Questions 38

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ATI RN Test Bank

ATI NUR 104 Final Assessment Fundamentals Questions

Extract:

A nurse is preparing to transfuse one unit of packed RBC to a client who experienced a mild allergic reaction during a previous transfusion. The nurse should administer diphenhydramine prior to the transfusion for which of the following allergic responses?


Question 1 of 5

Hemolysis

Correct Answer: B

Rationale: Diphenhydramine prevents urticaria (hives), a mild allergic reaction. Hemolysis, fever, and fluid overload require different management.

Extract:

A hospice nurse is caring for a client who has terminal cancer and takes PO morphine for pain relief. The client reports that he had to increase the dose of morphine this week to obtain pain relief. Which of the following scenarios should the nurse document as the explanation for this situation?


Question 2 of 5

The client has not been taking the medication properly

Correct Answer: C

Rationale:
Tolerance, requiring higher doses for the same effect, explains the need for increased morphine. Addiction involves compulsive use, not dose increase, and other options are unrelated.

Extract:

A nurse is caring for a client who has a hip fracture that requires surgical repair. Which of the following health care professionals is responsible for obtaining informed consent from the client for the procedure?


Question 3 of 5

Surgeon

Correct Answer: A

Rationale: The surgeon is responsible for obtaining informed consent, explaining risks, benefits, and alternatives. Other roles may assist or educate but do not obtain consent.

Extract:

A nurse is receiving change-of-shift report for a group of assigned clients. The nurse anticipates which of the following activities first in delivering client care using the nursing process?


Question 4 of 5

Collect and organize client data

Correct Answer: A

Rationale: Collecting and organizing data is the first step in the nursing process, enabling subsequent analysis, planning, and evaluation.

Extract:

A nurse is completing a client's history and physical examination. Which of the following information should the nurse consider subjective data?


Question 5 of 5

Nausea

Correct Answer: A

Rationale: Nausea is subjective, reported by the client. Petechiae, blood pressure, and cyanosis are objective, observable, or measurable.

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