ATI RN
RN ATI FUNDAMENTALS 2024 EXAM Questions
Extract:
Question 1 of 5
A nurse is caring for a client who requires an NG tube for stomach decompression. Which of the following actions should the nurse take when inserting the NG tube?
Correct Answer: D
Rationale:
Correct Answer: D - Have the client take sips of water to promote insertion of the NG tube into the esophagus.
Rationale: Having the client take sips of water helps facilitate the passage of the NG tube through the esophagus by promoting swallowing reflexes and lubricating the tube. This method is commonly used to aid in the insertion process and reduce discomfort for the client.
Summary of other choices:
A: Positioning the client at the head of the bed elevated to 30° is important for NG tube insertion but not the direct action needed during insertion.
B: Removing the NG tube if the client gags or chokes is incorrect; these are common reactions during insertion and do not necessarily indicate a problem.
C: Applying suction to the NG tube prior to insertion is unnecessary and can cause discomfort or injury to the client.
Question 2 of 5
A nurse is admitting a client who is having an exacerbation of heart failure. In planning this client's care, when should the nurse initiate discharge planning?
Correct Answer: A
Rationale: The correct answer is A. Initiating discharge planning during the admission process ensures that the nurse can start early assessment of the client's needs, establish goals, and coordinate resources for a smooth transition post-hospitalization. This proactive approach allows for comprehensive evaluation and preparation, ultimately enhancing the client's overall outcome.
Choice B is incorrect because waiting until the client's condition is stable may delay crucial planning and implementation.
Choice C is incorrect as it may not address the individual client's needs adequately.
Choice D is incorrect as family consultation should complement, not precede, the initial planning process.
Question 3 of 5
A nurse on a medical-surgical unit is caring for a client who has a new prescription for wrist restraints. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct answer is A: Pad the client's wrist before applying the restraints. This is crucial to prevent skin breakdown and ensure the client's comfort. Padding helps distribute pressure and reduces the risk of injury. Option B is incorrect because evaluating circulation every 8 hours is not frequent enough to monitor for potential complications. Option C is incorrect as restraints should be removed every 2 hours, not every 4 hours, to assess the client's status. Option D is incorrect because securing restraint ties to the bed's side rails is unsafe and can lead to injury. It is important to prioritize client safety and comfort when using restraints.
Question 4 of 5
A client who is postoperative is verbalizing pain as a 2 on a pain scale of 0 to 10. Which of the following statements should the nurse identify as an indication that the client understands the preoperative teaching she received about pain management?
Correct Answer: C
Rationale: The correct answer is C. The client verbalizing that breathing faster will help keep their mind off the pain indicates understanding of distraction techniques learned during preoperative teaching. This response demonstrates the client's grasp of non-pharmacological pain management strategies. Options A and B suggest increasing medication without consulting healthcare providers, which can be dangerous. Option D focuses on listening to music for pain relief, which is a helpful technique but not related to preoperative teaching. Option E indicates avoidance of walking due to pain, which is not in line with effective pain management strategies.
Question 5 of 5
A nurse is initiating a protective environment for a client who has had an allogeneic stem cell transplant. Which of the following precautions should the nurse plan for this client?
Correct Answer: A
Rationale: The correct answer is A: Make sure the client's room has at least six air exchanges per hour. This is important for a client post allogeneic stem cell transplant to reduce the risk of exposure to pathogens. The high air exchange rate helps maintain a clean environment and reduce the transmission of infections.
Choice B is incorrect because wearing a mask outside the room does not address the air quality within the client's room.
Choice C is incorrect as negative-pressure airflow rooms are typically used for clients with airborne infections, not for those post stem cell transplant.
Choice D is incorrect as wearing an N95 respirator is not necessary if the room has adequate air exchanges.