ATI RN
ATI Nur 112 Fundamentals of Nursing Exam Questions
Question 1 of 5
What should the nurse teach family caregivers when a patient has fecal incontinence because of cognitive impairment?
Correct Answer: B
Rationale: The correct answer is B: Initiate a bowel or habit training program to promote continence. This is the most appropriate response as it addresses the underlying issue of cognitive impairment causing fecal incontinence. By implementing a structured training program, caregivers can help the patient relearn and establish bowel habits, potentially improving continence.
Choice A is incorrect as antibacterial soap can be harsh on the skin and talcum powder may worsen skin irritation.
Choice C only addresses managing the symptoms, not the underlying cause.
Choice D is not practical and may not address the cognitive impairment issue.
Question 2 of 5
A nurse is caring for a client who is well-hydrated and who demonstrates no evidence of anemia. Which of the following laboratory values gives the nurse an assessment of the adequacy of the client’s protein uptake and synthesis?
Correct Answer: D
Rationale: The correct answer is D: Albumin. Albumin is a protein synthesized by the liver and its levels in the blood reflect the body's protein status. In a well-hydrated and non-anemic client, albumin levels can indicate protein uptake and synthesis. Sodium, potassium, and calcium are electrolytes and do not directly reflect protein status.
Therefore, they are incorrect choices in this context.
Question 3 of 5
A nurse is administering a tap water enema to a client who is constipated. During the administration of the enema, the client states he is having abdominal cramps. Which of the following actions should the nurse take to relieve the client's discomfort?
Correct Answer: B
Rationale: The correct answer is B: Lower the height of the solution container. Lowering the height of the solution container will slow down the flow rate of the enema solution, which can help alleviate the abdominal cramps the client is experiencing. This action allows for a more gradual administration of the enema, reducing the discomfort caused by rapid distension of the bowel.
A: Stopping the enema and documenting that the client did not tolerate the procedure does not address the client's discomfort or provide immediate relief.
C: Encouraging the client to bear down may worsen the cramps and should be avoided.
D: Allowing the client to expel some fluid before continuing may not address the root cause of the cramps and may not provide immediate relief.
In summary, lowering the height of the solution container is the best option to relieve the client's discomfort during the administration of the tap water enema.
Question 4 of 5
A patient requests the nurse's help to the bedside commode and becomes frustrated when unable to void in front of the nurse. How should the nurse interpret the patient's inability to void?
Correct Answer: D
Rationale: The correct answer is D: The patient can be anxious, making it difficult for abdominal and perineal muscles to relax enough to void. When a patient is anxious, the sympathetic nervous system is activated, leading to muscle tension and difficulty relaxing. This can affect the ability to void. The frustration expressed by the patient indicates a possible underlying anxiety contributing to the inability to void.
Incorrect options:
A: The patient being lonely and seeking attention does not explain the physiological inability to void.
B: Lack of recognition of physiological signals is unlikely if the patient requested assistance to void.
C: Inadequate fluid intake may lead to decreased urine output but does not explain the inability to void in this specific situation.
Question 5 of 5
A nurse is caring for a client who has impaired renal function. For which of the following findings should the nurse notify the provider?
Correct Answer: A
Rationale:
Correct
Answer: A. The nurse should notify the provider about a urine output of 175 mL in the past 8 hours in a client with impaired renal function. This is indicative of oliguria, which can be a sign of worsening renal function or dehydration. Notifying the provider is important for further assessment and intervention.
B: Cloudy urine after sitting for 6 hours is likely due to sediment or bacteria, not necessarily indicative of renal impairment.
C: Strong odor in first-voided urine is common and not necessarily concerning in the absence of other symptoms.
D: Urine output of 2,200 mL in the past 24 hours is within normal limits and not a cause for concern in this context.