all areas of test plan & across all difficulty levels--- NO partial credit TPN- Hyperalimentation: 1. TPN is a/an __________________ solution (hypotonic, hypertonic, isotonic). 2. TPN may be given via ______________...

1. a nurse is preparing a client who speaks limited English for surgery. which of the following is the most appropriate nursing action in obtaining informed consent from this client? a. do nothing as this is the provider's primary concern b. the nurse should explain the procedure using pictures and hand gestures c. have the nurse respond to the client's concerns so the provider can prepare for surgery d. seek the assistance of a nurse on the floor who is fluent in the client's language -...

What o2 equipment has the highest level of O2? - correct answer Non-rebreather Signs of depression - correct answer powerlessness and hopelessness What types of questions should be asked with someone who has asphagia - correct answer Closed ended question What should you inspect on a patient who is at risk for pressure ulcers - correct answer Skin What do you administer before a wound irrigation - correct answer Pain medications With COPD patients, should ...

A nurse is caring for a client who is having surgery for the removal of an encapsulated acoustic tumor. Which of the following potential complication should the nurse monitor for postoperatively? SATAA. A. Increased ICP B. Hemorrhagic shock C. Hydrocephalus D. Hypoglycemia E. Seizures - correct answer A. Increased ICP C. Hydrocephalus E. Seizures rationale: hemorrhagic shock occurs secondary to SIADH and hypoglycemia is not a concern for brain surgery A nurse is caring for a c...

A nurse prepares a staff in-service on incident reports. Which of the following should the nurse include? Select all that apply. 1. Risk management investigates the incident. 2. A copy of report is placed in client's health record. 3. Reports include description of incident and actions taken 4. Reports are confidential and not shared with non-involved staff 5. Completion of report should be documented in the nurses' notes. - correct answer 1, 3, 4 Never in the client's chart. O...

A nurse is discussing restorative health care with a newly licensed nurse. Which of the following examples should the nurse include in the teaching? select all that apply Restorative health care involves intermediate follow up care for restoring health and promoting self care. Know the different facilities: SECONDARY HEALTH CARE Diagnostic centers are a TERTIARY is a specialized highly technical care such as oncology center. PRIMARY healthcare is office doctor visits for regular checkup...

a nurse reinforces teaching to a client about end-of-life decisions. which information about advance directives is correct? a. informed consent should be verified b. a health care proxy can be designated c. specific dietary restrictions are identified d. legal counsel is needed to make decisions - correct answer b. a health care proxy can be designated a client who has a terminal illness decides to discontinue treatment. what is the appropriate response from the nurse? a. why ar...

A charge nurse is discussing mental status exams with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? (Select all that apply) A. "To assess cognitive ability, I should ask the client to count backwards by sevens." B. "To asses affect, I should observe the client's facial expression." C. "To assess language ability, I should instruct the client to write a sentence." D. "To assess remote memory, I should ...

A nurse in a provider's office is preparing to test a client's cranial nerve function. What directions should she include when testing cranial nerve V? (was select all that apply) - correct answer "Close your eyes" "Clench your teeth" "Tell me when you feel a touch" A client asks the nurse what her Snellen eye test results mean. Her visual acuity is 20/30. What is the appropriate response? - correct answer "Your eyes see at 20 feet what visually unimpaired eyes see at 30 ...