ATI RN
ATI RN Fundamentals Online Practice 2023 B Questions
Extract:
Question 1 of 5
A nurse is caring for a patient who needs a nasogastric (NG) tube for stomach decompression. Which of the following steps should the nurse take when inserting the NG tube?
Correct Answer: D
Rationale:
Correct Answer: D - Encourage the patient to take sips of water to facilitate the insertion of the NG tube into the esophagus.
Rationale: Encouraging the patient to take sips of water helps lubricate the esophagus and aids in the passage of the NG tube smoothly. This technique can reduce discomfort and resistance during insertion.
Summary:
A: Positioning the patient with the head of the bed elevated is important for NG tube insertion, but it is not the immediate step during the process.
B: Removing the NG tube if the patient gags or chokes is incorrect; these are common reactions and do not necessarily indicate a need for removal.
C: Applying suction before insertion is unnecessary and can cause discomfort to the patient.
Extract:
Nurses’ Notes
• The client reports a sudden onset of chest tightness and difficulty breathing starting approximately 30 minutes ago.
• The client is anxious and visibly distressed, clutching her chest intermittently.
• She has a history of hypertension and diabetes, which are being managed with medication.
• On examination, the client is sitting upright and appears to be in moderate respiratory distress.
• The client mentions feeling lightheaded and reports a slight headache.
• She is sweating profusely and her skin is pale.
• The client denies any recent physical exertion or known exposure to irritants.
Vital Signs
• Temperature: 37.2°C (99.0°F)
• Heart Rate: 104 beats per minute
• Respiratory Rate: 22 breaths per minute
• Blood Pressure: 158/92 mmHg
Physical Examination Results
• The client’s lungs exhibit bilateral wheezing and crackles upon auscultation.
• There is no visible swelling or edema in the extremities.
• The client has a dry cough that is intermittent.
• No cyanosis is noted around the lips or extremities.
• The client’s skin is cool and clammy.
• The client appears slightly disoriented when asked questions.
• There is no sign of trauma or injury.
Question 2 of 5
A 45-year-old female client is admitted to the emergency department with complaints of sudden shortness of breath and chest tightness. She has a history of hypertension and diabetes.Exhibits:A nurse is assessing the client at 0700 hrs. Which of the following actions should the nurse take first? A Initiate a cardiac enzyme panel
Correct Answer: D
Rationale: The correct answer is D: Obtain an electrocardiogram (ECG). The client's symptoms of sudden shortness of breath and chest tightness, along with her history of hypertension and diabetes, raise concerns for a possible cardiac event such as a heart attack. An ECG is crucial for promptly identifying any cardiac abnormalities and guiding further treatment. It provides valuable information on the heart's electrical activity, helping to assess for signs of ischemia or arrhythmias. Initiating a cardiac enzyme panel (choice
A) may be necessary later but obtaining an ECG takes priority for immediate assessment. Starting IV fluid therapy (choice
B), providing pain relief medication (choice
C), performing a comprehensive physical assessment (choice E) are important interventions but obtaining an ECG is the most urgent action to rule out a cardiac emergency in this scenario.
Extract:
Question 3 of 5
A nurse is caring for a client who is expressing anger about their diagnosis of colorectal cancer. Which action should the nurse take?
Correct Answer: D
Rationale: The correct answer is D: Reassure the client that this is an expected response to grief. This option acknowledges the client's feelings of anger and normalizes their response, showing empathy and understanding. By reassuring the client, the nurse validates their emotions and helps establish a therapeutic relationship.
A: Discussing risk factors for colon cancer may not address the client's immediate emotional needs of dealing with anger and grief.
B: Focusing on teaching future management may be premature at this stage when the client is still processing their emotions.
C: Providing written information about phases of loss and grief may be helpful, but it does not directly address the client's current expression of anger.
Summary: Option D is the best choice as it prioritizes addressing the client's emotional needs and building rapport. Options A, B, and C do not effectively address the client's current emotional state.
Question 4 of 5
A nurse is giving a change-of-shift report about a client they admitted earlier that day who has pneumonia. Which piece of information is the priority for the nurse to provide?
Correct Answer: B
Rationale: The correct answer is B: Breath sounds. This is the priority because it provides crucial information about the client's respiratory status and the effectiveness of treatment for pneumonia. Abnormal breath sounds could indicate worsening respiratory distress or pneumonia complications. Providing this information helps the oncoming nurse assess the client's current condition and make timely interventions. The other choices are not as critical: A - Admitting diagnosis is important but does not provide immediate information on the client's current status; C - Body temperature is relevant but may not indicate the severity of pneumonia; D - Diagnostic test results are important but may not provide real-time data on the client's respiratory status.
