ATI RN
ATI Nursing 100 Day Exam 4 Fundamentals Questions
Extract:
Question 1 of 5
An alert competent client refuses to take her antihypertensive medication. The nurse has explained why the medication is important and the client states that she understands but doesn't want to take the medication. What is the best nursing action?
Correct Answer: B
Rationale: Respecting the client’s autonomy the nurse withholds the medication and notifies the prescriber for further action as the client understands but refuses. Administering against wishes violates ethics filing a report is unnecessary and insisting without prescriber input disregards autonomy.
Question 2 of 5
The nurse finds a client on bed rest experiencing clear signs of dyspnea. The nurse should assist the client to a:
Correct Answer: D
Rationale: Semi-Fowler’s position (head elevated 30-45 degrees) improves lung expansion and oxygenation in dyspnea by reducing diaphragm pressure. Trendelenberg worsens breathing by increasing abdominal pressure side-lying and supine may not optimize lung function.
Question 3 of 5
A nurse receives an order for blood urine stool and nasal cultures on a client with a high fever. Which prefix describes this order?
Correct Answer: D
Rationale: “Pan” indicates comprehensive testing across multiple sites (blood urine stool nasal) suggesting a broad infection workup. Macro (large) oligo (few) and mono (single) do not describe the inclusive nature of this order.
Question 4 of 5
When doing the client's skin assessment the nurse notes a 3 cm area of partial thickness skin loss that looks like a blister on the client's sacral area. The nurse consults the wound care nurse who stages the wound as a pressure ulcer.
Correct Answer: B
Rationale: Partial thickness skin loss appearing as a blister indicates a Stage II pressure ulcer involving the epidermis and dermis. Stage I is intact skin with redness Stage III involves full-thickness loss and Stage IV includes deep tissue damage like muscle or bone.
Question 5 of 5
The nurse understands that the major factor affecting oxygenation in a client who has fluid in the lungs is:
Correct Answer: B
Rationale: Fluid in the lungs (e.g. pulmonary edema) impairs oxygen diffusion across the alveolar membrane reducing oxygenation as fluid blocks gas exchange. Poor perfusion lowered hemoglobin or reduced ambient oxygen are secondary or unrelated to lung fluid’s direct effect on diffusion.