ATI RN
ATI RN Fundamentals 2023 Questions
Extract:
Question 1 of 5
A nurse is caring for a client who requires airborne precautions. The nurse is preparing to leave the client's room following a dressing change. Which of the following pieces of personal protective equipment should the nurse remove first?
Correct Answer: C
Rationale: The correct answer is C: Gloves. The nurse should remove gloves first after a dressing change to prevent contamination of other surfaces. Gloves are the primary barrier protecting the nurse from direct contact with bodily fluids. Removing gloves first helps minimize the risk of spreading pathogens. Removing eyewear, mask, or gown first could potentially expose the nurse to airborne pathogens or splash contamination. Removing the mask or gown first could also lead to contamination of the nurse's face or clothing. Removing gloves first ensures proper infection control practices are followed.
Question 2 of 5
A nurse is teaching a client who can only bear weight on one leg how to ambulate using crutches. Which of the following crutch gaits should the nurse plan to instruct the client to use?
Correct Answer: D
Rationale: The correct answer is D: Three-point gait. This gait is suitable for a client who can only bear weight on one leg. In a three-point gait, the client advances both crutches and the affected leg together followed by the unaffected leg. This maintains stability and minimizes weight-bearing on the affected leg. The other choices are incorrect because:
A: Two-point alternating gait requires partial weight-bearing on both legs.
B: Four-point alternating gait involves slow and stable movement, not ideal for a client with weight-bearing restrictions on one leg.
C: Swing-through gait involves both legs swinging through, which is not suitable for a client with weight-bearing restrictions on one leg.
Question 3 of 5
A nurse is caring for a client who is anxious about being admitted to a health care facility for the first time. Which of the following statements should the nurse make?
Correct Answer: D
Rationale: The correct answer is D: "We can discuss what you can expect during your stay." This response acknowledges the client's anxiety and offers support by providing information. It empowers the client by involving them in the discussion and helps alleviate fear of the unknown.
Choice A dismisses the client's feelings and lacks empathy.
Choice B generalizes and may not address the client's specific concerns.
Choice C may come off as confrontational and put the client on the spot.
Question 4 of 5
A nurse is preparing to perform an anthropometric assessment on a client. Which of the following client data should the nurse include?
Correct Answer: B
Rationale: The correct answer is B: Weight. Anthropometric assessment involves measuring the client's body composition, which includes weight. Weight provides important information about the client's nutritional status and overall health. Respiratory rate (
A) is part of a vital signs assessment, not anthropometric assessment. Level of orientation (
C) and current pain level (
D) are important for assessing mental status and pain management, respectively, but they are not part of anthropometric assessment.
Question 5 of 5
A nurse is collecting a blood pressure (BP) reading from a client who is sitting in a chair. The nurse determines that the client's BP is 158/96 mm Hg. Which of the following actions should the nurse take?
Correct Answer: B
Rationale: The correct answer is B: Recheck the client's BP in her other arm for comparison. This is the best course of action to confirm the accuracy of the initial BP reading. Taking the BP in both arms helps identify any discrepancies due to differences in blood pressure between arms or measurement errors. It also allows for better assessment of the client's overall blood pressure status.
Choice A is incorrect because the width of the BP cuff should be about 40% of the upper arm circumference, not 50%.
Choice C is inappropriate as waiting 30 minutes without immediate action can be risky if the high BP is indicative of a serious condition.
Choice D is unnecessary and may not provide additional information about the client's BP accuracy.