ATI RN
ATI RN Fundamentals 2023 I Questions
Extract:
Question 1 of 5
A nurse is planning care for a client who has a prescription for extremity restraints to both wrists. Which of the following actions should the nurse include in the plan of care? (Select all that apply.)
Correct Answer: A,B,D
Rationale:
Correct Answer: A, B, D
Rationale:
A: Ensuring the client’s bed is in the lowest position prevents falls and minimizes injury risk if the client tries to get out of bed.
B: Assessing skin temperature and color before applying restraints ensures proper circulation and skin integrity.
D: Padding bony prominences before applying restraints prevents pressure ulcers and discomfort for the client.
Summary:
C: Attaching the restraints to the bed rail can increase the risk of injury if the client moves around.
E: Allowing three fingers to slide under the restraints is incorrect as it can lead to improper fit and ineffective restraint.
Question 2 of 5
A nurse is preparing to administer medications to a client. At which of the following times should the nurse compare the medication administration record and the medication label? (Select all that apply.)
Correct Answer: A,D,E
Rationale: The correct times for the nurse to compare the medication administration record and the medication label are A, D, and E. A is correct because comparing them when preparing the medication dosage ensures the right medication is being administered. D is important when removing the medication from the drawer to verify it matches the record. E is crucial directly before administering to double-check accuracy.
Choice B is incorrect as reconciling controlled substances doesn't involve verifying specific medications.
Choice C at the end of the shift is not ideal as errors may have already occurred.
Question 3 of 5
A charge nurse is observing a staff nurse performing a wound irrigation for a client who has a pressure injury. Which of the following actions by the staff nurse indicates an understanding of the procedure?
Correct Answer: B
Rationale: The correct answer is B because using a syringe with a catheter for wound irrigation allows for controlled and directed flow of the irrigation solution into the wound, ensuring effective cleansing and minimizing contamination. This method helps prevent trauma to the wound and surrounding tissues.
A: Using one pair of gloves for dressing removal and irrigation increases the risk of cross-contamination.
C: Administering an analgesic medication before irrigation is not a standard practice and does not demonstrate understanding of the procedure.
D: Refrigerating the solution before irrigation is unnecessary and may cause discomfort to the client.
In summary, choice B is correct as it aligns with best practices for wound irrigation, while the other choices do not demonstrate a proper understanding of the procedure.
Question 4 of 5
A nurse is reviewing the laboratory results of a female client who has liver dysfunction and is receiving a continuous tube feeding. Which of the following findings should the nurse identify as a protein deficiency?
Correct Answer: A
Rationale: The correct answer is A: Albumin 3.1 g/dL. Albumin is the main protein in the blood and is produced by the liver. In liver dysfunction, the synthesis of albumin is decreased, leading to low levels in the blood, indicating protein deficiency. Transferrin (
B) is a protein involved in iron transport, not a direct indicator of protein deficiency. Uric acid (
C) and total iron-binding capacity (
D) are not specific markers for protein deficiency.
Question 5 of 5
A nurse is teaching a client who has decreased mobility about passive range-of-motion exercises. Which of the following statements should the nurse make?
Correct Answer: B
Rationale: The correct answer is B: "I will repeat these movements 3 to 5 times." This is the appropriate statement because passive range-of-motion exercises should be repeated multiple times to prevent joint stiffness and contractures. Repeating the movements helps maintain joint flexibility and circulation.
Explanation of why the other choices are incorrect:
A: "I will move your joints to the point of mild pain" - Incorrect because pain should be avoided during passive range-of-motion exercises to prevent injury and discomfort.
C: "I will move your joints quickly" - Incorrect because slow, controlled movements are recommended to prevent injury and ensure effectiveness.
D: "These movements will be performed once per day" - Incorrect because passive range-of-motion exercises are usually performed multiple times throughout the day to promote joint mobility and prevent stiffness.