ATI Fundamentals 2024 Exam -Nurselytic

Extract:

Question 1 of 5

A nurse is preparing to administer an injection of an opioid medication to a client. The nurse draws out 1 mL of the medication from a 2 mL vial. Which of the following actions should the nurse take?

A. Ask another nurse to observe the medication wastage.B. Notify the pharmacy when wasting the medication.C. Lock the remaining medication in the controlled substances cabinet.D. Dispose of the vial with the remaining medication in a sharps container.

Correct Answer: C

Rationale: The correct answer is C: Lock the remaining medication in the controlled substances cabinet. This is important because opioids are controlled substances and must be securely stored to prevent diversion or misuse. By locking the remaining medication in the controlled substances cabinet, the nurse ensures that only authorized personnel have access to it, maintaining safety and compliance.

Other choices are incorrect:
A: Asking another nurse to observe the medication wastage is not necessary in this situation as the issue is about proper storage, not administration.
B: Notifying the pharmacy when wasting the medication is not relevant here as the focus should be on proper disposal and storage.
D: Disposing of the vial with the remaining medication in a sharps container is incorrect as controlled substances should be handled and stored appropriately, not simply disposed of in a sharps container.

Question 2 of 5

A nurse is admitting a client who is having an exacerbation of heart failure. In planning this client's care, when should the nurse initiate discharge planning?

A. During the admission process.B. As soon as the client's condition is stable.C. During the initial team conference.D. After consulting with the client's family.

Correct Answer: A

Rationale: The correct answer is A. Initiating discharge planning during the admission process ensures that the nurse can start early assessment of the client's needs, establish goals, and coordinate resources for a smooth transition post-hospitalization. This proactive approach allows for comprehensive evaluation and preparation, ultimately enhancing the client's overall outcome.
Choice B is incorrect because waiting until the client's condition is stable may delay crucial planning and implementation.
Choice C is incorrect as it may not address the individual client's needs adequately.
Choice D is incorrect as family consultation should complement, not precede, the initial planning process.

Question 3 of 5

A nurse is caring for a client who requires an NG tube for stomach decompression. Which of the following actions should the nurse take when inserting the NG tube?

A. Position the client at the head of the bed elevated to 30Â° prior to insertion of the NG tube.B. Remove the NG tube if the client begins to gag or choke.C. Apply suction to the NG tube prior to insertion.D. Have the client take sips of water to promote insertion of the NG tube into the esophagus.

Correct Answer: D

Rationale:
Correct Answer: D - Have the client take sips of water to promote insertion of the NG tube into the esophagus.

Rationale: Having the client take sips of water helps facilitate the passage of the NG tube through the esophagus by promoting swallowing reflexes and lubricating the tube. This method is commonly used to aid in the insertion process and reduce discomfort for the client.

Summary of other choices:
A: Positioning the client at the head of the bed elevated to 30° is important for NG tube insertion but not the direct action needed during insertion.
B: Removing the NG tube if the client gags or chokes is incorrect; these are common reactions during insertion and do not necessarily indicate a problem.
C: Applying suction to the NG tube prior to insertion is unnecessary and can cause discomfort or injury to the client.

Question 4 of 5

A nurse is preparing to administer 0.9% sodium chloride 750 mL IV to infuse over 7 hr. The nurse should set the infusion pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer: 107

Rationale:
To calculate the infusion rate, divide the total volume to be infused (750mL) by the total time in hours (7 hours). 750mL / 7 hours = 107 mL/hr. This is the correct answer as it determines the rate at which the solution should be administered to ensure the correct dosage is delivered over the specified time. Other choices are incorrect as they do not result from the correct calculation method, which is essential in determining the appropriate infusion rate for the patient.

Question 5 of 5

The nurse is placing the client on isolation precautions. Which of the following interventions should the nurse include? Select all that apply.

A. Wear an N95 mask when caring for the client.B. Place a container for soiled linens inside the client's room.C. Place the client in a negative airflow room.D. Remove mask after exiting the client's room.E. Wear a sterile water-resistant gown if within 3 feet of the client.

Correct Answer: A, B, C, E

Rationale: The correct choices are A, B, C, and E.
A) Wearing an N95 mask is essential for respiratory protection.
B) Placing a container for soiled linens in the room prevents contamination.
C) Isolating the client in a negative airflow room helps prevent the spread of airborne pathogens. E) Wearing a sterile water-resistant gown within 3 feet of the client reduces the risk of contact transmission.
D) Removing the mask after exiting the room increases the chance of self-contamination. Thus, D is incorrect. Option F and G are not provided in the question.