a nurse is caring for a client who has a history of depression and is experiencing a situational crisis which of the following actions should the nurs
Logo

Nursing Elites

ATI RN

ATI Comprehensive Exit Exam 2023 With NGN

1. A client with a history of depression is experiencing a situational crisis. Which of the following actions should the nurse take first?

Correct answer: A

Rationale: The correct answer is to confirm the client's perception of the event. In crisis intervention, understanding the client's perspective is crucial as it helps the nurse assess the situation accurately and provide tailored support. This step can also help build rapport and trust with the client. Option B, notifying the client's support system, may be important but should come after assessing the client's perception. Option C, helping the client identify personal strengths, and option D, teaching relaxation techniques, are valuable interventions but should follow the initial step of confirming the client's perception.

2. What is the initial intervention for a patient with chest pain?

Correct answer: A

Rationale: The correct initial intervention for a patient with chest pain is to administer aspirin. Aspirin helps reduce the risk of clot formation by inhibiting platelet aggregation, which can be beneficial in case the chest pain is due to a cardiac event. Administering nitroglycerin may follow aspirin administration to help relieve chest pain by dilating blood vessels. Providing pain relief is a general approach and may not address the underlying cause of chest pain. Preparing for surgery would not be the initial intervention for chest pain unless there are specific indications for immediate surgical intervention.

3. A nurse is caring for an infant who has coarctation of the aorta. Which of the following should the nurse identify as an expected finding?

Correct answer: A

Rationale: Corrected Rationale: Weak femoral pulses are an expected finding in an infant with coarctation of the aorta. The narrowing of the aorta leads to decreased blood flow to the lower extremities, resulting in weak or absent femoral pulses. Frequent nosebleeds (Choice B) are not typically associated with coarctation of the aorta. Upper extremity hypotension (Choice C) is not a common finding in coarctation of the aorta; instead, blood pressure is usually elevated in the upper extremities. Increased intracranial pressure (Choice D) is not directly related to coarctation of the aorta.

4. A healthcare professional is receiving a change-of-shift report for an adult female client who is postoperative. Which client information should the healthcare professional report?

Correct answer: A

Rationale: In a postoperative client, a low-grade fever can be an early sign of infection, which is crucial to report to the healthcare team for timely intervention. Shortness of breath and decreased urine output are also important to monitor, but in the context of postoperative care, infection is a more immediate concern. A high platelet count is not typically a priority in the immediate postoperative period.

5. A nurse is caring for a client who is 36 weeks gestation and has preeclampsia. Which of the following findings should the nurse report to the provider?

Correct answer: D

Rationale: Nonpitting ankle edema is a concerning sign of worsening preeclampsia due to fluid retention and should be reported immediately. Proteinuria of 1+ is a common finding in preeclampsia. A blood pressure of 120/80 mm Hg is within normal limits. A respiratory rate of 18/min is also within normal range. Therefore, choices A, B, and C are not as urgent as nonpitting ankle edema in this scenario.

Similar Questions

A client is being assessed in the PACU. Which of the following findings indicates decreased cardiac output?
When documenting an incorrect dose of medication administered, which fact related to the incident report should the nurse document in the client's medical record?
A healthcare professional is assessing a client who has chronic kidney disease. Which of the following findings is an indication for hemodialysis?
A nurse is caring for a client who has generalized petechiae and ecchymoses. The nurse should expect a prescription for which of the following laboratory tests?
A nurse is planning care for a client who has diabetes insipidus and is receiving desmopressin. Which of the following should the nurse monitor?

Access More Features

ATI RN Basic
$69.99/ 30 days

  • 5,000 Questions with answers
  • All ATI courses Coverage
  • 30 days access

ATI RN Premium
$149.99/ 90 days

  • 5,000 Questions with answers
  • All ATI courses Coverage
  • 30 days access

Other Courses