Extract:
Vital Signs (Updated)
• 0700 hrs:
o Blood Pressure (BP): 138/72 mm Hg
o Heart rate: 80/min
o Respirations: 22/min
o Temperature: 38.3°C (101.1°F)
o Oxygen saturation: 90% on room air
• 1100 hrs:
o Blood Pressure (BP): 132/68 mm Hg
o Heart rate: 92/min
o Respirations: 24/min
o Temperature: 39.0°C (102.2°F)
o Oxygen saturation: 88% on room air
• 1500 hrs:
o Blood Pressure (BP): 126/64 mm Hg
o Heart rate: 100/min
o Respirations: 26/min
o Temperature: 39.5°C (103.1°F)
o Oxygen saturation: 86% on room air
Nurses' Notes
• 0700 hrs:
o The client is alert but appears fatigued. Complaints of increased shortness of breath over the past 24 hours. The client has a productive cough with thick, yellow sputum. The client reports feeling increasingly weak and dizzy. Mild confusion is noted, with difficulty maintaining focus during the assessment. The client is diaphoretic and has been experiencing chills intermittently. The skin appears flushed and warm to the touch.
• 1100 hrs:
o The client is visibly distressed and reports worsening dyspnea. The cough is now accompanied by greenish, foul- smelling sputum. The client exhibits increased confusion and disorientation. The skin is cool and clammy, with noticeable pallor. Respiratory effort is labored, with audible wheezing and crackles upon auscultation. The client reports persistent nausea and decreased appetite. There is a noticeable increase in fatigue and lethargy.
• 1500 hrs:
o The client is significantly drowsy and difficult to arouse. Respiratory distress is evident, with use of accessory muscles for breathing. The sputum is now blood-tinged and the cough is frequent and severe. The skin is very pale, with a bluish tinge noted around the lips. The client shows signs of hypotension and rapid pulse. There is an overall decline in mental status, with severe confusion and disorientation. The client complains of severe weakness and generalized body aches.
Medical History
• Diabetes mellitus, well-managed with medication
• Chronic obstructive pulmonary disease (COPD)
• History of hypertension
• No known drug allergies
• Recent travel to an area with known respiratory infections
Diagnostic Results
• 0700 hrs:
o Chest X-ray: Mild infiltrates in the lower lobes
o CBC: Elevated white blood cell count (WBC) 12,000/µL
• 1100 hrs:
o Chest X-ray: Progression of infiltrates with more pronounced consolidation
o CBC: Further elevated white blood cell count (WBC) 15,000/µL; Elevated C-reactive protein (CRP)
• 1500 hrs:
o Chest X-ray: Extensive consolidation with possible pleural effusion
o CBC: High white blood cell count (WBC) 18,000/µL; Elevated CRP; Low hemoglobin (Hb)
Provider's Prescriptions
• 0700 hrs:
o Antibiotic therapy initiated: Levofloxacin 500 mg IV every 24 hours
o Oxygen therapy: 2 L/min via nasal cannula
• 1100 hrs:
o Increased oxygen therapy to 4 L/min via nasal cannula
o Addition of nebulized bronchodilators
• 1500 hrs:
o Oxygen therapy increased to 6 L/min via non-rebreather mask
o Initiation of intravenous corticosteroids
Question 5 of 5
A 60-year-old male client is admitted to the medical-surgical unit. The client is experiencing a worsening of symptoms over the last 24 hours. The client's initial presentation was similar to previous days, but his condition has deteriorated.Exhibits:Based on the evolution of the client’s condition and the provided exhibits, select all that apply. Which of the following actions should the nurse include in the client's care plan?
Correct Answer: B,C,D,E,F
Rationale: The correct answer includes preparing for possible intubation and mechanical ventilation (
B) because the client is experiencing a worsening of symptoms, indicating respiratory distress. Monitoring blood glucose levels frequently (
C) is essential as stress can cause fluctuations in blood sugar levels. Administering IV antibiotics as prescribed (
D) is crucial to treat any infection that may be contributing to the deterioration. Ensuring strict hand hygiene (E) helps prevent the spread of infection. Increasing fluid intake (F) can help thin sputum and ease breathing. Implementing airborne precautions (
A) is not necessary unless specific respiratory infections are suspected. Assisting with chest tube insertion (G) is not indicated based on the information provided.