ATI RN
ATI RN Fundamentals Exam 6 Questions
Extract:
Question 1 of 5
A nurse is performing postural drainage for a client. Which of the following is an appropriate intervention?
Correct Answer: A
Rationale: Positioning the client for secretion drainage by gravity is a key component of postural drainage to facilitate the removal of respiratory secretions. Postural drainage is typically done before meals to avoid potential nausea during the procedure. Bronchodilators are often administered before postural drainage to open the airways and improve the effectiveness of the procedure. Encouraging fluid intake is important to help thin respiratory secretions and promote their removal during postural drainage. Fluid restrictions are not typically indicated in this context.
Question 2 of 5
A nurse is teaching a client who can bear weight on only one leg how to ambulate using crutches. Which of the following crutch gaits should the nurse plan to instruct this client to use?
Correct Answer: D
Rationale: Two-point gait involves simultaneous partial weight-bearing on both legs. For a client who can bear weight on only one leg this gait is not suitable. Four-point gait involves alternating weight-bearing on each leg. It provides a stable and slow gait pattern making it appropriate for a client who can bear weight on only one leg. Swing-through gait is more advanced and involves swinging both crutches and the affected leg forward together. This is typically used for clients with more strength and coordination. Three-point gait involves non-weight-bearing on one leg and requires the use of crutches or an assistive device on one side only. It is not suitable for a client who can bear weight on one leg.
Question 3 of 5
A nurse is preparing to administer a tap water enema to a client. Which of the following actions should the nurse take?
Correct Answer: C
Rationale: Sterile gloves are not necessary for a tap water enema; clean non-sterile gloves are sufficient. Lubricating the tip of the rectal tube is appropriate to ease insertion and enhance client comfort. Placing the client into a left Sims' position facilitates optimal administration of a tap water enema. Lowering not raising the enema bag will allow for a slower flow and may reduce cramping.
Question 4 of 5
A nurse is preparing a client for a central line dressing change. Which of the following actions should the nurse take as part of the procedure?
Correct Answer: C
Rationale: Opening the first flap of the sterile kit away from the body helps maintain the sterility of the contents. The sterile field should be above waist level to avoid contamination. Placing dry sterile supplies 1/2 inch from the edge of the sterile field helps prevent contamination of the items. Sterile gloves should be donned before preparing the sterile field to avoid contamination.
Question 5 of 5
The parent of a toddler is concerned that his child has suddenly become disinterested in certain foods. Which of the following statements is the appropriate response by the nurse?
Correct Answer: C
Rationale: Encouraging feeding anything the child will eat might lead to poor nutrition. It's important to ensure a balanced diet. Acknowledging the concern is valid but the nurse should provide guidance rather than just expressing concern. This response acknowledges the concern but reassures the parent that if the child appears healthy no immediate intervention is necessary promoting a balanced approach. Increasing calories and water without a specific reason or assessment may not address the underlying issue and is not the initial recommended intervention.