ATI RN
ATI N103N103 Fundamentals Final Exam Questions
Extract:
Question 1 of 5
A nurse on the medical-surgical unit is conducting a fall risk assessment on four clients. Which of these clients would be at greatest risk for falls?
Correct Answer: C
Rationale: An older adult with confusion and urinary frequency is at greatest fall risk due to disorientation and urgency compounded by age-related declines in strength/balance. Postoperative assistance (
A) crutch adaptation (
B) and leg ulcer (
D) pose lower risks.
Question 2 of 5
A nurse is reviewing the arterial blood gas values for a client. The nurse should recognize that the values indicate which of the following acid-base imbalances? pH: 7.56 PaCO2: 55 mmHg HCO3: 33 mEq/L
Correct Answer: A
Rationale: pH 7.56 (high) and HCO3 33 mEq/L (high) indicate metabolic alkalosis with elevated PaCO2 (55 mmHg) suggesting respiratory compensation. Metabolic acidosis (
B) respiratory alkalosis (
C) and respiratory acidosis (
D) do not match the values.
Question 3 of 5
A nurse on the medical-surgical unit is conducting a fall risk assessment on four clients. Which of these clients would be at greatest risk for falls?
Correct Answer: C
Rationale: An older adult with confusion and urinary frequency is at greatest fall risk due to disorientation and urgency compounded by age-related declines in strength/balance. Postoperative assistance (
A) crutch adaptation (
B) and leg ulcer (
D) pose lower risks.
Question 4 of 5
A nurse is caring for a client brought to the emergency room. The client’s caregiver reports the client had a sudden onset of confusion. Which intervening technique by the nurse is most appropriate to evaluate mentation for this client?
Correct Answer: B
Rationale: Open-ended questions allow comprehensive assessment of thought processes orientation and cognitive function in sudden confusion. Close-ended (
A) directive (
C) and reflective (
D) questions are less effective for initial mental status evaluation.
Question 5 of 5
A nurse is caring for a client who has returned to the unit following a surgical procedure of the abdomen. The client is complaining of pain 6/10. On assessment, the client's oxygen saturation is 85%. Which action should the nurse take first?
Correct Answer: D
Rationale: Administering oxygen at 2 L/min addresses the critical hypoxemia (85% saturation) to prevent further complications. Pain management and positioning follow after stabilizing oxygenation.