ATI RN
ATI Fundamentals Quiz Questions
Extract:
Question 1 of 5
A nurse is caring for a client who has a tracheostomy. Which of the following interventions should the nurse implement when performing tracheostomy care?
Correct Answer: A
Rationale:
Correct
Answer: A - Secure new tracheostomy ties before removing old ones.
Rationale: By securing new tracheostomy ties before removing old ones, the nurse ensures that the tracheostomy tube remains in place and prevents accidental dislodgment. This step is crucial to maintain the client's airway patency and prevent complications.
Summary of other choices:
B: Using aseptic technique is important in tracheostomy care, but it is not directly related to securing tracheostomy ties.
C: Applying suction when inserting the catheter is incorrect as it increases the risk of trauma and should not be done during routine tracheostomy care.
D: Cleaning the inner cannula with mild soap and water is a part of tracheostomy care, but it is not directly related to securing tracheostomy ties.
Question 2 of 5
A nurse is providing skin care for a client who has urinary incontinence. Which of the following actions should the nurse take?
Correct Answer: C
Rationale: The correct answer is C: Apply a barrier cream to the client's skin. This is the correct action because barrier creams help protect the skin from moisture and irritation caused by urinary incontinence. Applying a barrier cream forms a protective layer on the skin, preventing breakdown and promoting healing.
Choice A is incorrect as friction can further damage the skin.
Choice B is incorrect as soap can be drying and irritating to the skin.
Choice D is incorrect as hot water can also be drying and damaging to the skin.
Question 3 of 5
A nurse is caring for a client who has respiratory alkalosis and is hyperventilating. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct action is to have the client breathe into a paper bag. When a client is hyperventilating with respiratory alkalosis, they are blowing off too much CO2, causing their blood pH to rise. Breathing into a paper bag helps the client re-breathe some of the exhaled CO2, which can help normalize their blood pH levels by increasing CO2 levels. Administering insulin (
Choice
B) is not indicated for respiratory alkalosis. Administering sodium bicarbonate (
Choice
C) would worsen the alkalosis. Having the client place their head between their knees (
Choice
D) would not address the underlying issue of respiratory alkalosis.
Extract:
Nurses' Notes
Client admitted to the emergency department with palpitations, fatigue, weakness, and nocturia.
Client reports awakening 2 to 3 times each night to urinate.
Breath sounds scattered crackles heard bilaterally.
Client reports a dry, hacking cough, especially at night.
Apical heart rate rapid and irregular. Audible 5, gallop.
Color pale, skin cool and clammy to touch.
Vital Signs
Temperature 38.6° C (101.5° F)
Blood pressure 98/50 mm Hg
Pulse rate 112/min
Respiratory rate 28/min
Oxygen saturation 88% on room air
Diagnostic Results
B-type natriuretic peptide (BPN) 410 pg/mL (less than 100 pg/mL) Electrocardiogram: Atrial fibrillation
Question 4 of 5
A nurse in the emergency department is caring for a client. Exhibit 1: Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.
Action to Take
Potential Condition
Parameter to Monitor
Correct Answer:
Rationale: Action to Take: Administer supplemental oxygen, Prepare to administer bronchodilator; Potential Condition: Asthma; Parameter to Monitor: Pulmonary function tests, Neurological Status.
Rationale:
1. Administering supplemental oxygen and preparing to administer a bronchodilator are appropriate actions for managing an asthma exacerbation.
2. Asthma is the most likely condition based on the symptoms described (wheezing, shortness of breath).
3. Monitoring pulmonary function tests can assess the client's lung function, and monitoring neurological status can help detect any complications or changes in mental status.
4. The other choices (Pulmonary embolism, Dehydration, Left-sided heart failure) do not align with the given symptoms and actions, making them incorrect options.
Extract:
Vital Signs
1500:
Heart rate 52/min
Respiratory rate 28/min)
Blood pressure 74/50 mm Hg
Temperature 36.1° C (97° F)
Sa02 90% on 2 L/min via nasal cannula
Nurses Notes
1515:
Client arrived at the ED via ambulance. Emergency medical technicians (EMTS) state the client fainted at place of employment while walking down a flight of stairs. Client fell and rolled down several steps. Coworkers called for an ambulance. Client was awake upon EMTs arrival. Client oriented to person, place, time, but appears lethargic. Reports dizziness and headache. No injury noted from fall. Client states, "I think I just haven't eaten enough today. That must be why I passed out." Client states they have passed out numerous times in the past month. Reports only eating one meal a day for the past few months because they have been "dieting"
Client is thin and appears emaciated with diminished muscle mass.
Skin is cold, dry, poor turgor, mottled with bluish tint to extremities Lanugo present to arms
S1 S2 heard on auscultation, peripheral pulses weak
Respirations rapid, labored. Client reports feeling short of breath. Chest clear on auscultation.
Bowel sounds hypoactive x 4 quadrants. Cannot recall last bowel movement. States “I’ve been constipated lately.”
Reports no difficulty with urination. Urine obtained for urinalysis and is dark, concentrated.
Question 5 of 5
A nurse in the emergency department (ED) is caring for a client. Laboratory Results Exhibits: Complete the following sentence by using the list of options.The nurse should first address the client------------- followed by the client ----------------
Correct Answer: B,A
Rationale: Action to Take: B, A; Potential Condition: Hypotension; Parameter to Monitor: Urine output, Oxygen saturation.
Rationale: The correct actions to take first would be addressing the client's blood pressure (
B) as hypotension can be life-threatening in an emergency setting. This should be followed by addressing the client's oxygenation (
A) as inadequate oxygenation can also lead to serious complications. Monitoring the client's urine output is crucial to assess renal function in response to hemodynamic changes, and monitoring oxygen saturation helps ensure adequate tissue oxygenation. Addressing the other choices would be important too, but not as immediate and critical in this scenario.