Review ATI Advanced Concept Exam 240

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ATI Advanced Concept Exam 240

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Total Questions : 64

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Question 1:

The nurse is reinforcing teaching to the patient about the cause of pain from coronary artery disease. The nurse would evaluate the patient as understanding the education if the patient stated which of the following causes the pain from coronary artery disease?

A. Lack of sufficient oxygen to the myocardium. B. Increased cardiac workload. C. Interrupted electrical activity to areas of the heart. D. Lack of nutrients to the heart.

Answer and Explanation

Choice A:

The myocardium requires a constant supply of oxygen to function properly. Coronary artery disease (CAD) causes a reduction in blood flow due to narrowed or blocked coronary arteries, leading to a lack of oxygen in the heart muscle, which can result in angina or chest pain.

Choice B:

While increased cardiac workload can exacerbate chest pain, it is not the primary cause of pain in CAD. The pain is primarily due to ischemia, which is the lack of oxygen and nutrients to the heart tissue due to reduced blood flow.

Choice C:

Interrupted electrical activity can lead to arrhythmias or heart attack, but it is not the direct cause of pain in CAD. The pain is related to ischemia, not electrical disturbances.

Choice D:

A lack of nutrients, including oxygen, to the heart does contribute to the pain experienced in CAD; however, the primary factor is the insufficient oxygen supply, which is explicitly stated in choice A.

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Question 2:

A newly licensed nurse is assisting with the involuntary admission of a client who has depression to an acute care mental health facility. Which of the following guidelines should the nurse follow when caring for the client?

A. The client can undergo electroconvulsive therapy without giving informed consent. B. The nurse can share information with the client's family without his permission. C. The client has the right to refuse medication. D. The nurse may use restraints as needed (PRN).

Answer and Explanation

Choice A:

Electroconvulsive therapy (ECT) requires informed consent, as it is a significant medical procedure involving anesthesia and induced seizures. Informed consent is a process where a patient is fully informed about the procedures and risks involved in a treatment and voluntarily agrees to it.

Choice B:

Nurses cannot share information with a client's family without the client's permission due to confidentiality laws, except in specific circumstances defined by law. Patient information is protected under the Health Insurance Portability and Accountability Act (HIPAA), which requires patient consent for disclosure.

Choice C:

Patients have the right to refuse medication. This right is part of the patient's autonomy and informed consent process. A mentally competent adult can refuse treatment, even if it may result in serious illness or death.

Choice D:

The use of restraints in mental health facilities is highly regulated. Restraints may only be used when necessary to prevent immediate harm to the patient or others and must be discontinued as soon as the risk of harm has subsided.

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Question 3:

A nurse is preparing to administer digoxin to a client who has heart failure. Before administering this medication, which of the following actions should the nurse take?

A. Measure the client's apical pulse. B. Offer the client a light snack. C. Check the client's blood pressure. D. Weigh the client.

Answer and Explanation

Choice A:

Monitoring the apical pulse helps ensure safety and effectiveness of digoxin therapy.

Choice B:

Offering a light snack is not relevant to digoxin administration.

Choice C:

While checking the client's blood pressure is important, it is not directly related to digoxin administration.

Choice D:

Weighing the client is not a specific action related to digoxin administration.

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Question 4:

The patient is being discharged on furosemide (Lasix). The nurse evaluates the patient as understanding medication teaching if the patient states that which of the following laboratory tests will be monitored as ordered?

A. I will have my potassium level checked. B. I will have my calcium level checked. C. I will have my prothrombin time checked. D. I will have my urine sodium checked.

Answer and Explanation

Choice A:

Furosemide is a loop diuretic that can cause hypokalemia, so monitoring potassium levels is important.

Choice B:

While calcium levels can be affected by furosemide, it is not typically the primary concern.

Choice C:

Prothrombin time is not usually affected by furosemide and is not routinely monitored unless the patient is on anticoagulant therapy.

Choice D:

Urine sodium could be checked, but it is the serum potassium that is most commonly monitored due to the risk of hypokalemia with furosemide use.

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Question 5:

A nurse on the mental health unit is caring for a client who has bipolar disorder and comes to the nurse's station at 0300 demanding to see the provider. Which of the following responses should the nurse make?

A. "Why don't you wait to speak to your provider in the morning?" B. "Go back to your room, and I'll try to get in touch with your provider in the morning." C. "You seem to be very upset about something. Tell me about it." D. "Everything will be okay until morning. You can speak with your provider then."

Answer and Explanation

Choice A:

This response may come off as dismissive and does not address the patient's immediate concerns or feelings.

Choice B:

While this response offers a solution, it does not engage with the patient's current emotional state or provide immediate support.

