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ATI NURSEN TESNursing Q&A
Edited by Sally L
. Lagerqu
ist, RN
, MS
Nursing Q&A
Edited by Sally L. Lagerquist, RN, MS
Critical Thinking Exercises
With disc, includes over 1,000 NCLEX® style Review Questions!
ATI NURSEN TESBuild critical thinking skills and prepare for the NCLEX-RN® in one book!ATI Nursing Q&A: Critical Thinking Exercises is a single source for developing critical thinking through more than 1,000 case-based questions with detailed answers! Learn to think through patient problems – just like practicing nurses do – with the practical and relevant explanations provided. As a bonus, ATI Nursing Q&A provides a disc with over 300 NCLEX-RN® style questions and explanations to help ready you for the most important examination of your nursing career!
Reasons Why Students Will Love This Book:F act-filled pages offer more exercises to test your reasoning skills.Unique index grid helps locate your individual study needs.Nursing exam preparation is made easy! andE ssential concepts are covered by easy-to-remember cases.Assess your ability to apply nursing knowledge by using the coded and detailed answers.Special hints are given for test-wise guidelines to gain higher scores.Your study time will be spent in a better way, for success on exams.
Reasons Why Nursing Instructors Will Love This Book:Nursing problems/diagnoses are featured with medical problems.E xam question spin-offs from 75 case scenarios.Wide array of clinical situations enliven your teaching. andCase-management approach is a more interesting alternative to lectures.Real-life clinical nursing examples cover encounters with patients, families, and colleagues.E xercises that enhance critical-thinking skills.Adjunct to all clinical nursing textbooks.T ools to focus and structure discussion groups.Inference-making devices.Vignettes used in problem-based learning have everyday applicability.E xamples stimulate students’ curiosity about related situations; the broad content range naturally progresses into
related areas.
Where do today’s nursing students turn forcomprehensive help with specific study topics?
About the Author/Editor: Sally Lambert Lagerquist, RN, MS, is founder and president of Review for Nurses, Inc. and Review for Nurses Tapes Co. of San Francisco, California. She is the author and editor of five ATI NurseNotes titles, the ATI How to Pass Nursing Exams book, and a series of audio, DVD/CD-ROM, and video exam reviews. She has lectured nationwide at RN licensure exam review courses since 1976 and has been a faculty member at the University of California, San Francisco, School of Nursing where she also obtained her degrees. Sally is a charter member of Sigma Theta Tau.
ATI NURSEN TES
Contents vii
Contents
Preface ix
Acknowledgments xiii
Contributing Authors xiv
How to Use This Book xvii
I. How to Prepare for ExaminationsIntroduction 2
1. Preparing Yourself Intellectually 3
2. Preparing Yourself Emotionally 11
3. Preparing Yourself Physically 19
4. Coping with Exam-Related Anxiety 23
5. How to Take Tests 29
II. Case Management Scenarios with Critical-Thinking Exercises: Questions and Answers
Introduction 37
6. Typical Test Designs for Critical-Thinking Exams in
Clinical Nursing Areas 39
7. Children and Adolescents 51
Case Situations and Questions 51
Answers and Rationale 103
8. Young Adult and Reproductive Years 141
Case Situations and Questions 141
Answers and Rationale 200
viii Contents
9. Adult Health Problems 245
Case Situations and Questions 245
Answers and Rationale 299
10. Older Adult and Geriatrics 335
Case Situations and Questions 335
Answers and Rationale 351
11. Behavioral and Emotional Problems 363
Case Situations and Questions 363
Answers and Rationale 404
III. Coding Tables and Summary Grids 425Introduction 425
Reference Code Abbreviations 427
12. Coding Tables 429
Summary Grids 450
References 461
IndexesIndex to Nursing Problems/Diagnosis 469
Index to Medical Diagnosis/Case Management Scenarios 475
xiv Acknowledgments
BookReviewers
Janet Baatz Darrow, MS, RN, CPNLecturerSan Jose State UniversitySan Jose, California(Pediatrics)
Christine Hooper, RN EdDAssociate ProfessorSan Jose State UniversitySan Jose, California(Medical-Surgical)
Janice McMillin, BSN, MSN, EdDInstructor of Maternal-Child
Nursing Sacramento State UniversityClinical Coordinator of Family
Birth Center Methodist HospitalSacramento, California(Maternal-Newborn)
Mary St. John Seed, RN, PhDAssociate ProfessorDepartment of Community Mental Health School of NursingUniversity of San FranciscoSan Francisco, California(Psychiatric-Mental Health)
Kathleen E. Snider, RN, MSN, CNSProfessor of NursingLos Angeles Valley CollegeValley Glen, California(Pediatrics)
Item Writers for the Disk in This Edition
Christine Hooper, RN, EdDAssociate ProfessorSan Jose State UniversitySan Jose, California(Medical-Surgical)
Janice McMillin, BSN, MSN, EdDInstructor of Maternal-Child
Nursing Sacramento State UniversityClinical Coordinator of Family
Birth Center Methodist HospitalSacramento, California(Maternal-Newborn)
Mary St. John Seed, RN, PhDAssociate ProfessorDepartment of Community Mental
Health School of NursingUniversity of San FranciscoSan Francisco, California(Psychiatric-Mental Health)
