ATI RN
ATI RN Fundamentals 2023 I Questions
Extract:
Question 1 of 5
A nurse is preparing to provide tracheostomy care for a client. Which of the following actions should the nurse plan to take?
Correct Answer: C
Rationale: A hook-and-loop collar secures the tracheostomy tube safely, preventing dislodgement. Cutting gauze risks loose fibers, hydrogen peroxide is too harsh, and sterile (not clean) gloves are required for inner cannula cleaning to prevent infection.
Question 2 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: A: Low bed prevents falls. B: Assessing skin ensures circulation. D: Padding prevents pressure injuries. C: Bed rails risk injury—use bed frame. E: Three fingers is too loose—two is standard.
Question 3 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: Comparing MAR and label at preparation, removal, and administration ensures accuracy (three checks). Reconciliation is separate, and end-of-shift isn’t a standard time.
Question 4 of 5
A nurse in an emergency department is caring for a client who is unconscious and requires surgery. There is no one available to give consent for the treatment. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: Implied consent applies in emergencies, allowing surgery to save life or prevent harm. Ethics consultation delays action, waiting risks deterioration, and surgeons can’t consent.
Question 5 of 5
A nurse is caring for a client who is postoperative and is on bed rest. Which of the following actions should the nurse take to decrease the client’s risk of developing a pressure injury?
Correct Answer: C
Rationale: Elevating heels off the mattress prevents pressure injuries on this vulnerable area. Four-hour repositioning is too infrequent (2 hours is standard), a 60° angle risks sacral pressure, and massaging increases tissue damage risk.