ATI RN
RN ATI Fundamentals of Nursing Questions
Question 1 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: B
Rationale: The correct answer is B: WBC count. An elevated white blood cell count indicates the presence of infection as WBCs increase in response to an infection to help fight off pathogens. This is a common sign of infection in patients with pressure ulcers. The other choices (A: RBC count, C: Potassium, D: BUN) are not typically indicators of infection in this context. RBC count is related to anemia, potassium to electrolyte balance, and BUN to kidney function.
Therefore, an elevated WBC count is the most relevant indicator of infection in this scenario.
Question 2 of 5
A nurse is planning care for a client who requires airborne precautions. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct answer is D: Wear an N95 respirator mask. When a client requires airborne precautions, the nurse should wear an N95 respirator mask to protect against inhaling infectious particles. Standing 1.8 m away (
A) does not provide sufficient protection. Allowing the client to ambulate in the hall (
B) can spread the infection. Providing a positive-pressure airflow room (
C) is ideal but not a practical nursing action. Thus, wearing an N95 respirator mask is the most effective measure to prevent transmission.
Question 3 of 5
A nurse is caring for a client who has impaired mobility. Which of the following support devices should the nurse plan to use to prevent the client from developing plantar flexion contractures?
Correct Answer: B
Rationale: The correct answer is B: Footboard. Plantar flexion contractures can occur due to prolonged bed rest. A footboard helps maintain the foot in a neutral position, preventing the toes from pointing downward and the development of contractures. A sheepskin heel pad (
A) provides cushioning but does not address the positioning concern. Trochanter roll (
C) is used for hip abduction, not foot positioning. Abduction pillow (
D) is used to maintain hip abduction, not foot alignment.
Question 4 of 5
A nurse is teaching a client who has constipation. Which of the following should the nurse discuss as causes of constipation?
Correct Answer: B,C,E
Rationale: The correct answers are B, C, and E. Ignoring the urge to defecate can lead to constipation by allowing stool to become harder and more difficult to pass. Inadequate fluid intake can result in dehydration, making stool harder and more challenging to pass. Excessive laxative use can lead to dependence on laxatives for bowel movements, causing constipation when laxatives are not used. Increased fiber in the diet (choice
A) is actually a recommended treatment for constipation as it helps promote regular bowel movements. Increased activity (choice
D) can also help prevent constipation by stimulating bowel movements.
Question 5 of 5
A nurse is assessing a client and discovers the infusion pump with the client's total parenteral nutrition (TPN) solution is not infusing. The nurse should monitor the client for which of the following conditions?
Correct Answer: D
Rationale: The correct answer is D, shakiness and diaphoresis. When a client's TPN solution stops infusing, it can lead to a sudden drop in blood glucose levels, causing symptoms like shakiness and diaphoresis, which are indicative of hypoglycemia. The nurse should monitor for these signs as they can progress to serious complications such as seizures or loss of consciousness.
A: Hypertension and crackles - These symptoms are not directly related to TPN infusion interruption.
B: Fever and chills - These symptoms are more indicative of an infection rather than TPN infusion interruption.
C: Excessive thirst and urination - These symptoms are more suggestive of diabetes or dehydration, not TPN infusion interruption.
D: Shakiness and diaphoresis - Correct, as these are classic signs of hypoglycemia due to TPN interruption.