ATI RN
ATI RN VATI Fundamentals S 2019 Final Questions
Extract:
Question 1 of 5
A nurse is planning to assist a client who has left-sided weakness to ambulate using a gait belt. Which of the following actions should the nurse plan to take?
Correct Answer: C
Rationale: Sitting for 60 seconds prevents orthostatic hypotension ensuring safe ambulation. Walking on the right side is incorrect (should be left) looking down risks falls and the gait belt goes around the waist not chest.
Question 2 of 5
A nurse is teaching pursed-lip breathing to a client who has COPD. Which of the following instructions should the nurse include in the teaching?
Correct Answer: B
Rationale: Exhaling slowly through pursed lips creates backpressure keeping airways open and improving oxygen exchange in COPD. Lying down restricts lung expansion inhaling through pursed lips is incorrect and puffing cheeks is ineffective.
Question 3 of 5
A nurse is setting up a sterile field prior to changing a client's dressing. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: Placing the sterile kit on the overbed table above waist level maintains sterility by avoiding contamination from lower surfaces. Opening the flap toward the body turning back to the field when coughing or dropping gauze from 12 inches risks contaminating the sterile field.
Question 4 of 5
A nurse is providing teaching to a client who has a new colostomy. Which of the following actions should the nurse take when demonstrating how to change the ostomy appliance?
Correct Answer: D
Rationale: Tracing the size of the stoma onto the skin barrier ensures a precise fit which is crucial for preventing leaks and maintaining the integrity of the ostomy. A proper fit also helps in preventing skin irritation and discomfort. Applying skin sealant on damp skin compromises adhesion and can lead to skin irritation. Removing the appliance before emptying the pouch is unnecessary and disrupts the seal. Ensuring the skin is slightly damp is incorrect as the skin should be completely dry for proper adhesion.
Question 5 of 5
A nurse is preparing to notify the provider about a change in a client's status. Which of the following information should the nurse plan to include in the 'background' portion of the Situation,Background,Assessment,Recommendation (SBAR) Communication tool?
Correct Answer: A
Rationale: In the 'background' portion of the SBAR tool the nurse should include the client's present condition to provide context and a baseline for the provider. Suggestions and physical findings belong in the 'assessment' or 'recommendation' sections. Previous treatments may be relevant but are secondary to the current condition in the 'background' section.