ATI RN
ATI Nurs 104 Fundamentals Quiz Questions
Question 1 of 5
A nurse is caring for an older adult client who is at risk for skin breakdown. Which of the following interventions should the nurse use to help maintain the integrity of the client's skin?
Correct Answer: A
Rationale: The correct answer is A: Provide the client with a diet high in protein. Protein is essential for skin health as it helps in tissue repair and regeneration, aiding in maintaining skin integrity. Adequate protein intake can also help prevent skin breakdown in older adults.
- Option B is incorrect as massaging bony prominences can actually cause skin breakdown in at-risk individuals.
- Option C is incorrect because repositioning every 2 hours is the standard of care to prevent skin breakdown, not every 3 hours.
- Option D is incorrect as applying cornstarch can lead to moisture accumulation, increasing the risk of skin breakdown.
Question 2 of 5
A nurse is reviewing the laboratory results of a client who has a pressure ulcer. The nurse should identify an elevation in which of the following laboratory values as an indication that the client has developed an infection?
Correct Answer: A
Rationale: The correct answer is A: WBC count. An elevated WBC count is indicative of an infection as white blood cells increase in response to an infection, helping to fight off pathogens. The other choices, BUN, Potassium, and RBC count, are not specific indicators of infection. BUN measures kidney function, Potassium levels relate to electrolyte balance, and RBC count assesses oxygen-carrying capacity. Only an elevated WBC count directly points towards an infection.
Question 3 of 5
A nurse is measuring a client's oral temperature. The client informs the nurse that he has just eaten some ice chips. Which of the following actions should the nurse take?
Correct Answer: B
Rationale: The correct answer is B: Wait 30 min and return to measure the oral temperature. After consuming ice chips, the client's oral temperature may be temporarily affected, leading to inaccurate readings. Waiting for 30 minutes allows the oral cavity to return to a more stable temperature, providing a more accurate measurement.
A: Documenting inability to measure the temperature is premature as waiting is a better option.
C: Proceeding to measure the temperature immediately may result in inaccurate readings.
D: Providing warm water may help normalize the oral cavity temperature, but waiting is still necessary for accurate results.
Question 4 of 5
A nurse is preparing to collect health history data during a client's admission. Which of the following questions should the nurse use to promote this discussion?
Correct Answer: B
Rationale: The correct answer is B: "What brought you to the hospital?" This question is open-ended and allows the client to share the reason for their admission, leading to a more detailed health history discussion. It helps the nurse understand the client's current health status and the context of their hospital visit.
Incorrect answers:
A: This question is more focused on feelings rather than specific health issues.
C: Asking about all medical issues may be overwhelming and not focused on the current reason for admission.
D: While this question addresses health concerns, it is not as specific as asking about the reason for hospitalization.
Question 5 of 5
Preventive measures such as immunizations and water fluoridation are examples of which type of prevention?
Correct Answer: D
Rationale: The correct answer is D: Primary prevention. Primary prevention aims to prevent disease before it occurs by addressing underlying causes and risk factors. Immunizations and water fluoridation fall under this category as they target the root causes of diseases to prevent them from developing. Quaternary prevention (
A) focuses on avoiding unnecessary medical interventions, tertiary prevention (
B) aims to prevent complications and manage existing conditions, and secondary prevention (
C) involves early detection and treatment to halt disease progression. In this scenario, primary prevention is the most appropriate choice as it aligns with the proactive nature of immunizations and water fluoridation.