ATI RN
RN ATI FUNDAMENTALS 2024 EXAM Questions
Extract:
Question 1 of 5
A nurse is preparing to administer enoxaparin subcutaneously to a client. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct answer is A: Administer the medication with the needle at a 45° angle. This is the correct action because enoxaparin is a subcutaneous medication that should be injected at a 45° angle to ensure proper absorption and reduce the risk of tissue damage. Administering it at this angle helps to ensure that the medication is effectively delivered into the subcutaneous tissue.
Choice B is incorrect as the administration site is not dependent on the client's dominant arm.
Choice C is incorrect as pulling the skin layer downward is not necessary for subcutaneous injections.
Choice D is incorrect as massaging the injection site after administration can lead to bruising and should be avoided.
Extract:
Nurses’ Notes
First Clinic Vist:
Cliet arrives to dinc with report of increasing shortness of breath, fatigue. and weakness. States they gt short of breath with minimal activiy.
Cllent s alert and oriented to person, pace, and time. Maoves allextremities well, follows simple commands. Sinus tachycardia, Pulses to lowr extremitis wesk with +2 dependent edema present,
Slightlylabored respirations at rst. Chest with wheezes and crackles n the basas. Reports productive cough, especially during the overnight hours.
Bowel sounds al presen. Abdomen distended. Reports bowel movement this am.
States voiding without dfficulty, lear yellow urine
Teaching provided on nuition therapy and adhering to & ow-sodium diet, monitoring fud intake, and Ifestyle changes for heart fallure. Provided medication teaching following provider's increase in furosemide dosage
Question 2 of 5
A nurse is assessing a client with heart failure. The client reports increasing shortness of breath, fatigue, and weakness. Which of the following findings in the assessment should the nurse identify as most concerning?
Correct Answer: C
Rationale: The correct answer is C: Wheezes and crackles in the chest. This finding is most concerning in a client with heart failure because it indicates potential fluid buildup in the lungs, known as pulmonary edema, which can lead to severe respiratory distress and compromise oxygenation. Wheezes suggest bronchoconstriction, while crackles indicate fluid in the alveoli. These signs are indicative of worsening heart failure and require immediate intervention.
Weak pulses with +2 dependent edema in lower extremities (
Choice
A) are expected findings in heart failure due to fluid retention, but they do not directly indicate acute respiratory compromise. Slightly labored respirations at rest (
Choice
B) may be common in heart failure, but they are not as concerning as the presence of wheezes and crackles. Reports of productive cough during overnight hours (
Choice
D) may suggest underlying respiratory infection but are not as urgent as the respiratory distress indicated by wheezes and crackles.
Extract:
Question 3 of 5
The nurse is placing the client on isolation precautions. Which of the following interventions should the nurse include? Select all that apply.
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.
Question 4 of 5
A nurse in a provider's office is assessing the deep tendon reflexes of a client. Which of the following images should the nurse identify as indicating the correct technique for eliciting the client's patellar reflex?
Correct Answer: A
Rationale: The correct answer is A. The nurse should identify this image as indicating the correct technique for eliciting the client's patellar reflex because the client is sitting with legs dangling over the edge of the table, which allows the quadriceps muscle to be in a slightly stretched position. The examiner is tapping below the patella with a reflex hammer, directly stimulating the patellar tendon to elicit the reflex. This position and technique are essential for a proper response, as it activates the muscle spindle fibers to trigger the reflex arc involving the sensory and motor neurons.
Choices B, C, and D are incorrect because they do not follow the correct technique for eliciting the patellar reflex. In choice B, tapping above the patella would not directly stimulate the patellar tendon. In choice C, having the client's legs crossed would not allow for proper muscle tension required for the reflex. In choice D, having the client standing with knees slightly bent may not provide the necessary muscle tension or positioning for an accurate
Question 5 of 5
A nurse is providing discharge instructions to a client who will be using a walker. Which of the following client statements indicates an understanding of the teaching?
Correct Answer: B
Rationale: The correct answer is B: "I will hire someone to trim the tree that hangs low over the stairs of my front porch." This statement shows an understanding of safety precautions when using a walker. Trimming the tree will prevent any potential hazards or obstacles that could hinder the client's safe movement with the walker. Placing an extension cord (choice
A) can lead to tripping, placing the alarm clock across the room (choice
C) is not directly related to walker safety, and replacing a rug (choice
D) addresses a different safety concern. Hiring someone to trim the tree directly addresses the safety issue posed by the low-hanging tree branches, making it the most appropriate choice.