ATI RN
ATI Fundamentals Assessment Exam Midterm Questions
Extract:
Question 1 of 5
A nurse is assessing a client who has a pressure ulcer. The nurse should recognize which of the following findings is a manifestation of a stage 3 pressure ulcer?
Correct Answer: B
Rationale: The correct answer is B: Skin loss involving up to the subcutaneous tissue (fat). In a stage 3 pressure ulcer, the skin is completely lost, exposing the subcutaneous tissue. This stage indicates significant tissue damage and requires immediate attention to prevent further complications.
A: Reddened intact skin is characteristic of a stage 1 pressure ulcer.
C: Skin loss involving up to the dermis layer is indicative of a stage 2 pressure ulcer.
D: Exposed bone is a manifestation of a stage 4 pressure ulcer, where tissue damage extends to the bone.
Question 2 of 5
A nurse is assessing a client who has myxedema. Which of the following findings should the nurse expect?
Correct Answer: C
Rationale: The correct answer is C: Facial edema. Myxedema is a severe form of hypothyroidism characterized by facial edema, especially around the eyes and cheeks. This occurs due to the accumulation of mucopolysaccharides in the skin and other tissues. Tachycardia (choice
A) is more commonly associated with hyperthyroidism. Diarrhea (choice
B) and heat intolerance (choice
D) are also more indicative of hyperthyroidism. In summary, the presence of facial edema in a client with myxedema is a hallmark sign due to the underlying pathophysiology of the condition.
Question 3 of 5
A Drug Rehabilitation nurse is conducting the health history. When would be the most natural time to ask the client about alcohol use?
Correct Answer: B
Rationale: The correct answer is B: After asking about cigarette smoking. This is the most appropriate time to ask about alcohol use because both alcohol and cigarette smoking are common substances of abuse, and asking about one may prompt the client to disclose information about the other. It is essential to discuss substance use early in the health history to assess the client's overall health risks accurately. Asking about alcohol use after discussing reactions to allergens (
A), reviewing current medications (
C), or asking about previous surgeries (
D) would not be as relevant or conducive to obtaining comprehensive information on substance abuse.
Question 4 of 5
Which of the following should the nurse do before conducting a physical examination of a client? (Select all that apply)
Correct Answer: A,C,D
Rationale: The correct answers are A, C, and D. A nurse should first obtain and check the needed equipment to ensure a smooth examination process. Identifying ways to ensure client privacy is crucial for maintaining confidentiality and trust. Washing hands is essential to prevent the spread of infection. Turning on relaxing music (
B) and dimming the lighting (E) are subjective and may not be appropriate for every client. In summary, A, C, and D are necessary steps to ensure safety, privacy, and professionalism during a physical examination.
Question 5 of 5
The nurse is planning to instruct a group of adolescents on ways to prevent traumatic brain injuries. What should be included in these instructions?
Correct Answer: A,B,C,D
Rationale: The correct answer includes wearing nonslip shoes to prevent falls, supervision when using guns to prevent firearm-related injuries, using seat belts to prevent head injuries in car accidents, and avoiding risky activities like snowboarding to prevent head trauma. Each option addresses a different aspect of preventing traumatic brain injuries in adolescents, covering a range of potential risks and providing comprehensive safety measures.
Choices E, F, and G are left blank as they do not offer specific preventive measures relevant to traumatic brain injuries in adolescents.