Kathleen E. Snider, RN, MSN, CNSProfessor of NursingLos Angeles Valley CollegeValley Glen, California(Pediatrics)
Contributing Authors xv
Contributing Authors to Previous Editions
Judith E. Barrett, RN, MSN, MNPFormer Associate Professor, University of San Francisco, School of Nursing, San Francisco
Irene M. Bobak, RN, PhD, FAANProfessor Emerita, Women’s Health and Maternity Nursing, San Francisco State University, San Francisco
Geraldine C. Colombraro, RN, MA, PhD Assistant Dean, Center for Continuing Education in Nursing and Health Care, Lienhard School of Nursing, Pace University, Pleasantville, New York
Jane Corbett, RN, MS, PhDProfessor Emerita, University of San Francisco, School of Nursing, San Francisco
Marlene Farrell, RN, MAFormer Professor of Nursing, California State University, Los Angeles
Sandra Faux, RN, MNFormer Faculty, University of Illinois College of Nursing, Chicago
Lois A. Fenner Giles, RN, MSFormer Faculty, University of Maryland, School of Nursing, Baltimore, Maryland
Marilyn Brolin Hopkins, RN, MS, DNScProfessor of Nursing, California State University, Sacramento, California
Sister Mary Brian Kelber, RN, DNScAssociate Professor, University of San Francisco, School of Nursing, San Francisco
Sally Lambert Lagerquist, RN, MSPresident and Course Coordinator, Review for Nurses, Inc. and RN Tapes Company; Former Instructor of Undergraduate, Graduate, and Continuing Education in Nursing, University of California, San Francisco, School of Nursing, San Francisco
xvi Contributing Authors
Diane R. Lapkin, RN, MS, EdDFormer Dean, School of Nursing, Salem State College, Salem, Massachusetts
Sister Mary Peter McKusker, RN, MS, MA Former Instructor, Puno, Peru
Janice Majewski Rhoades, RN, MS, DNScFormer Clinical Research Nurse, Cardiac Rehabilitation, Sequoia Hospital District, Redwood City, California
Karen L. Miller, RN, MSN Wilmette, Illinois
Robyn M. Nelson, RN, DNScDepartment Chair and Professor of Nursing, California State University, Sacramento, California
Agnes F. Padernal, RN, MSFormer Assistant Clinical Professor, University of California, Los Angeles, School of Nursing, Los Angeles
Kathy Rose, RN, MSFormer Assistant Professor, University of Illinois School of Nursing, Chicago
Williamina Rose, RN, MSFormer Education Director and Associate Professor, Montana State University, Butte Extended Campus, Butte, Montana
Patricia Sparacino, RN, MSVice Chairperson, Family Health Care Nursing, University of California School of Nursing, San Francisco
Janice Horman Stecchi, RN, EdDDean Emerita, College of Health Professions, University of Massachusetts Lowell, Lowell, Massachusetts
Janet Jordan Veatch, RN, MNClinical Nurse Specialist, Pediatric Oncology, University of California, San Francisco, Department of Nursing, San Francisco
Kathleen Hickel Viger, RN, MSDirector of Nursing, River Ridge Brain Injury Rehabilitation Center, Kennebunk, Maine
Adult Health Problems 245
9. Adult Health Problems
Case Management Scenarios and Critical-Thinking Exercises
Medical Diagnosis: Diabetic ketoacidosis.n NursingProblems/Diagnosis:
Electrolyte imbalance: hypokalemia.
Fluid volume deficit.
Altered nutrition.
n ChiefComplaint:
Dennis Rose, who is 18-years old and a high school basketball star, was admitted to the hospital for treatment of polyuria, polydipsia, and dry cough.
n HistoryofPresentIllness:
The patient was well until 10 days prior to admission, when he developed gastroenteritis followed by bronchitis. He had diarrhea, abdominal pain, intermittent vomiting, and dry cough.
n PastHistory:
Measles at age 7. No allergies.
n FamilyHistory:
Hyperthyroidism in maternal grandmother. Adult-onset diabetes mellitus in maternal uncle.
n ReviewofSymptoms:
10 pound weight loss over the past 6 days.
n PhysicalExam:
Head and neck: Eyes sunken. Tongue dry. Fruity breath odor.
Lungs: Clear on auscultation.
Abdomen: Benign.
Extremities: Skin dry with decreased turgor.
Vital signs: BP: 110/70. Temperature: 100.6°F. P: 110. R: 40.
246 II. Case Management Scenarios with Critical Thinking Exercises: Questions and Answers
n LaboratoryData:
Na+: 138.
K+: 3.2.
CO2: 6.
Cl-: 102.
Glucose: 860.
WBC: 17,000/mL.
Hgb: 18.1g.
Hct: 54%.
Urinalysis: 4 + glucose; ketones—large.
1. The nurse knows that the condition that does not precipitate diabetic ketoacidosis in the client is:
A. Diarrhea.
B. Intermittent vomiting.
C. Bronchitis.
D. Dehydration.
2. The nurse knows that Dennis will require insulin injections. Which statement best explains the rationale for insulin therapy?
A. The person with diabetes, type 1 requires insulin to supplement circulating insulin.
B. The person with diabetes, type 1 is insulin-dependent.
C. The injections are temporary until the pancreas increases insulin production.
D. All people who have diabetes must receive insulin.
3. Which admitting symptom indicates the incomplete lipid metabolism that occurs in diabetes?
A. Polyuria.
B. Polydipsia.
C. Fruity breath.
D. Weight loss.
4. The nurse knows that the presence of hypokalemia (after treatment with insulin) increases the risk of the client developing:
A. Cardiac irritability.
B. Renal failure.
C. Cardiac depression.
D. Respiratory failure.