ATI RN
ATI RN Fundamentals 2023 I Questions
Extract:
Question 1 of 5
A nurse is caring for a client who has dysphagia. When assisting the client during breakfast, which of the following actions by the client indicates the nurse should intervene?
Correct Answer: B
Rationale: The correct answer is B. When a client has dysphagia, drinking thickened liquids with a straw can increase the risk of aspiration because the liquid may move too quickly through the straw. This can lead to choking or aspiration pneumonia.
Choices A, C, and D are all appropriate actions for a client with dysphagia. Adjusting the bed to 90° helps with swallowing, tucking the chin can prevent aspiration, and taking breaks while eating can reduce the risk of choking.
Question 2 of 5
A home health nurse is teaching a client about home safety. Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply.)
Correct Answer: A,B,E
Rationale:
Correct Answer: A, B, E
Rationale:
A: Using grab bars in the bathtub prevents slips and falls, promoting safety.
B: Having a fire escape plan ensures preparedness in case of emergencies.
E: Checking medication expiration dates maintains their effectiveness and prevents harm.
Incorrect
Choices:
C: Setting the hot water heater to 140°F can scald and cause burns.
D: Applying tape to frayed electrical cords is a fire hazard and can lead to electrocution.
Question 3 of 5
A charge nurse is observing a staff nurse performing a wound irrigation for a client who has a pressure injury. Which of the following actions by the staff nurse indicates an understanding of the procedure?
Correct Answer: B
Rationale: The correct answer is B because using a syringe with a catheter for wound irrigation allows for controlled and directed flow of the irrigation solution into the wound, ensuring effective cleansing and minimizing contamination. This method helps prevent trauma to the wound and surrounding tissues.
A: Using one pair of gloves for dressing removal and irrigation increases the risk of cross-contamination.
C: Administering an analgesic medication before irrigation is not a standard practice and does not demonstrate understanding of the procedure.
D: Refrigerating the solution before irrigation is unnecessary and may cause discomfort to the client.
In summary, choice B is correct as it aligns with best practices for wound irrigation, while the other choices do not demonstrate a proper understanding of the procedure.
Question 4 of 5
A nurse is providing discharge teaching about safety considerations to an older adult client who lives at home. The client has heart failure and a new prescription for hydrochlorothiazide. Which of the following statements by the client indicates an understanding of the teaching?
Correct Answer: D
Rationale: The correct answer is D: "I will leave a light on in my bathroom at night." This statement indicates an understanding of the teaching because older adults with heart failure who take hydrochlorothiazide may experience nocturia, which can increase the risk of falls at night due to frequent trips to the bathroom. Leaving a light on in the bathroom at night can help the client navigate safely.
Choice A is incorrect because weighing once weekly does not address the safety concern related to nocturia.
Choice B is incorrect as taking the medication in the evening is not directly related to safety considerations.
Choice C is incorrect because taking a hot bath before bed may exacerbate heart failure symptoms.
Question 5 of 5
A nurse is caring for a client who is postoperative and is on bed rest. Which of the following actions should the nurse take to decrease the client’s risk of developing a pressure injury?
Correct Answer: C
Rationale: The correct answer is C: Ensure the client’s heels are not touching the mattress. This is important because pressure injuries commonly occur on bony prominences, such as the heels, due to prolonged pressure and friction. By ensuring the client’s heels are elevated off the mattress, the nurse can reduce the risk of pressure injury development in this area. Repositioning the client every 4 hours (choice
A) is important but may not specifically address the risk of pressure injury on the heels. Raising the head of the client’s bed to a 60° angle (choice
B) is more related to preventing aspiration in a postoperative client than preventing pressure injuries. Massaging the client’s bony prominences (choice
D) can actually increase the risk of skin breakdown due to friction and shearing forces.