ATI RN
ATI RN Fundamentals 2023 I Questions
Extract:
Question 1 of 5
A nurse is caring for a client who has a colostomy. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: A pouch 1/8 inch larger than the stoma prevents irritation and ensures a secure fit. Damp skin barriers reduce adhesion, daily changes may irritate skin, and rubbing can damage peristomal skin—patting dry is preferred.
Question 2 of 5
A nurse is teaching a client how to self-administer heparin. Which of the following instructions should the nurse include in the teaching?
Correct Answer: B
Rationale: Injecting 2 inches from the umbilicus avoids vascular areas, reducing bleeding risk. An 18-gauge needle is too large (25-27 gauge is standard), air bubbles in prefilled syringes ensure full dosing, and massaging increases bruising risk due to heparin’s anticoagulant effect.
Question 3 of 5
A nurse is providing teaching to a client about reducing the adverse effects of immobility. Which of the following statements by the client indicates an understanding of the teaching?
Correct Answer: B
Rationale: Hourly ankle and knee exercises prevent muscle atrophy, contractures, and thromboembolism by promoting circulation and mobility. Removing stockings reduces DVT protection, holding breath risks hypotension, and 4-hour repositioning is too infrequent—every 2 hours is standard.
Question 4 of 5
A nurse is planning care for a client who has a prescription for extremity restraints to both wrists. Which of the following actions should the nurse include in the plan of care? (Select all that apply.)
Correct Answer: A,B,D
Rationale: A: Low bed prevents falls. B: Assessing skin ensures circulation. D: Padding prevents pressure injuries. C: Bed rails risk injury—use bed frame. E: Three fingers is too loose—two is standard.
Question 5 of 5
A nurse is planning to administer insulin to a client who has type 1 diabetes mellitus, what action should the nurse perform first?
Correct Answer: C
Rationale: Verifying the dose with another nurse ensures accuracy, preventing errors in this high-risk medication. Administering, using a filter needle, or mixing come after confirmation.