ATI RN
ATI Fundamentals Assessment Exam Midterm Questions
Extract:
Question 1 of 5
A patient is diagnosed with left ear unilateral sensorineural hearing loss. During the performance of the Weber test, the nurse expects lateralization of the sound/vibration to the:
Correct Answer: C
Rationale: In sensorineural hearing loss, the Weber test lateralizes to the unaffected ear (right ear), which has better cochlear function. Conductive loss would lateralize to the affected ear, and equal lateralization suggests normal or symmetrical hearing.
Question 2 of 5
What cranial nerve is responsible for the taste sensation of the posterior third of the tongue?
Correct Answer: C
Rationale: The glossopharyngeal nerve (IX) provides taste sensation to the posterior third of the tongue. The facial nerve (VII) covers the anterior two-thirds, abducens (VI) controls eye movement, and hypoglossal (XII) controls tongue movement.
Question 3 of 5
When conducting a physical examination of a client with generalized muscle weakness, which of the following is the PRIORITY for the nurse?
Correct Answer: B
Rationale: Limiting position changes prevents fatigue and injury in clients with muscle weakness, prioritizing safety. Draping ensures privacy, hand-washing and stethoscope cleaning prevent infection, but these are secondary to client safety.
Question 4 of 5
When asked to assess an area of broken skin on an older adult client in a long-term care facility, the nurse notes a break in the skin with erythema and a small amount of serosanguineous drainage over the sacrum. The area appears blister-like. The nurse would interpret this finding as indicating which stage of pressure ulcer?
Correct Answer: D
Rationale: Stage II pressure ulcers involve partial-thickness skin loss, presenting as a shallow ulcer or blister with a red-pink wound bed, matching the description of erythema, serosanguineous drainage, and a blister-like appearance. Stage I has intact skin with non-blanchable redness, Stage III extends to subcutaneous tissue with a crater-like appearance, and Stage IV involves full-thickness loss with exposed bone or muscle.
Question 5 of 5
A client has arrived at the clinic for a routine physical examination. Prior to assessing the client's blood pressure, what should the nurse do?
Correct Answer: C
Rationale: Sitting quietly for 5 minutes stabilizes heart rate and blood pressure for accurate measurement. Below-waist arm positioning raises readings, radial pulse palpation is unnecessary, and clothing interferes with cuff placement.