ATI RN
ATI RN Fundamentals 2019 with NGN Questions
Extract:
Question 1 of 5
A home health nurse is teaching a client about home safety. Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply.)
Correct Answer: C,D,E
Rationale: Having a fire escape plan, using grab bars, and checking medication expiration dates are correct safety measures. Setting the water heater to 140°F risks scalding (120°F is recommended), and taping frayed cords is unsafe; they should be replaced. Installing a motion-sensor light enhances safety but is not listed as a required measure here.
Question 2 of 5
A nurse is caring for a client who is restrained to each extremity. Which of the following assessments should the nurse perform first?
Correct Answer: D
Rationale: Assessing peripheral pulses first ensures that restraints are not compromising circulation, which could lead to tissue damage. Elimination, comfort, skin integrity, and respiratory status are important but secondary to circulation.
Question 3 of 5
When preparing medication from a vial for a subcutaneous injection for a client, which of the following actions should the nurse take?
Correct Answer: B
Rationale: Holding the vial with the top upward while injecting air maintains pressure and prevents fluid leakage. Bubbles at the plunger are not relevant, injecting air with the needle in fluid risks contamination, and a 45° angle is for injection, not dosage verification. A filter needle is used for ampules, not vials.
Question 4 of 5
A nurse is caring for a client who is receiving continuous enteral feeding via NG tube. Which of the following is an unexpected finding?
Correct Answer: A
Rationale: A gastric residual of 300 mL at the end of the shift is unexpected, as residuals exceeding 500 mL every 6 hours may indicate poor gastric emptying or intolerance to feeding, requiring further assessment. Weight gain is expected, a blood glucose level of 110 mg/dL is normal, and one episode of diarrhea is not uncommon with enteral feeding. Abdominal distension would be unexpected but is not listed as a finding here.
Question 5 of 5
A nurse is reviewing the medical record of a newly admitted client. Which of the following laboratory values should the nurse report to the provider?
Correct Answer: A
Rationale: Potassium 5.8 mEq/L is above the normal range (3.6–5.2 mEq/L) and indicates hyperkalemia, which can cause cardiac arrhythmias and requires immediate reporting. Sodium (135–145 mEq/L), magnesium (1.7–2.2 mEq/L), and calcium (8.5–10.2 mg/dL) values are within normal ranges. Glucose 110 mg/dL is normal and does not require reporting.