Choice C:

This response is therapeutic as it acknowledges the patient's emotional state and invites them to discuss their concerns, which is important in managing patients with bipolar disorder.

Choice D:

This response might minimize the patient's feelings and does not encourage communication about the patient's current distress.

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Question 6:

The nurse is caring for a male patient, age 54, who had a myocardial infarction 2 days ago. His wife, who is very talkative, has remained at his bedside. Which of these interventions should the nurse implement to reduce the workload of the heart? (Select all that apply.)

A. Administer daily stool softener. B. Provide bedside commode. C. Advocate for rest periods with no visitors. D. Provide regular diet. E. Ambulate four times a day. F. Maintain bedrest.

Answer and Explanation

Choice A:

Administering a daily stool softener can help prevent straining during bowel movements, which can increase cardiac workload.

Choice B:

Providing a bedside commode reduces the effort required to go to the bathroom, thus reducing cardiac workload.

Choice C:

Advocating for rest periods with no visitors can help reduce emotional stress and physical exertion, which can increase cardiac workload.

Choice D:

A regular diet is not specifically an intervention to reduce cardiac workload and may not be appropriate immediately following a myocardial infarction.

Choice E:

Ambulating four times a day is not recommended immediately following a myocardial infarction as it can increase cardiac workload.

Choice F:

Maintaining bedrest can help reduce the workload on the heart by minimizing physical activity.

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Question 7:

What is cyclothymic disorder?

A. A continuous state of hypomania for 2 years. B. A one-time event of hypomania. C. Chronic depression for 2 years. D. A chronic mood disorder of at least 2 years.

Answer and Explanation

Choice A:

Cyclothymic disorder involves periods of hypomanic symptoms, but not continuously for 2 years.

Choice B:

Cyclothymic disorder is not a one-time event; it involves multiple episodes of hypomanic and depressive symptoms.

Choice C:

While chronic depression can be a part of cyclothymic disorder, it alone does not define it.

Choice D:

Cyclothymic disorder is characterized by at least 2 years of numerous periods of hypomanic symptoms and depressive symptoms.

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Question 8:

A nurse is caring for a hospitalized client who has bipolar disorder and is disturbing other clients with incessant talking. Which of the following actions should the nurse take?

A. Inform the client that restraints may be necessary if she cannot control her behavior. B. Assist the client to practice social interaction with peers during a community meeting. C. Escort the client to her room when she is observed trying to interact with other clients. D. Allow the client to interact freely with others on the unit.

Answer and Explanation

Choice A:

Informing the client about the potential use of restraints could be perceived as threatening and may not be therapeutic.

Choice B:

Assisting the client to practice social interaction in a structured setting like a community meeting can provide a safe environment for interaction and can be part of a therapeutic plan.

Choice C:

Escorting the client to her room could be isolating and may not address the need for social interaction, which is important for clients with bipolar disorder.

Choice D:

Allowing the client to interact freely might not be appropriate if the behavior is disturbing others. It's important to find a balance that respects both the client's needs and those of others.

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Question 9:

A nurse is reinforcing teaching with a client who has a new diagnosis of angina pectoris. Which of the following information about anginal pain should the nurse include in the teaching?

A. The pain worsens with deep inspiration. B. The pain persists with rest and organic nitrates. C. Exertion and anxiety can trigger the pain. D. The pain usually lasts more than 20 minutes.

Answer and Explanation

Choice A:

Anginal pain typically does not worsen with deep inspiration; this is more characteristic of pleuritic chest pain.

Choice B:

Anginal pain usually does not persist with rest and organic nitrates; these interventions are typically used to alleviate angina.

Choice C:

Exertion and anxiety increase the heart's demand for oxygen, which can trigger anginal pain due to reduced blood flow in narrowed coronary arteries.

Choice D:

Anginal pain typically lasts for a short time, usually less than 20 minutes. If the pain lasts longer, it may indicate a more serious condition like a myocardial infarction.

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Question 10:

Ms. S is admitted to your medical unit with a diagnosis of dehydration and a history of depression. She tells you, "I just can't eat, I'm not hungry." What would be your best therapeutic response?

A. "You aren't hungry?" B. "If you can't eat, what is that candy bar wrapper doing under your bed?" C. "You really should try to eat some real food." D. "Why aren't you hungry?"

Answer and Explanation

Choice A:

This response is a closed-ended question that might not encourage further discussion or reveal the underlying issues.

Choice B:

This confrontational approach could make the patient defensive and is not conducive to building a therapeutic relationship.

Choice C:

While encouraging the patient to eat is important, this directive does not address the patient's feelings or concerns.

Choice D:

Asking an open-ended question invites the patient to share more about their feelings and can lead to a better understanding of their lack of appetite.

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Total Questions : 64

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ATI Advanced Concept Exam 240

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