ATI RN
ATI Nsg 131 Fundamentals Exam Questions
Extract:
Question 1 of 5
A nurse is caring for a client who is unconscious and has a breathing pattern characterized by alternating periods of hyperventilation and apnea. The nurse should document that the client has which of the following respiratory alterations?
Correct Answer: D
Rationale: Cheyne-Stokes respirations involve alternating hyperventilation and apnea, fitting the described pattern.
Question 2 of 5
A nurse is using the communication principle of presence when establishing a collaborative relationship with a client. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: Attentive listening demonstrates presence, fostering a collaborative relationship.
Question 3 of 5
A nurse is planning care for a client who has a decreased level of consciousness. The client is receiving continuous enteral feedings via a gastrostomy tube due to an inability to swallow. Which of the following is the priority action by the nurse?
Correct Answer: C
Rationale: Elevating the bed 30° to 45° reduces aspiration risk, a priority for unconscious clients.
Question 4 of 5
A nurse is preparing to measure a client's level of oxygen saturation and observes edema of both hands and thickened toenails. The nurse should apply the pulse oximeter probe to which of the following locations?
Correct Answer: D
Rationale: The earlobe is suitable for pulse oximetry when fingers and toes are compromised by edema or thickened nails.
Question 5 of 5
A nurse is caring for a client who is immobile. Which of the following actions is the priority for the nurse to include in the client's plan of care?
Correct Answer: B
Rationale: Auscultating breath sounds every 2 hours monitors for respiratory compromise, a priority in immobile clients.