ATI RN
ATI Fundamental Proctored Exam 2024-2025 Online Practice 250 Simulated Exam Questions Questions
Extract:
Question 1 of 5
Which of the following should the nurse recognize as a sign of possible infection in a postoperative client? (Select all that apply.)
Correct Answer: B,C,E
Rationale: Adventitious breath sounds suggest pneumonia, decreased consciousness may indicate sepsis, and fever is a systemic infection response. Increased urine output is not a sign, and dry crust is part of normal healing.
Question 2 of 5
A nurse is preparing to perform wound care and remove staples from a client's surgical incision following a hip replacement. Identify the sequence the nurse should follow. (Move the steps of staple removal into the box on the right, placing them in the selected order of performance. All steps must be used.)
Order the Items
Source Container
Correct Answer: D, E, A, C, B
Rationale: First, remove the wound dressing to expose the incision.
Then, clean the skin along the sides to reduce infection risk. Next, remove every other staple to maintain stability before removing the remaining ones. Finally, wipe cleansing solution to keep the site clean.
Question 3 of 5
A nurse is collecting data about the fluid status of four clients. Which of the following clients should the nurse identify as being at risk for fluid volume deficit?
Correct Answer: B
Rationale: The correct answer is B: A client who has heart failure and is receiving diuretic therapy. In heart failure, the heart's ability to pump blood effectively is compromised, leading to fluid retention. Diuretics are prescribed to reduce fluid overload by increasing urine output. This process can potentially lead to fluid volume deficit if excessive fluid is removed. Clients with heart failure on diuretics are at risk for electrolyte imbalances and dehydration.
A: NPO status for an endoscopy does not necessarily indicate fluid volume deficit.
C: Clients with end-stage kidney disease undergoing dialysis are at risk for fluid volume overload due to the accumulation of waste products and fluid in the body.
D: Clients with gastroenteritis receiving oral fluids are typically at risk for fluid volume deficit, but the scenario does not provide enough information to confirm this as the correct choice.
In summary, choice B is correct because clients with heart failure on diuretics are at risk for fluid volume deficit due to the medication
Question 4 of 5
A nurse is preparing a client for magnetic resonance imaging (MRI). Which of the following statements should the nurse include when reinforcing teaching?
Correct Answer: A
Rationale: The correct answer is A: You'll have to remove metal objects such as watches and body jewelry. This is important for MRI safety as the magnetic field can interact with metal objects, causing harm or image distortion. Removing metal ensures the client's safety during the procedure.
Choice B is incorrect as MRI does not involve radiation exposure but magnetic fields.
Choice C is incorrect as communication with the technician is usually possible through an intercom system.
Choice D is incorrect as clients must remain still during an MRI to prevent image blurring.
Question 5 of 5
A nurse is administering a tap-water enema to a client. The client reports cramping as the nurse instills the irrigating solution. Which of the following actions should the nurse take to relieve the client's discomfort?
Correct Answer: A
Rationale:
Correct
Answer: A: Lower the height of the solution container.
Rationale: Lowering the height of the solution container will decrease the rate of flow, reducing the pressure and volume of the solution entering the client's colon. This can help alleviate the cramping sensation by slowing down the administration of the enema.
Summary of other choices:
B: Encouraging the client to bear down may increase intra-abdominal pressure, worsening the cramping sensation.
C: Allowing the client to expel some fluid before continuing may not address the root cause of the discomfort, which is the rapid influx of solution.
D: Stopping the enema and documenting that the client did not tolerate the procedure does not actively address the client's discomfort or provide immediate relief.