ATI RN Fundamentals 2023 Exam 3

Extract:

Question 1 of 5

A nurse is caring for a client who is 6 hr postoperative following abdominal surgery and is having difficulty voiding. Which of the following actions should the nurse take?

A. Allow the client to hear running water while attempting to void.B. Provide the client a bedpan while lying supine.C. Encourage fluid intake up to 1,000 mL daily.D. Insert an indwelling urinary catheter and connect it to gravity drainage.

Correct Answer: C

Rationale: Encouraging fluids (
C) promotes urine output, addressing retention non-invasively first. Running water (
A) helps some, supine (
B) hinders voiding, and catheterization (
D) is a last resort.

Question 2 of 5

A nurse is administering an intramuscular injection to a client using the Z-track method. Which of the following actions should the nurse take?

A. Release the skin before withdrawing the needle.B. Insert at a 45° angle.C. Withdraw the needle quickly.D. Pull the skin laterally.

Correct Answer: D

Rationale: Pulling skin laterally (
D) in Z-track seals medication in muscle, preventing leakage. Releasing early (
A) negates this, 45° (
B) is too shallow (90° typical), and quick withdrawal (
C) risks leakage.

Question 3 of 5

A nurse is preparing to administer prescribed medications to a client. According to the rights of medication administration, when should the nurse compare the medication administration record against the medication container? (Select all that apply.)

A. When documenting the medication administrationB. Before selecting the medication containerC. While removing medication from the containerD. When providing client education about the medicationE. At the client's bedside before administering the medication

Correct Answer: B,C,E

Rationale: Comparing the MAR with the container before selecting (
B), while removing (
C), and at bedside (E) ensures accuracy (right drug, dose, patient). Documentation (
A) follows, and education (
D) doesn’t require this step.

Question 4 of 5

A nurse is assessing a client who received morphine for severe pain 30 min ago. Which of the following findings is the nurse's priority?

A. Respiratory rate 7/minB. Distended bladderC. Last bowel movement was 3 days agoD. Reports pain of 8 on a scale from 0 to 10

Correct Answer: A

Rationale: Respiratory rate 7/min (
A) indicates opioid-induced respiratory depression, a life-threatening priority per ABCs. Bladder (
B), constipation (
C), and pain (
D) are less urgent.

Question 5 of 5

A staff nurse is teaching a newly hired nurse how to complete an informed consent document for a client. The staff nurse should include that the nurse's signature on the form confirms which of the following requirements? (Select all that apply)

A. The client signed in the nurse's presenceB. The client has legal authority to do soC. The client does not have a mental health conditionD. The client was not coercedE. The client speaks the same language as the nurse

Correct Answer: A,B,D

Rationale: The nurse’s signature verifies witnessing the signing (
A), legal capacity (
B), and no coercion (
D). Mental health (
C) isn’t confirmed, and language (E) isn’t required.

ATI RN Fundamentals 2023 Exam 3 | Nurselytic

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ATI RN

ATI RN