ATI RN
ATI RN Fundamental Proctored Exam With NGN Graded Questions
Extract:
Question 1 of 5
A nurse observes an AP reprimanding a client for not using the urinal properly. The AP tells him she will put a diaper on him if he does not use the urinal more carefully next time. Which of the following torts is the AP committing?
Correct Answer: A
Rationale: The correct answer is A: Assault. Assault is the act of intentionally causing someone to fear that they will be physically harmed. In this case, the AP's threat of putting a diaper on the client if he doesn't use the urinal properly next time constitutes an act of assault because it instills fear in the client.
Choice B, Battery, involves actual physical harm, which is not present in this scenario.
Choice C, False imprisonment, involves restricting someone's freedom of movement, which is not the case here.
Choice D, Invasion of privacy, refers to intruding into someone's private affairs, which is not relevant in this situation.
Question 2 of 5
A nurse educator is reviewing with a newly hired nurse the difference in clinical manifestations of a localized vs. a systemic infection. The nurse indicates understanding when she states that which of the following are clinical manifestations of a systemic infection? Select all.
Correct Answer: A, B, E
Rationale: The correct answer is A, B, E. Fever, malaise, and an increase in pulse and respiratory rate are typical clinical manifestations of a systemic infection. Fever indicates the body's response to an infection, malaise reflects a general feeling of discomfort or illness, and an increase in pulse and respiratory rate can be signs of the body's effort to fight the infection. Edema and pain/tenderness are more commonly associated with localized infections rather than systemic ones. In summary, the correct choices reflect the body's overall response to a systemic infection, while the other options are more indicative of localized infections.
Question 3 of 5
A nurse is preparing to administer a cleansing enema to an adult client in preparation for a diagnostic procedure. Which of the following are appropriate steps for the nurse to take? Select all.
Correct Answer: A, B, C
Rationale:
Correct Answer: A, B, C
Rationale:
A: Warming the enema helps prevent cramping and discomfort during instillation.
B: Positioning the client on the left side with the right leg flexed forward helps facilitate easier insertion of the enema.
C: Lubricating the rectal tube or nozzle helps prevent injury and discomfort during insertion.
Incorrect
Choices:
D: Slowly inserting the rectal tube about 2 inches is incorrect as it may not be deep enough to reach the sigmoid colon.
E: Hanging the enema container 24 inches above the client's anus is incorrect as it may cause rapid flow leading to discomfort and cramping.
Question 4 of 5
A nurse is preparing to administer digoxin (Lanoxin) to a client who states, 'I don't want to take that med. I do not want one more pill.' Which of the following responses by the nurse is appropriate in this situation?
Correct Answer: D
Rationale: The correct answer is D: "Tell me your concerns with taking this med." This response demonstrates therapeutic communication by acknowledging the client's feelings and opening up a dialogue to address their concerns. By actively listening to the client's reasons for not wanting to take the medication, the nurse can provide education, address misconceptions, and work collaboratively with the client to find a solution. This approach promotes client autonomy and informed decision-making.
Choice A is incorrect as it dismisses the client's feelings and does not address their concerns.
Choice B is inappropriate as it shows a lack of empathy and understanding.
Choice C is incorrect as it ignores the client's refusal of the specific medication. These responses do not promote effective communication or client-centered care.
Question 5 of 5
A nursing instructor is reviewing the wound healing process with a group of nursing students. They should be able to identify which of the following alterations as a wound or injury that heals by secondary intention? Select all.
Correct Answer: A, E
Rationale: The correct answers are A and E. Wounds healing by secondary intention involve tissue loss and heal from the bottom up, such as Stage III pressure ulcers and open burn areas. These wounds require more tissue regeneration and granulation tissue formation.
Choices B and D heal by primary intention with minimal tissue loss and precise wound edges.
Choice C heals by tertiary intention, where there is a delay in wound closure.
Choices F and G are likely irrelevant options.