ATI Nur 231 Fundamentals Exam | Nurselytic

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ATI Nur 231 Fundamentals Exam Questions

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Question 1 of 5

A nurse is assessing a client who has a wrist restraint applied. For which of the following findings should the nurse loosen the restraint?

Correct Answer: C

Rationale: The correct answer is C: The client's hand is cool and pale. If the client's hand is cool and pale, it may indicate poor circulation due to the restraint being too tight. Loosening the restraint is necessary to prevent impaired blood flow and potential tissue damage. A: The client attempting to remove the restraint is not a direct indication of the need to loosen it. B: Having full range of motion in the wrist is unrelated to the need to loosen the restraint. D: Capillary refill time less than 2 seconds is a sign of good circulation, so loosening the restraint is not necessary in this case.

Question 2 of 5

Correct Answer:

Rationale:

Question 3 of 5

Correct Answer:

Rationale:

Question 4 of 5

Correct Answer:

Rationale:

Question 5 of 5

Correct Answer:

Rationale:

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A nurse is assessing a client who has a wrist restraint applied. For which of the following findings should the nurse loosen the restraint?

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