ATI RN
ATI RN Fundamental Proctored Exam With NGN Graded Questions
Extract:
Question 1 of 5
A nurse is obtaining history from a client who has pain. The nurse's guiding principle throughout this process should be that:
Correct Answer: D
Rationale: The correct answer is D: Pain is whatever the client says it is. This principle is based on the concept of respecting the client's subjective experience of pain. Pain is a personal and individualized experience, and the client's perception and description of pain are crucial in guiding assessment and treatment. By acknowledging and accepting the client's self-report of pain, the nurse can provide more effective and compassionate care.
Other choices are incorrect:
A: Some clients exaggerate their level of pain - This choice assumes a negative bias towards clients and disregards the importance of validating their pain experience.
B: Pain must have an identifiable source to justify the use of opioids - This choice imposes unnecessary criteria for pain management and may lead to under-treatment of pain.
C: Objective data are essential in assessing pain - While objective data can complement pain assessment, they should not override the client's subjective experience as the primary guide for pain management.
Question 2 of 5
A nurse is caring for an older adult client who lives alone & is to be discharged in 3 days. He states that it is difficult to prepare adequate nutritious meals at home for just 1 person. To which of the following members of the health care team should the nurse refer him?
Correct Answer: D
Rationale:
Correct Answer: D (Social worker)
Rationale: The social worker is the most appropriate referral for the older adult facing difficulty in preparing nutritious meals. Social workers can assess the client's social needs, such as access to community resources, meal delivery services, or support groups. They can also help with financial assistance or other social services to ensure the client's well-being.
Summary of other choices:
A: Registered dietitian - While a dietitian can provide nutritional guidance, the client's issue is not solely about dietary recommendations but also about access to nutritious meals.
B: Occupational therapist - OTs focus on assisting clients with daily living activities and functional independence, not specifically addressing the client's meal preparation concerns.
C: Physical therapist - PTs focus on rehabilitation and physical function, not directly related to the client's nutritional challenges.
Question 3 of 5
A nurse is preparing to administer a cleansing enema to an adult client in preparation for a diagnostic procedure. Which of the following are appropriate steps for the nurse to take? Select all.
Correct Answer: A, B, C
Rationale:
Correct Answer: A, B, C
Rationale:
A: Warming the enema helps prevent cramping and discomfort during instillation.
B: Positioning the client on the left side with the right leg flexed forward helps facilitate easier insertion of the enema.
C: Lubricating the rectal tube or nozzle helps prevent injury and discomfort during insertion.
Incorrect
Choices:
D: Slowly inserting the rectal tube about 2 inches is incorrect as it may not be deep enough to reach the sigmoid colon.
E: Hanging the enema container 24 inches above the client's anus is incorrect as it may cause rapid flow leading to discomfort and cramping.
Question 4 of 5
A nurse is assessing the pain level of a client who has come to the ER reporting severe abdominal pain. The nurse asks the client whether he has nausea & has been vomiting. The nurse is assessing which of the following?
Correct Answer: A
Rationale: The correct answer is A: Presence of associated symptoms. This is because asking about nausea and vomiting helps the nurse understand if the abdominal pain may be related to gastrointestinal issues or other underlying conditions. This information provides important context for the assessment and can guide further evaluation and treatment.
Summary of other choices:
B: Location of the pain - While important, knowing the location alone does not provide insight into potential causes or severity.
C: Pain quality - Important for understanding the nature of pain but does not specifically address associated symptoms.
D: Aggravating & relieving factors - Relevant for understanding pain triggers but does not directly address associated symptoms.
Question 5 of 5
A nurse is reviewing the reported medications of a client who was recently admitted. The medications include cimetidine (Tagamet) and imipramine hydrochloride (Tofranil). Knowing that cimetidine decreases the metabolism of imipramine hydrochloride, the nurse should identify that this combination is likely to result in which of the following effects?
Correct Answer: B
Rationale: The correct answer is B: Increased risk of imipramine hydrochloride toxicity. Cimetidine inhibits the metabolism of imipramine hydrochloride, leading to increased levels of imipramine in the body. This can result in a higher risk of imipramine toxicity, as the drug will not be efficiently cleared from the system. Increased levels of imipramine can lead to adverse effects such as drowsiness, confusion, and cardiac arrhythmias.
Choice A is incorrect because cimetidine's therapeutic effects are not affected by its interaction with imipramine.
Choice C is incorrect as there is no evidence to suggest that cimetidine's adverse effects are decreased by its interaction with imipramine.
Choice D is incorrect as the increased levels of imipramine due to cimetidine inhibition do not necessarily translate to increased therapeutic effects; instead, it leads to toxicity.