ATI RN
ATI RN Fundamentals 2023 I Questions
Extract:
Question 1 of 5
A nurse in a mental health clinic is caring for an older adult client who has depression and has stopped taking their medication. The client tells the nurse, 'I want to die now that my partner is gone.' Which of the following responses should the nurse make?
Correct Answer: B
Rationale:
Correct Answer: B
Rationale:
1. The nurse must assess the client's risk for self-harm or suicide, as the client expressed a desire to die.
2. Asking directly about self-harm opens the conversation and allows the nurse to assess the severity of the client's thoughts.
3. This response shows the nurse's concern for the client's safety and well-being.
4. It initiates a crucial dialogue to determine the appropriate level of intervention needed for the client's safety.
Summary of other choices:
A: Asking about the partner may divert the conversation and miss addressing the immediate risk of self-harm.
C: While discussing feelings with a provider is important, the urgency of the situation requires immediate assessment by the nurse.
D: Inquiring about medication adherence is relevant but not the priority when the client expresses suicidal ideation.
Question 2 of 5
A nurse is teaching a client how to self-administer heparin. Which of the following instructions should the nurse include in the teaching?
Correct Answer: B
Rationale: The correct answer is B: Inject 5.1 cm (2 in) away from the umbilicus. This instruction is crucial to prevent any potential bruising or irritation at the injection site. Injecting too close to the umbilicus can lead to discomfort and complications. Option A is incorrect as a smaller gauge needle is recommended for heparin injections to minimize tissue trauma. Option C is incorrect as air bubbles should be removed to prevent air embolism, not specifically related to heparin administration. Option D is incorrect as massaging the injection site can cause bruising and should be avoided.
Question 3 of 5
A nurse is teaching a client who can only bear weight on one leg how to ambulate using crutches. Which of the following statements nurse plan to instruct the client to use?
Correct Answer: B
Rationale: The correct answer is B: Three-point gait. This gait technique is suitable for a client who can only bear weight on one leg as it involves bearing weight on both crutches and the unaffected leg while the affected leg remains non-weight bearing. The swing-through gait (
A) involves both legs swinging through together, which may not be feasible for a client with weight-bearing restrictions. The four-point alternating gait (
C) and two-point alternating gait (
D) require partial weight-bearing on both legs, which is not suitable for this client.
Question 4 of 5
A nurse is preparing to teach a female client about osteoporosis prevention. Which of the following recommendations should the nurse make for this client?
Correct Answer: A
Rationale: The correct answer is A: Walk for 30 minutes three to five times each week. Walking is a weight-bearing exercise that helps prevent osteoporosis by strengthening bones. Weight-bearing exercises stimulate bone formation and slow down bone loss. Walking for 30 minutes three to five times a week helps improve bone density and reduce the risk of fractures. Performing water aerobics (choice
B) is beneficial for overall fitness but may not have the same impact on bone density as weight-bearing exercises. Maintaining a lean body mass (choice
C) is important for overall health but does not specifically target osteoporosis prevention. Increasing intake of vitamin B12 (choice
D) is important for nerve function and red blood cell production but is not directly related to osteoporosis prevention.
Question 5 of 5
A nurse is caring for a client who had a stroke and coughs frequently when swallowing. The nurse should identify that which of following members of the interdisciplinary team?
Correct Answer: D
Rationale: The correct answer is D: Speech-language pathologist. The speech-language pathologist specializes in evaluating and treating swallowing difficulties (dysphagia) following a stroke. They can help the client with exercises and strategies to improve swallowing function and prevent complications like aspiration pneumonia. The other options are incorrect because:
A) An occupational therapist focuses on helping with activities of daily living;
B) A physical therapist assists with mobility and strength training;
C) A social worker provides emotional support and resources.