ATI RN
ATI Custom T1 PM Summer 2023 Exam 5 Questions
Extract:
Question 1 of 5
A nurse is caring for a toddler who is scheduled to have a lumbar puncture. Which of the following actions should the nurse take?
Correct Answer: B
Rationale: The correct answer is B: Place the toddler in a side-lying, knee-chest position. This position helps open the spaces between the vertebrae, making it easier to perform a lumbar puncture safely and effectively. Restraint (
A) is unnecessary and can cause distress. Asking another nurse to assist with a prone position (
C) can be challenging and not recommended. Swaddling (
D) may hinder the procedure.
Question 2 of 5
A nurse is collecting data on a client who received an opioid narcotic for incisional pain. Which of the following findings is the priority?
Correct Answer: A
Rationale: The correct answer is A: Pulse oximetry. Monitoring oxygen saturation is crucial in clients receiving opioid narcotics due to the risk of respiratory depression. Decreased oxygen saturation indicates inadequate ventilation, which can be life-threatening. Blood pressure (
B) and pain level (
D) are important but not as urgent as monitoring oxygen levels. Level of sedation (
C) is also important but can be assessed after ensuring adequate oxygenation. Other choices were not provided, but they would likely be less critical in this scenario compared to monitoring oxygen saturation.
Question 3 of 5
A nurse is collecting data on a client following administration of an opioid narcotic. Which of the following findings indicates a decrease in the client's pain?
Correct Answer: A
Rationale: The correct answer is A: The client is asleep. When a client is asleep following the administration of an opioid narcotic, it indicates a decrease in pain because opioids can cause sedation as a side effect, leading to relief from pain. Sleep is a common response to decreased pain levels due to the central nervous system depression caused by opioids. Elevated blood pressure (
B) and increased respiratory rate (
C) are not indicative of decreased pain but could be signs of opioid overdose or inadequate pain management. Diaphoresis (
D) may indicate pain or withdrawal symptoms but does not directly indicate a decrease in pain.
Question 4 of 5
A nurse is calculating the protein needs of a client who is a physical trainer. The client weighs 220 lb and requires an increase of protein by 2.0 g/kg/day. The client has taken 0.8 g of protein/kg/day in the past. How much total protein/day should the nurse recommend?
Correct Answer: C
Rationale:
To calculate the total protein/day for the client, we first convert their weight from pounds to kilograms by dividing 220 lb by 2.2 (1 kg = 2.2 lb) = 100 kg. The client's previous protein intake was 0.8 g/kg/day, so they were consuming 0.8 x 100 = 80 g/day. The client requires an increase of 2.0 g/kg/day, so the additional protein needed is 2.0 x 100 = 200 g/day. Adding this to the previous intake of 80 g, the total protein/day should be 80 + 200 = 280 g/day.
Therefore, choice C, 280 g of protein/day, is the correct answer.
Choices A, B, and D are incorrect because they do not consider the client's weight, previous protein intake, and the required increase in protein intake.
Question 5 of 5
A nurse is contributing to the plan of care for a client who has a spinal cord injury and paralysis. Which of the following actions should the nurse include in the plan to decrease the client's risk of skin breakdown?
Correct Answer: B
Rationale: The correct answer is B: Minimize skin exposure to moisture. Moisture can lead to skin breakdown, especially in clients with limited mobility. Keeping the skin dry helps prevent breakdown. Turning the client every 4 hours (
A) helps with pressure relief but does not specifically address moisture. Massaging erythematous bony prominences (
C) can cause further damage to fragile skin. Environmental humidity less than 30% (
D) is not directly related to skin breakdown. Using pillows to keep heels off the bed surface (E) helps with pressure redistribution but does not address moisture.