ATI RN
ATI Fundamentals 2023 Retake Questions
Extract:
Question 1 of 5
A nurse is admitting a client who is at risk for falls to a medical-surgical unit. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct answer is A: Provide the client with a night light. This is important for fall prevention as it helps the client see clearly at night, reducing the risk of tripping or falling in the dark. Night lights can improve visibility and safety without disrupting sleep.
Choice B could potentially restrict the client's movement and increase the risk of entrapment.
Choice C does not directly address fall prevention.
Choice D focuses on room temperature, which is not directly related to fall risk.
Question 2 of 5
A nurse in an emergency department is caring for a client who is unconscious and requires surgery. There is no one available to give consent for the treatment. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct answer is D: Prepare the client for surgery. In emergency situations where a client is unconscious and immediate surgery is necessary, the principle of implied consent applies. The nurse should prioritize the client's well-being by preparing them for surgery to save their life or prevent further harm. Contacting the ethics committee (
A) or waiting for a family member (
B) could cause a dangerous delay. Obtaining consent from the surgeon (
C) is not appropriate as the surgeon's role is to perform the procedure, not provide consent. Thus, preparing the client for surgery is the most ethical and appropriate action in this scenario.
Question 3 of 5
A nurse is caring for a client who has dysphagia. When assisting the client during breakfast, which of the following actions by the client indicates the nurse should intervene?
Correct Answer: A
Rationale:
Correct Answer: A. The client drinking thickened juice with a straw should prompt intervention by the nurse. Thickened liquids are often recommended for clients with dysphagia to prevent aspiration. Using a straw with thickened liquids can alter the consistency and may increase the risk of aspiration. This action is potentially harmful to the client's safety and should be corrected immediately.
Summary:
B: Tucking the chin when swallowing is a proper technique to help prevent aspiration, so this action does not require intervention.
C: Taking frequent breaks while eating is a common strategy for individuals with dysphagia to pace themselves and reduce the risk of aspiration.
D: Adjusting the head of the bed to 90° is a recommended position to facilitate safe swallowing and reduce the risk of aspiration.
Question 4 of 5
A nurse is teaching an older adult client about reducing the risk for osteoporosis. Which of the following statements by the client indicates an understanding of the teaching?
Correct Answer: C
Rationale: The correct answer is C: "I will walk three times per week." Walking is weight-bearing exercise, which helps build bone density and reduce the risk of osteoporosis. This statement shows understanding of the importance of physical activity in preventing osteoporosis.
Choice A is incorrect because the recommended daily calcium intake for older adults is higher than 250mg.
Choice B is incorrect because dairy products are a good source of calcium, essential for bone health.
Choice D is incorrect because sun exposure is needed for vitamin D synthesis, which is important for calcium absorption.
Question 5 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 crutch gaits should the nurse plan to instruct the client to use?
Correct Answer: A
Rationale: The correct answer is A: Three-point gait. This gait is appropriate for a client who can only bear weight on one leg as it involves bearing weight on one leg while advancing both crutches forward, then advancing the unaffected leg forward. This gait provides maximum stability and support for the client.
B: Two-point alternating gait involves bearing weight on both legs alternately, which may not be suitable for a client who can only bear weight on one leg.
C: Four-point alternating gait involves bearing weight on both legs and crutches in a coordinated manner, which may be too complex for a client with limited weight-bearing ability.
D: Swing-through gait involves swinging both legs forward simultaneously, which is not suitable for a client who can only bear weight on one leg.
Therefore, the three-point gait is the most appropriate choice for this client.