ATI RN
ATI RN Fundamentals Online Practice 2023 B Questions
Extract:
Vital Signs (Updated)
• 0700 hrs:
o Blood Pressure (BP): 138/72 mm Hg
o Heart rate: 80/min
o Respirations: 22/min
o Temperature: 38.3°C (101.1°F)
o Oxygen saturation: 90% on room air
• 1100 hrs:
o Blood Pressure (BP): 132/68 mm Hg
o Heart rate: 92/min
o Respirations: 24/min
o Temperature: 39.0°C (102.2°F)
o Oxygen saturation: 88% on room air
• 1500 hrs:
o Blood Pressure (BP): 126/64 mm Hg
o Heart rate: 100/min
o Respirations: 26/min
o Temperature: 39.5°C (103.1°F)
o Oxygen saturation: 86% on room air
Nurses' Notes
• 0700 hrs:
o The client is alert but appears fatigued. Complaints of increased shortness of breath over the past 24 hours. The client has a productive cough with thick, yellow sputum. The client reports feeling increasingly weak and dizzy. Mild confusion is noted, with difficulty maintaining focus during the assessment. The client is diaphoretic and has been experiencing chills intermittently. The skin appears flushed and warm to the touch.
• 1100 hrs:
o The client is visibly distressed and reports worsening dyspnea. The cough is now accompanied by greenish, foul- smelling sputum. The client exhibits increased confusion and disorientation. The skin is cool and clammy, with noticeable pallor. Respiratory effort is labored, with audible wheezing and crackles upon auscultation. The client reports persistent nausea and decreased appetite. There is a noticeable increase in fatigue and lethargy.
• 1500 hrs:
o The client is significantly drowsy and difficult to arouse. Respiratory distress is evident, with use of accessory muscles for breathing. The sputum is now blood-tinged and the cough is frequent and severe. The skin is very pale, with a bluish tinge noted around the lips. The client shows signs of hypotension and rapid pulse. There is an overall decline in mental status, with severe confusion and disorientation. The client complains of severe weakness and generalized body aches.
Medical History
• Diabetes mellitus, well-managed with medication
• Chronic obstructive pulmonary disease (COPD)
• History of hypertension
• No known drug allergies
• Recent travel to an area with known respiratory infections
Diagnostic Results
• 0700 hrs:
o Chest X-ray: Mild infiltrates in the lower lobes
o CBC: Elevated white blood cell count (WBC) 12,000/µL
• 1100 hrs:
o Chest X-ray: Progression of infiltrates with more pronounced consolidation
o CBC: Further elevated white blood cell count (WBC) 15,000/µL; Elevated C-reactive protein (CRP)
• 1500 hrs:
o Chest X-ray: Extensive consolidation with possible pleural effusion
o CBC: High white blood cell count (WBC) 18,000/µL; Elevated CRP; Low hemoglobin (Hb)
Provider's Prescriptions
• 0700 hrs:
o Antibiotic therapy initiated: Levofloxacin 500 mg IV every 24 hours
o Oxygen therapy: 2 L/min via nasal cannula
• 1100 hrs:
o Increased oxygen therapy to 4 L/min via nasal cannula
o Addition of nebulized bronchodilators
• 1500 hrs:
o Oxygen therapy increased to 6 L/min via non-rebreather mask
o Initiation of intravenous corticosteroids
Question 1 of 5
A 60-year-old male client is admitted to the medical-surgical unit. The client is experiencing a worsening of symptoms over the last 24 hours. The client's initial presentation was similar to previous days, but his condition has deteriorated.Exhibits:Based on the evolution of the client’s condition and the provided exhibits, select all that apply. Which of the following actions should the nurse include in the client's care plan?
Correct Answer: B,C,D,E,F
Rationale:
Choice A: Implementing airborne precautions is not necessary as the client's symptoms suggest a severe respiratory infection, possibly pneumonia, but not an airborne disease.
Choice B: The client's worsening respiratory distress indicates potential need for intubation and mechanical ventilation to ensure adequate oxygenation.
Choice C: Monitoring blood glucose is important due to the client's diabetes and corticosteroid use, which can elevate glucose levels.
Choice D: Administering prescribed antibiotics like Levofloxacin is critical for treating a likely bacterial infection.
Choice E: Strict hand hygiene is a standard precaution to prevent infection spread.
Choice F: Increasing fluid intake helps thin sputum, aiding respiratory function.
Choice G: There is no indication for chest tube insertion as the pleural effusion is not significant enough.
Extract:
A nurse is preparing to insert a peripheral IV catheter for an older adult client.
Question 2 of 5
Which action should the nurse plan to take?
Correct Answer: B
Rationale: Positioning the client's arm in a dependent position can help engorge the veins, making it easier to insert the IV catheter.
Extract:
A nurse is providing discharge instructions to a patient who will be using a walker.
Question 3 of 5
Which of the following statements by the patient indicates that the teaching has been effective?
Correct Answer: B
Rationale: Hiring someone to trim the tree that overhangs the front porch stairs indicates an understanding of the need to remove potential obstacles that could interfere with the safe use of the walker.
Extract:
A client with herpes zoster is inquiring about the use of complementary and alternative therapies for pain management.
Question 4 of 5
Which therapy should the nurse inform the client is contraindicated for their condition?
Correct Answer: D
Rationale: Acupuncture involves the insertion of thin needles into specific points on the body. It is contraindicated for a client with herpes zoster because it could potentially open a portal on the skin's surface.
Extract:
A nurse is providing discharge instructions to a patient who has a new prescription for a home oxygen concentrator.
Question 5 of 5
Which of the following instructions should the nurse provide to the patient and their family?
Correct Answer: A,B,C,D
Rationale:
Choice A: Inspecting the cord prevents electrical hazards.
Choice B: Keeping the unit away from stoves reduces fire risk.
Choice C: A generator ensures continuous oxygen supply.
Choice D: Monitoring for hypoxia ensures patient safety.
Choice E: Synthetic materials increase fire risk and are not recommended.