a nurse is assessing a client with chronic obstructive pulmonary disease copd which finding indicates the condition is worsening
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Nursing Elites

ATI RN

RN ATI Capstone Proctored Comprehensive Assessment Form B

1. A client with chronic obstructive pulmonary disease (COPD) is being assessed by a nurse. Which finding indicates the condition is worsening?

Correct answer: A

Rationale: The correct answer is A: Increased shortness of breath. In COPD, worsening symptoms often include increased shortness of breath due to impaired lung function. This indicates a decline in respiratory status and the need for prompt intervention. Choice B, decreased wheezing, is not indicative of worsening COPD as it could suggest better airflow. Choice C, productive cough with green sputum, may indicate an infection but not necessarily worsening COPD. Choice D, a slight increase in fatigue, is non-specific and may not directly correlate with the worsening of COPD.

2. What are the signs of infection that should be monitored in a postoperative patient?

Correct answer: D

Rationale: The correct answer is D: 'Redness, swelling, and warmth at the surgical site.' These are specific signs of infection at the surgical site that a nurse should monitor for in a postoperative patient. While fever, chills, and increased pain can also indicate infection, the most direct signs are redness, swelling, and warmth at the surgical site. Therefore, 'D' is the best choice as it directly relates to the site of the surgery and is crucial to monitor for potential postoperative infections.

3. A nurse in an emergency department is preparing a change-of-shift report for an adult client who is transferring to a medical-surgical unit using the SBAR communication tool. Which of the following information should the nurse include in the report?

Correct answer: A

Rationale: In an SBAR report, key information such as the client's do-not-resuscitate (DNR) status should be included as it directly impacts the client's care and treatment plan. Choices B and C are important details but may not be as critical for immediate care planning during the shift change. Choice D, the client having Medicare insurance, is important for billing purposes but does not directly impact the client's immediate care needs.

4. During an initial visit, a home health nurse is assessing a client who has cultural beliefs different from their own. Which of the following questions should the nurse ask to determine the client's beliefs about environmental control?

Correct answer: C

Rationale: The correct question to ask in this scenario is: 'What do you think you can do to affect your health status?' This question directly addresses the client's beliefs about their ability to control their health and reflects their beliefs about environmental control. Choices A, B, and D do not directly relate to assessing the client's beliefs about environmental control. Choice A focuses on time orientation, choice B pertains to family decision-making dynamics, and choice D is related to family medical history, which are not directly relevant to understanding the client's beliefs about environmental control.

5. What is a primary goal when managing a client with generalized anxiety disorder (GAD)?

Correct answer: D

Rationale: When managing a client with generalized anxiety disorder (GAD), a primary goal is to teach relaxation techniques to help manage anxiety. Relaxation techniques such as deep breathing, progressive muscle relaxation, and mindfulness can be effective in reducing anxiety symptoms. Encouraging the client to engage in regular physical exercise (Choice A) can be beneficial but teaching relaxation techniques is more specific to managing anxiety. Avoiding anxiety triggers through behavioral therapy (Choice B) may be part of the treatment plan but teaching relaxation techniques is more directly aimed at managing anxiety. While encouraging the client to express feelings openly (Choice C) can be important for overall emotional well-being, teaching relaxation techniques is more focused on addressing the symptoms of anxiety.

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