ATI PN Fundamentals 2023

Extract:

Question 1 of 5

A nurse is collecting data from a client who reports feeling short of breath and notes that the client's SpO2 level is 88% while on room air. Which of the following actions should the nurse take first?

A. Recheck the client's SaO2 level after having the client cough and clear their throat. B. Notify the charge nurse of the client's condition. C. Review the client's most recent SaO2 level in the medical record. D. Check the client's medical records to see which medications were recently admitted.

Correct Answer: A

Rationale: Rechecking SpO2 after clearing the airway rules out temporary obstruction as the cause.

Question 2 of 5

A nurse is collecting a urine specimen for culture and sensitivity from a client who has an indwelling urinary catheter. Which of the following actions should the nurse take?

A. Place the specimen in a clean specimen cup. B. Clamp the catheter tubing below the needleless port. C. Clamp the catheter tubing for 60 min. D. Remove 45 mL of urine from the catheter with a syringe.

Correct Answer: B

Rationale: Clamping below the port allows fresh urine to collect for an accurate culture.

Question 3 of 5

A nurse is preparing to insert an indwelling urinary catheter and is verifying the client's express consent for this procedure. Which of the following actions should the nurse take?

A. Obtain verbal consent from the client. B. Witness the client's signature on a consent form. C. Check the medical record for the client's signature on a previous consent form. D. Have another nurse co-sign the client's consent

Correct Answer: B

Rationale: Witnessing the signature ensures informed consent is documented per protocol.

Question 4 of 5

A nurse is reviewing the medical record of a client. Click to highlight below the findings that require immediate follow-up.

A. Neurological: Alert and oriented to person, place, and time; deep tendon reflexes 4+ B. Musculoskeletal: Generalized weakness with equal bilateral muscle strength and mild leg cramping C. Respiratory: Lungs clear D. Cardiovascular: Heart rate irregular, Heart rate 95/min E. Gastrointestinal: Bowel sounds hyperactive x 4 quadrants

Correct Answer: D

Rationale: An irregular heart rate (
D) requires immediate follow-up due to potential arrhythmia risks.

Question 5 of 5

A nurse is reinforcing teaching with a client about blood glucose monitoring. The client becomes quiet and appears distracted while the nurse is providing the instructions. Which of the following responses should the nurse make?

A. Aren't you interested in learning how to perform this test? B. Let's talk about what you're thinking. C. I'll discuss this with your partner instead. D. Is this something you think you can do?

Correct Answer: B

Rationale: Exploring the client's thoughts addresses distractions and improves teaching effectiveness.

ATI PN Fundamentals 2023 | Nurselytic

Nurselytic

ATI LPN

ATI LPN