ATI RN
RN-ATI-Fundamentals-of-Nursing-2023-2024 Questions
Extract:
Question 1 of 5
A nurse is assessing an older adult client's risk for falls. Which of the following assessments should the nurse use to identify the client's safety needs? (Select all that apply.)
Correct Answer: B,C,D,E
Rationale: The correct assessments for identifying an older adult client's safety needs are B, C, D, and E. Pupil clarity is important to assess for any visual impairments that may affect balance and mobility. The appearance of bulbar conjunctivae can indicate any eye conditions that might increase fall risk. Evaluating visual fields can detect peripheral vision issues that can impact navigation and safety. Lastly, assessing visual acuity is crucial to determine the client's ability to see clearly and avoid obstacles.
Choices A and F are irrelevant to assessing fall risk in older adults.
Choice G is not provided.
Extract:
Nurses' Notes
1100: Client reports fever, chills, cough, and night sweats for past 2 weeks. Client has recently traveled outside of the country. Lethargic, but oriented to person, place, and time. Crackles heard in lower lobes of lungs upon auscultation. Cough is productive with small amounts of blood. Reports tightness in chest and pain when coughing. Reports losing 5 Ib in the last week. Has no appetite and is nauseated. Obtained blood work, chest x-ray, and sputum cult
Question 2 of 5
The nurse is placing the client on isolation precautions. Which of the following interventions should the nurse include? Select all that apply.
Correct Answer: B
Rationale: The correct answer is B: Place a container for soiled linens inside the client's room. This is essential for infection control as it helps prevent the spread of pathogens. Soiled linens can harbor infectious organisms, so having a designated container inside the room reduces the risk of contamination to other areas. Option A is incorrect because an N95 mask is typically not required for standard isolation precautions. Option C is incorrect as negative airflow rooms are usually reserved for clients with airborne infections. Option D is incorrect because the mask should be removed inside the room to prevent contamination.
Extract:
Question 3 of 5
A nurse is caring for a client who is postoperative and refuses to use an incentive spirometer following major abdominal surgery. Which of the following actions is the nurse's priority?
Correct Answer: B
Rationale: The correct answer is B: Determine the reasons why the client is refusing to use the incentive spirometer. The priority is to understand the client's rationale behind refusal to address any barriers or concerns. This allows for tailored interventions to promote compliance and prevent complications like atelectasis. Requesting a respiratory therapist (
A) may be helpful later, but not the priority. Documenting refusal (
C) is important but doesn't address the root cause. Administering pain medication (
D) is not the priority over addressing the refusal.
Question 4 of 5
A nurse is admitting a client who is hesitant to create advance directives due to concerns about affording legal representation. Which of the following statements should the nurse make?
Correct Answer: B
Rationale: The correct answer is B because advance directives do not require legal representation to be valid. Advance directives are legal documents that allow individuals to specify their medical treatment preferences in advance. They can be signed by the individual without the need for a lawyer. Option A is incorrect because medical care can still be provided even without advance directives. Option C is incorrect as advance directives must be written and signed documents. Option D is incorrect because social workers typically assist with other aspects of care, not legal representation.
Question 5 of 5
A client who is postoperative is verbalizing pain as a 2 on a pain scale of 0 to 10. Which of the following statements should the nurse identify as an indication that the client understands the preoperative teaching she received about pain management?
Correct Answer: C
Rationale: The correct answer is C: "It might help me to listen to music while trying to sleep." This answer indicates that the client understands non-pharmacological pain management strategies taught preoperatively. Music can distract from pain, promote relaxation, and improve sleep quality. Option A suggests misinterpreting the need for more frequent pain medication. Option B distracts from pain temporarily but does not address long-term management. Option D indicates avoidance behavior, which is not a constructive approach to pain management.