ATI RN
ATI Fundamentals Exam Special Unit ADN Questions
Extract:
Question 1 of 5
A nurse is assessing a client's radial pulse and determines that the pulse is irregular. Which of the following actions should the nurse take?
Correct Answer: C
Rationale: Assess the apical pulse for a full minute: When an irregular radial pulse is detected, the most accurate way to assess heart rate and rhythm is by auscultating the apical pulse for a full minute. This helps determine the presence of arrhythmias. Assess the pedal pulses for a full minute: Pedal pulses assess circulation to the lower extremities and are not related to confirming an irregular heart rate. Assess the apical pulse with a Doppler device: A Doppler is not typically necessary to assess the apical pulse unless pulses are difficult to detect due to poor circulation. Assess the pedal pulses with a Doppler device: Checking pedal pulses with a Doppler is useful for assessing circulation in the lower extremities but does not help confirm an irregular heart rate.
Question 2 of 5
A patient who has been taking antihypertensive drugs for a few months states that a new, persistent dry cough is very bothersome. The nurse knows that this cough is an adverse effect of which class of antihypertensive drugs?
Correct Answer: C
Rationale: Angiotensin-converting enzyme (ACE) inhibitors: ACE inhibitors (e.g., lisinopril, enalapril) can cause a persistent dry cough due to the accumulation of bradykinin, a substance that can irritate the airways. Calcium channel blocker: Calcium channel blockers (e.g., amlodipine, diltiazem) do not commonly cause a dry cough. They primarily work by relaxing blood vessels and reducing heart workload. Angiotensin II receptor blocker: ARBs (e.g., losartan, valsartan) do not typically cause a persistent cough. They are often prescribed instead of ACE inhibitors for patients who experience this side effect. Beta-blockers: Beta-blockers (e.g., metoprolol, propranolol) are not commonly associated with a dry cough. They mainly affect heart rate and blood pressure but can cause bronchospasms in some patients.
Question 3 of 5
As part of an annual physical examination, a nurse is preparing a client to undergo a chest x-ray. Which of the following instructions should the nurse give the client prior to the procedure?
Correct Answer: A
Rationale: Remove all metal necklaces: Metal can obscure the x-ray image, so all metal jewelry, piercings, and clothing with metal components should be removed. Take several shallow breaths during the procedure: Patients should take a deep breath and hold it during the x-ray to expand the lungs fully for clearer imaging. Do not eat or drink anything the morning of the test: Fasting is not needed for a chest x-ray; it is typically required for procedures like CT scans with contrast or abdominal ultrasounds. Expect minor discomfort after the procedure: A chest x-ray is non-invasive and painless. There is no expected discomfort afterward.
Question 4 of 5
A patient diagnosed with chronic obstructive pulmonary disease (COPD) asks the nurse why clubbing occurs. Which response by the nurse is the most therapeutic?
Correct Answer: D
Rationale: Your disease doesn't send enough oxygen to your fingertips': Chronic hypoxia in COPD leads to increased capillary growth and tissue changes, resulting in clubbing of the fingers. This response is accurate and appropriately explains the cause. 'Your disease often makes patients lose mental status': While severe hypoxia can cause confusion, this response does not address the reason for clubbing and lacks therapeutic communication. 'Your disease will be helped if you pursed-lip breathe': Pursed-lip breathing helps with air trapping and exhalation in COPD, but it does not explain clubbing of the fingers. 'Your disease affects both your lungs and your heart, and not enough blood is being pumped': COPD primarily affects oxygen exchange in the lungs, not necessarily blood pumping from the heart. Clubbing is due to chronic hypoxia, not poor cardiac output.
Question 5 of 5
Which finding will alert the nurse to a potential wound dehiscence?
Correct Answer: A
Rationale: Report by patient that something has given way: A patient reporting a 'giving way' sensation is a classic early sign of dehiscence, indicating that the wound edges are separating. Drainage that is odorous and purulent: Purulent (pus-like) and foul-smelling drainage suggests infection, not necessarily dehiscence. Infection can contribute to dehiscence, but it is not the defining feature. Protrusion of visceral organs through a wound opening: Evisceration occurs when internal organs protrude through the incision. Dehiscence is partial or complete separation of the wound edges without organ protrusion. Chronic drainage of fluid through the incision site: Persistent drainage suggests a fistula (abnormal connection between tissues), infection, or poor wound healing, rather than wound dehiscence.