ATI RN
ATI RN Fundamentals Updated 2023 Exam Questions
Extract:
Question 1 of 5
A nurse is preparing a medication from a vial for a subcutaneous injection for a client. Which of the following actions should the nurse take?
Correct Answer: C
Rationale: The correct answer is C: Hold the syringe so that bubbles collect at the level of the plunger. This is important to prevent air bubbles from being injected into the client, as they can cause harm. By holding the syringe in a way that allows any air bubbles to collect at the top near the plunger, the nurse can easily push them out before administering the medication.
Choice A is incorrect because injecting air into the vial with the needle immersed in the fluid can introduce air bubbles into the vial.
Choice B is incorrect as holding the syringe at a 45° angle does not specifically address the issue of air bubbles.
Choice D is incorrect as holding the vial with the top facing upward while injecting air can lead to air bubbles being pushed into the vial instead of out.
Question 2 of 5
A nurse is preparing to perform a physical assessment of a client's abdomen. Identify the sequence in which the nurse should perform the following steps.
Correct Answer: A,B,C,E,D
Rationale: Action to Take: A, B; Potential Condition: C; Parameter to Monitor: D, E.
The correct sequence for performing a physical assessment of a client's abdomen involves the following steps:
1. Provide adequate lighting to inspect the abdomen (Action
A) to ensure clear visibility.
2. Listen to the abdominal arteries using the bell of a stethoscope (Action
B) to assess vascular sounds.
3. Percuss all four quadrants of the abdomen (Potential Condition
C) to measure sound quality and identify any abnormalities.
4. Check for areas of tenderness by pressing fingers 1.3 cm (0.5 in) into the abdomen (Parameter to Monitor E) to assess for pain or discomfort.
5. Locate liver and spleen borders by pressing hands 2.5 to 7.5 cm (1 to 3 in) into the abdomen (Parameter to Monitor
D) to assess organ size and position.
This sequence ensures a systematic and comprehensive assessment of the abdomen,
Question 3 of 5
A nurse is caring for a client who has a tracheostomy. Which of the following actions should the nurse take?
Correct Answer: B
Rationale: The correct answer is B: Cleanse the skin around the stoma with normal saline. This is important to prevent infection and skin breakdown. Cleaning the skin helps maintain hygiene and prevents the build-up of secretions. Using normal saline is gentle and non-irritating to the skin.
A: Using a cotton tip applicator to clean inside the inner cannula can cause injury or dislodgment of the tracheostomy tube.
C: Soaking the outer cannula in warm, soapy tap water is not necessary for routine tracheostomy care and may introduce contaminants.
D: Securing the tracheostomy ties to allow one finger to fit snugly underneath is incorrect as it does not address the immediate need for skin cleansing.
Question 4 of 5
A nurse working on a medical-surgical unit is making client assignments for an upcoming shift. Which of the following tasks should the nurse assign to an assistive personnel?
Correct Answer: D
Rationale: The correct answer is D. Assigning the task of assisting with ambulation for a client who has a pulmonary infection to an assistive personnel is appropriate because it is a routine activity that does not require specialized nursing knowledge or skills. Ambulation is a basic care task that can be safely performed by assistive personnel under the supervision of a nurse. It helps promote mobility and prevent complications in clients with pulmonary infections.
Choices A, B, and C involve more complex and skilled nursing interventions that require assessment, critical thinking, and nursing judgment. Inserting a suppository, teaching how to use an incentive spirometer, and irrigating a wound all require specialized nursing knowledge and skills.
Therefore, they should not be assigned to assistive personnel.
In summary, assigning tasks that are routine and do not require nursing judgment to assistive personnel helps optimize nursing resources and promote safe and efficient care delivery.
Question 5 of 5
A nurse is preparing to obtain informed consent from a client who speaks a different language than the nurse and is scheduled for surgery. Which of the following actions should the nurse take?
Correct Answer: B
Rationale: The correct answer is B: Recommend an interpreter who is the same gender as the client. This is important for cultural sensitivity and to help the client feel more comfortable and at ease during the consent process. It ensures effective communication and understanding between the nurse, client, and interpreter. Using medical terminology (choice
A) may result in confusion for a client who does not speak the language. Addressing all questions to the interpreter (choice
C) may bypass direct communication with the client, leading to potential misunderstandings. Having the client nod to indicate understanding (choice
D) may not guarantee comprehension of the information.